AsiaIntervention最新文献

{"title":"Double-kissing crush versus provisional stenting in patients with true coronary artery bifurcation lesions: a pooled individual patient-level analysis of randomised trials (DKCRUSH X trial).","authors":"Shao-Liang Chen, Jing Kan, Teguh Santoso, Tak W Kwan, Imad Sheiban, Tanveer S Rab, Muhammad Munawar, Wei-Hsian Yin, Fei Ye, Lianglong Chen, Junjie Zhang, Kwan Seung Lee, On Behalf Of The Provisional Stenting Versus Systematic Two-Stent Dkcrush X Collaborator Group","doi":"10.4244/AIJ-D-25-00021","DOIUrl":"10.4244/AIJ-D-25-00021","url":null,"abstract":"<p><strong>Background: </strong>Provisional stenting is the standard treatment for patients with coronary artery bifurcation lesions.</p><p><strong>Aims: </strong>This pooled individual patient data (IPD) analysis aims to evaluate the long-term (six-year) outcomes of provisional stenting versus upfront two-stent techniques in patients with true coronary bifurcation lesions treated with drug-eluting stents.</p><p><strong>Methods: </strong>A systematic review and IPD analysis of randomised trials with centrally adjudicated endpoints was conducted to assess the efficacy and safety of provisional stenting versus upfront two-stent approaches in patients with true coronary bifurcation lesions undergoing percutaneous coronary intervention with drug-eluting stents. All patients were prospectively followed, with their intervention having been completed at least six years earlier. The primary endpoint, re-evaluated by an independent clinical event committee, was target lesion failure (TLF) - a composite of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularisation - assessed at the final follow-up on 8 November 2024.</p><p><strong>Results: </strong>A total of 6,225 citations were screened, and four randomised trials met the inclusion criteria. Among 1,573 patients in the intention-to-treat population, TLF at six years occurred in 144 patients (Kaplan-Meier estimate 18.2%) in the upfront two-stent group and 193 (Kaplan-Meier estimate 24.7%) in the provisional stenting group (hazard ratio [HR] 0.71, 95% confidence interval [CI]: 0.57-0.89; p=0.0022, τ²=0.00, I²=0%). These results were consistent across both unadjusted and per-protocol analyses. In patients with complex coronary bifurcation lesions, TLF occurred in 88 patients (Kaplan-Meier estimate 19.6%) in the two-stent group and 115 (Kaplan-Meier estimate 27.6%) in the provisional stenting group (HR 0.68, 95% CI: 0.52-0.90; p=0.0066).</p><p><strong>Conclusions: </strong>This IPD analysis provides robust long-term evidence that upfront two-stent techniques, particularly double-kissing crush stenting, significantly reduce TLF over a six-year follow-up period compared with provisional stenting, especially in patients with complex bifurcations.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"178-188"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The obesity paradox revisited - influence on the results of percutaneous coronary interventions.","authors":"Mohammad Reza Movahed, Allistair Nathan, Mehrtash Hashemzadeh","doi":"10.4244/AIJ-D-25-00006","DOIUrl":"10.4244/AIJ-D-25-00006","url":null,"abstract":"<p><strong>Background: </strong>The \"obesity paradox\" has been seen in patients with cardiovascular disease. However, the role of the obesity paradox in patients undergoing percutaneous coronary intervention (PCI) is controversial.</p><p><strong>Aims: </strong>Our study aims to investigate the effect of weight categories on mortality in patients undergoing PCI.</p><p><strong>Methods: </strong>The National Inpatient Sample database for the years 2016-2020 was analysed using International Classification of Diseases, Tenth Revision codes in adult patients >18 years of age. Patients undergoing PCI were identified and stratified using weight categories. Univariate and multivariate analyses were performed to assess mortality.