Cardiology journalPub Date : 2026-01-01Epub Date: 2025-11-25DOI: 10.5603/cj.106088
Marta Diachyshyn, Łukasz Niewiara, Piotr Szolc, Paweł Kleczyński, Paulina Judziało, Bartłomiej Guzik, Krzysztof Żmudka, Jacek Legutko
{"title":"Diagnostic performance of angiography-derived IMR for coronary microcirculation disease assessment in INOCA patients.","authors":"Marta Diachyshyn, Łukasz Niewiara, Piotr Szolc, Paweł Kleczyński, Paulina Judziało, Bartłomiej Guzik, Krzysztof Żmudka, Jacek Legutko","doi":"10.5603/cj.106088","DOIUrl":"10.5603/cj.106088","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of coronary microcirculatory dysfunction with wire-based methodology imposes a risk of unplanned revascularization in patients with ischemia and no obstructive coronary arteries (INOCA). Non-invasive, angiography-based methods are introduced to alleviate this risk. The angiography-based index of microcirculatory resistance (IMRangio) is a computational fluid dynamics (CFD)-based index utilizing high-quality angiography and aortic pressures to calculate a surrogate of the index of microcirculatory resistance (IMR).</p><p><strong>Aim of the study: </strong>This study aims to assess the correlation between IMRangio and invasive thermodilution-based IMR in INOCA patients qualified to the MOSAIC-COR registry.</p><p><strong>Methods: </strong>Data from 74 patients (92 coronaries including 52 left anterior descending arteries) from the MOSAIC-COR registry were used for this sub-analysis. All patients had undergone complex coronary physiology assessment using a thermistor-equipped wire and thermodilution-based methodology with subsequent vasomotor acetylcholine vasospasm testing. Post-hoc, CFD-based angiogram analysis was performed to calculate IMRangio values.</p><p><strong>Results: </strong>The median age of patients was 64 years, and 59.3% were female. The median calculated value of IMRangio was 29 (Q1-Q3: 22-46), whereas the invasively measured IMR median value was 17 (Q1-Q3: 13-26). A significant correlation between IMRangio and invasive-IMR was observed (Spearman rho 0.29, < 0.001). Angiography based index of microcirculatory resistance area under the curve (AUC) was 62.2, and a value > 46.5 U was identified as the best cut-off for prediction of IMR > 25 and provided 38% sensitivity and 82% specificity to detect coronary microcirculatory dysfunction (CMD).</p><p><strong>Conclusions: </strong>The angiography-based index of microcirculatory resistance significantly correlates with invasively measured IMR; however, a higher cut-off value should be considered to improve the specificity of the method to detect CMD.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":" ","pages":"e00226026"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lipoprotein(a) and clinical characteristics of Polish patients hospitalized in a tertiary referral hospital - an observational, cross-sectional study.","authors":"Julia M Umińska, Jakub Ratajczak, Jacek Kubica","doi":"10.5603/cj.109434","DOIUrl":"https://doi.org/10.5603/cj.109434","url":null,"abstract":"","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226024"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacek Kubica, Tomasz Topoliński, Robert Gajda, Przemysław Musz, Aldona Kubica, Łukasz Szarpak, Krzysztof Nowicki, Marcin Ziółkowski, Sebastian Meszyński, Sławomir Grzelak, Oleksandr Sokolov, Jakub Ratajczak, Julia M Umińska, Piotr Niezgoda, Klaudyna Grzelakowska, Przemysła Podhajski, Karolina Obońska, Ewa Laskowska, Ryszard Piotrowicz, Agnieszka Tycińska, Giuseppe Specchia, Stefan Frantz, Stefan Störk, Eliano P Navarese
{"title":"Artificial intelligence as the missing integrator in heart failure care - from remote monitoring to personalized therapy.","authors":"Jacek Kubica, Tomasz Topoliński, Robert Gajda, Przemysław Musz, Aldona Kubica, Łukasz Szarpak, Krzysztof Nowicki, Marcin Ziółkowski, Sebastian Meszyński, Sławomir Grzelak, Oleksandr Sokolov, Jakub Ratajczak, Julia M Umińska, Piotr Niezgoda, Klaudyna Grzelakowska, Przemysła Podhajski, Karolina Obońska, Ewa Laskowska, Ryszard Piotrowicz, Agnieszka Tycińska, Giuseppe Specchia, Stefan Frantz, Stefan Störk, Eliano P Navarese","doi":"10.5603/cj.111624","DOIUrl":"10.5603/cj.111624","url":null,"abstract":"<p><p>Heart failure (HF) remains a leading cause of morbidity, mortality, and