</p><p><strong>Results: </strong>We identified 10,069,454 patients who had undergone PCI. Compared to patients in the normal-weight category, cachectic patients had the highest mortality at 9.78% (odds ratio [OR] 3.88, 95% confidence interval [CI]: 3.65-4.12; p<0.001). Mortality was lowest in overweight patients at 1.28% (OR 0.46, 95% CI: 0.39-0.55; p<0.001), followed by obese patients at 1.61% (OR 0.58, 95% CI: 0.56-0.61; p<0.001). In the morbidly obese category, this protective effect was much less, with mortality being measured at 2.05% (OR 0.75, 95% CI: 0.42-0.78; p<0.001; vs 2.72% in the normal-weight category). After multivariate analysis, mortality remained high in cachectic patients (OR 3.65, 95% CI: 3.42-3.90; p<0.001) and remained low in overweight (OR 0.51, 95% CI: 0.43-0.61; p<0.001) and obese (OR 0.68, 95% CI: 0.66-0.71; p<0.001) patients, but the protective value of weight almost disappeared in the morbidly obese category (OR 0.96, 95% CI: 0.96-1.00; p=0.04).</p><p><strong>Conclusions: </strong>The obesity paradox held only partially, with the lowest mortality in the overweight category, followed by patients with obesity, then an almost complete loss of protection in those with morbid obesity, and the highest mortality in cachectic patients.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"199-204"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The AHEAD score as a predictor of all-cause mortality in patients with acute myocardial infarction: a secondary analysis of the Japan Acute Myocardial Infarction Registry.","authors":"Mike Saji, Satoshi Honda, Kensaku Nishihira, Sunao Kojima, Misa Takegami, Yasuhide Asaumi, Jun Yamashita, Kiyoshi Hibi, Jun Takahashi, Yasuhiko Sakata, Morimasa Takayama, Tetsuya Sumiyoshi, Hisao Ogawa, Kazuo Kimura, Satoshi Yasuda, On Behalf Of The Jamir Investigators","doi":"10.4244/AIJ-D-25-00020","DOIUrl":"10.4244/AIJ-D-25-00020","url":null,"abstract":"<p><strong>Background: </strong>The AHEAD score - comprising atrial fibrillation, haemoglobin, elderly age, abnormal renal function, and diabetes mellitus - is a validated prognostic model for patients with heart failure. However, its predictive value in acute myocardial infarction (MI), particularly in large real-world cohorts, remains uncertain.</p><p><strong>Aims: </strong>We aimed to assess the utility of the AHEAD score in predicting 1-year all-cause mortality in patients with acute MI.</p><p><strong>Methods: </strong>This secondary analysis of the Japan Acute Myocardial Infarction Registry (JAMIR) included 3,067 patients with acute MI enrolled across 50 Japanese institutions between December 2015 and May 2017. Patients were stratified by AHEAD score at admission. The primary endpoint was all-cause mortality within 1 year after acute MI. Multivariable Cox regression, Kaplan-Meier survival analysis, and restricted cubic spline modelling were used to evaluate the association between the AHEAD score and mortality.</p><p><strong>Results: </strong>Higher AHEAD scores were associated with older age, more comorbidities, a higher Killip class, and delayed reperfusion. The 1-year all-cause mortality rate increased significantly with rising AHEAD scores. The AHEAD score was an independent predictor of all-cause mortality (adjusted hazard ratio 1.60; 95% confidence interval: 1.39-1.84; p<0.001), and this association was consistent across predefined subgroups. Spline analysis demonstrated a linear relationship between the AHEAD score and the mortality risk.</p><p><strong>Conclusions: </strong>The AHEAD score is a simple, bedside-accessible tool that effectively predicts 1-year all-cause mortality in patients with acute MI, regardless of the presence of heart failure. Its use may aid early risk stratification and guide clinical decision-making in acute cardiovascular care. This study was registered with the Japanese UMIN Clinical Trials Registry (UMIN000019479).</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"170-177"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery embolism caused by disrupted calcified leaflets after self-expanding transcatheter aortic valve implantation.","authors":"Kenta Ayai, Satoru Kishimoto, Toshinobu Yoshida, Arudo Hiraoka, Atsushi Hirohata, Hidenori Yoshitaka","doi":"10.4244/AIJ-D-25-00010","DOIUrl":"10.4244/AIJ-D-25-00010","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"213-214"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fine-tuning the arc of orbital atherectomy: navigating eccentric calcium in tortuous vessels.","authors":"Arsalan Abu-Much, Ajay J Kirtane","doi":"10.4244/AIJ-E-25-00006","DOIUrl":"10.4244/AIJ-E-25-00006","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"153-154"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal profile of right and left ventricular wall deformation analysis using 2D speckle tracking echocardiography following atrial septal defect closure.","authors":"Shahnawaz Ali Ansari, Aditya Kapoor, Arpita Katheria, Harshit Khare, Arshad Nazir, Ankit Sahu, Roopali Khanna, Sudeep Kumar, Surendra Kumar Agarwal, Shantanu Pande, Prabhat Tewari, Bipin Chandra, Naveen Garg, Satyendra Tewari","doi":"10.4244/AIJ-D-25-00027","DOIUrl":"10.4244/AIJ-D-25-00027","url":null,"abstract":"<p><strong>Background: </strong>Analysing temporal strain changes in right ventricular (RV) and left ventricular (LV) walls post-atrial septal defect (ASD) closure is of clinical importance.</p><p><strong>Aims: </strong>We aimed to evaluate acute/short-term changes in RV/LV wall deformation after ASD closure using two-dimensional speckle tracking echocardiography (2D-STE).</p><p><strong>Methods: </strong>A total of 43 patients with ASD and 20 controls had echocardiograms before and after ASD closure.</p><p><strong>Results: </strong>Of the 43 patients with secundum ASD (mean age 27.37 years), 48.8% were closed surgically, while 51.2% underwent device closure. At baseline, LV global longitudinal strain (GLS; 2-chamber view GLS: 16.95% vs 20.73%; p=0.0001, apical long-axis view GLS 16.48% vs 20.90%; p=0.0001, 4-chamber view GLS 16.93% vs 21.56%; p=0.0001, average GLS 16.75% vs 21.31%; p=0.0001) and RV GLS (19.22% vs 24.27%; p=0.0001) were significantly lower in the patients with ASD compared to controls. After closure, the average LV GLS rapidly improved at 24 hours from baseline (16.75% to 17.28%; p=0.004), with sustained increases at 1 and 3 months (18.16% and 19.40%; p=0.001). The mean RV GLS also improved at all serial timepoints (baseline, 24 hrs, 1 month, and 3 months) with values of 19.22%, 19.85%, 20.70%, and 22.23%, respectively (p=0.0001). As compared to surgery, LV GLS and RV GLS were much better in the device group (average LV GLS at 24 hrs, 1 month, and 3 months: 16.54% vs 17.98%, 17.34% vs 18.92%, and 18.80% vs 19.96%, respectively; mean RV GLS at 24 hrs, 1, and 3 months: 17.83% vs 21.78%, 18.73% vs 22.58%, and 20.70% vs 23.70%, respectively).</p><p><strong>Conclusions: </strong>This GLS study demonstrates significant reverse remodelling of both the RV and LV after ASD closure. Device closure was associated with superior strain rate recovery compared to surgery at the 3-month midterm follow-up.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"190-198"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evaluation of the Hydra self-expanding THV: 30-day results from the GENESIS-II study.","authors":"Nagendra Boopathy Senguttuvan, John Jose, Anmol Sonawane, Sandeep Bansal, Rahul Gupta, Praveen Chandra","doi":"10.4244/AIJ-D-24-00075","DOIUrl":"10.4244/AIJ-D-24-00075","url":null,"abstract":"<p><strong>Background: </strong>The Hydra transcatheter heart valve (THV) utilised in the GENESIS-II study is equipped with an active release mechanism for tentacle deployment, distinguishing it from the Hydra THV used in earlier studies.</p><p><strong>Aims: </strong>The primary objective of the GENESIS-II study is to assess the ongoing safety and performance of the Hydra THV in treating severe aortic stenosis in patients deemed at high surgical risk.</p><p><strong>Methods: </strong>This is a prospective, multicentre, non-randomised, investigational study conducted between November 2021 and November 2023. The study enrolled a total of 40 patients exhibiting high surgical risk and symptomatic severe aortic stenosis from 19 sites across India. The primary safety endpoint of the study was cardiovascular mortality at 30 days, while the primary performance endpoint was device success as defined by Valve Academic Research Consortium-2. The 6-month follow-up of the GENESIS-II study is ongoing.