healthcare utilization worldwide, despite the availability of effective evidence-based therapies. The principal challenge is no longer the absence of treatment options but the limited capacity of traditional care models to deliver guidelinedirected medical therapy (GDMT) consistently and at scale. The COVID-19 pandemic exposed the fragility of hospital-centered HF care, highlighting the need for more resilient, patient-centered management strategies. Remote monitoring (RM) has been proposed as a solution, yet its clinical impact has been inconsistent due to fragmented data streams, declining patient adherence, and heavy reliance on continuous human oversight. Artificial intelligence (AI) offers an opportunity to address these limitations by integrating multidimensional clinical data, enabling earlier detection of deterioration, supporting adherence, and prioritizing clinically meaningful interventions. Emerging evidence suggests that AI-assisted workflows can accelerate GDMT optimization and improve surrogate and clinical outcomes when implemented within supervised care pathways. This has led to the concept of next-generation remote monitoring (NGRM), in which AI analyzes longitudinal physiological and behavioral signals to generate context-aware alerts and actionable recommendations while reducing clinical workload. Successful implementation, however, requires rigorous validation, clear governance, integration with clinical workflows, and safeguards for safety, equity, and accountability. When embedded within structured HF care pathways, AI-enabled monitoring may help bridge the persistent gap between evidence and real-world implementation.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226032"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlene Bielke, Bjoern A Remppis, Christof Burgdorf
{"title":"Hyperoxaluria as a form of cardiorenal syndrome.","authors":"Charlene Bielke, Bjoern A Remppis, Christof Burgdorf","doi":"10.5603/cj.108148","DOIUrl":"https://doi.org/10.5603/cj.108148","url":null,"abstract":"","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226030"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology journalPub Date : 2026-01-01Epub Date: 2025-09-22DOI: 10.5603/cj.91814
Maciej Pruski, Mateusz Kachel, Carlos Fernandez, Adam Janas, Aleksandra Błachut, Magdalena Michalak, Paweł Kaźmierczak, Paweł E Buszman, Krzysztof Milewski, Piotr P Buszman
{"title":"Identification of completed coronary stent healing by optical coherence tomography - validation study with histopathology in porcine model of coronary restenosis.","authors":"Maciej Pruski, Mateusz Kachel, Carlos Fernandez, Adam Janas, Aleksandra Błachut, Magdalena Michalak, Paweł Kaźmierczak, Paweł E Buszman, Krzysztof Milewski, Piotr P Buszman","doi":"10.5603/cj.91814","DOIUrl":"10.5603/cj.91814","url":null,"abstract":"<p><strong>Background: </strong>The potential of optical coherence tomography (OCT) is limited by incomplete validation with histopathology. The study aimed to assess whether OCT can identify a completely healed coronary stent.</p><p><strong>Material and methods: </strong>The study included 40 swine and total of 106 stents (82 DES, 24 BMS). Follow-up OCT and histopathology examination was done after 28 days (n = 53) and 90-days (n = 53). 273 frames were matched between histopathology and OCT. Histopathologic criteria for completed healing: high endothelialization score (2-3), low inflammation score (0-1), low fibrin score (0-1), high neointimal smooth muscle score (2-3) and lack of binary restenosis.</p><p><strong>Results: </strong>Predictors of a well healed stent were presence of homogenous neointima (OR: 2.53) and the total number of struts per section (OR: 1.11). The presence of microvessels (OR: 0.28) and increasing neointimal area (OR: 0.65) predicted incomplete healing. Cutoff values were identified: inflammation score was the highest in segments with neointima thickness over 0.35 mm. Persistent fibrin deposits were found at 28-day follow-up in DES with less than 13 embedded struts per section and neointima area less than 2.234 mm². The number of embedded struts per section showed a positive correlation with the healing score, while both protruding covered and protruding uncovered struts showed a negative correlation.</p><p><strong>Conclusions: </strong>OCT demonstrated moderate ability to predict completed stent healing.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":" ","pages":"e00226008"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology journalPub Date : 2026-01-01Epub Date: 2025-11-05DOI: 10.5603/cj.103075