</p><p><strong>Results: </strong>Among the 40 patients, the average age was 74.4±6.7 years, and 65% were male. The rate of device success was 95%. At 30 days, 2.5% of patients experienced cardiovascular mortality, and the incidence of new permanent pacemaker implantation was 7.9%. There was a progressive enhancement in the effective orifice area, transitioning from 0.6±0.2 cm² at baseline to 1.9±0.6 cm² at 30 days (p<0.001). Similarly, the mean aortic valve gradient demonstrated significant improvement from 53.1±12.5 mmHg at baseline to 8.4±4.0 mmHg at 30 days (p<0.001) post-intervention.</p><p><strong>Conclusions: </strong>The Hydra THV is the first device with an active release mechanism for deploying the supra-annular valve. The observed high rates of device success and procedural safety in the GENESIS-II study may support the continued safety and performance of the device.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"155-163"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency of orbital atherectomy for nodular calcium in bending vessels: in vitro vessel models.","authors":"Yutaka Tanaka, Haruki Mitsui, Keisuke Murakami, Shigeru Saito, Kiyotaka Iwasaki","doi":"10.4244/AIJ-D-25-00012","DOIUrl":"10.4244/AIJ-D-25-00012","url":null,"abstract":"<p><strong>Background: </strong>Orbital atherectomy (OA) operates via high-speed elliptical crown rotation, enabling focal plaque modification through controlled forward and backward movement.</p><p><strong>Aims: </strong>This study aimed to identify the anatomical conditions that optimise OA effectiveness on nodular calcium within curved lesions, using <i>in vitro</i> models to allow quantitative assessment of the debulked volume.</p><p><strong>Methods: </strong>Forty stenotic vessel models containing nodular calcium were created with varying anatomical parameters: two calcium positions (inner vs outer curve), two curvature radii (CR: 10 mm or 20 mm), and two bending angles (BA: 100° or 60°). Each model underwent OA with the Diamondback 360 Coronary OA System, using two 30-second low-speed passes and one 30-second high-speed pass. Microcomputed tomography was performed pre- and post-ablation to measure the calcium volume reduction, maximum depth, and width.</p><p><strong>Results: </strong>Ablation was significantly greater for nodular calcium on the inner curve compared to that on the outer curve (6.6±0.4 mm³ vs 2.7±0.4 mm³; p<0.0001). Among models with calcium on the inner curve, CR20/BA60 showed the highest volume reduction (8.3±1.4 mm³). For models with calcium on the outer curve, CR20/BA100 resulted in the greatest ablation (5.2±0.9 mm³). Ablation depth, more than width, correlated with the total ablated volume.</p><p><strong>Conclusions: </strong>Nodular calcium located on the inner curve is more effectively treated with OA. The combination of curvature radius and the bending angle significantly influences procedural efficiency, underscoring the importance of lesion anatomy in OA planning.</p>","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"164-169"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe lipid-rich plaque with post-stenting longitudinal plaque migration on optical coherence tomography and refractory no-reflow.","authors":"Esmond Yan Hang Fong, Leon Chung Yin Leung, Angus Shing Fung Chui, Alan Ka Chun Chan, Michael Kang Yin Lee","doi":"10.4244/AIJ-D-24-00068","DOIUrl":"10.4244/AIJ-D-24-00068","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"217-218"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional reverse CART by rotation-overlap method: CLARP manoeuvre.","authors":"Calvin Leung, Cheuk Bong Ho, Michael Chi Shing, Michael Kang-Yin Lee, Alan Ka Chun Chan","doi":"10.4244/AIJ-D-25-00014","DOIUrl":"10.4244/AIJ-D-25-00014","url":null,"abstract":"","PeriodicalId":72310,"journal":{"name":"AsiaIntervention","volume":"11 3","pages":"208-209"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}