Rafał Januszek, Sylwia Iwańczyk, Wojciech Wojakowski, Zenon Huczek, Adam Janas, Adrian Włodarczak, Rafał Wolny, Maksymilian P Opolski, Miłosz Dziarmaga, Kamil Bujak, Michał Hawranek, Krzysztof P Malinowski, Maciej Kaźmierski, Piotr Waciński, Paweł Gąsior, Zbigniew Siudak, Mariola Kłak, Piotr Niezgoda, Bernardo Cortese, Wojciech Wańha
{"title":"Temporal trends in the use of drug-coated balloons in Poland - an analysis based on the national registry.","authors":"Rafał Januszek, Sylwia Iwańczyk, Wojciech Wojakowski, Zenon Huczek, Adam Janas, Adrian Włodarczak, Rafał Wolny, Maksymilian P Opolski, Miłosz Dziarmaga, Kamil Bujak, Michał Hawranek, Krzysztof P Malinowski, Maciej Kaźmierski, Piotr Waciński, Paweł Gąsior, Zbigniew Siudak, Mariola Kłak, Piotr Niezgoda, Bernardo Cortese, Wojciech Wańha","doi":"10.5603/cj.103075","DOIUrl":"10.5603/cj.103075","url":null,"abstract":"<p><strong>Background: </strong>There has been increasing interest in drug-coated balloons (DCB) within the scientific and medical community in recent years. The aim of this study was to investigate the temporal trends of DCB utilization stratified by the type of target lesion, based on a large prospective national registry.</p><p><strong>Methods: </strong>The data for conducting the current analysis were obtained from the National Registry of Percutaneous Coronary Interventions (ORPKI, Ogólnopolski Rejestr Procedur Kardiologii Inwazyjnej), maintained in cooperation with the Association of Cardiovascular Interventions (AISN, Asocjacja Interwencji Sercowo-Naczyniowych) of the Polish Cardiac Society. The study covered data collected between January 2014 and December 2022. During this period, there were 170 active catheterization laboratories in which 899,635 percutaneous coronary intervention (PCI) procedures were performed. Among them, 5827 (0.65%) patients were treated with DCB and drug-eluting stents, 11,649 (1.29%) were treated with DCB only, and 882,159 (98.06%) were treated without DCB.</p><p><strong>Results: </strong>The frequency of DCB use during PCI increased across all main angiographic indications as follows: from 0.54% in 2014 to 1.02% in 2022 (p < 0.001) for de novo lesions, from 15.31% in 2014 to 33.95% in 2022 (p < 0.001) for in-stent restenosis, and from 2.41% in 2014 to 5.29% in 2022 (p < 0.001) for in-stent thrombosis. Similarly, there was a statistically significant increase in the frequency of DCB use among the following selected clinical presentations: acute heart failure (p = 0.037), cardiac arrest (p = 0.015), non-ST segment elevation myocardial infarction (p < 0.001), chronic coronary syndromes (p < 0.001), and unstable angina (p < 0.001).</p><p><strong>Conclusions: </strong>The frequency of DCB use has been constantly increasing in recent years, regardless of angiographic indications and across different clinical scenarios.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":" ","pages":"e00226020"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology journalPub Date : 2026-01-01Epub Date: 2025-12-05DOI: 10.5603/cj.108977
Stanisław Surma, Łukasz Lewandowski, Karol Momot, Michał Czapla, Tomasz Sobierajski, Joanna Lewek, Bogusław Okopień, Maciej Banach
{"title":"Domain-specific knowledge on salt-related health risks and medical professional identity: implications for cardiovascular prevention.","authors":"Stanisław Surma, Łukasz Lewandowski, Karol Momot, Michał Czapla, Tomasz Sobierajski, Joanna Lewek, Bogusław Okopień, Maciej Banach","doi":"10.5603/cj.108977","DOIUrl":"10.5603/cj.108977","url":null,"abstract":"<p><strong>Background: </strong>Excessive salt consumption is one of the most important and modifiable risk factors for cardiovascular disease (CVD). Despite general awareness of its cardiovascular impact, knowledge about other health consequences of excess sodium varies considerably, even among medical professionals. This study was conducted to examine whether domain-specific knowledge about salt-related health effects is predictive of professional affiliation with the medical community (medical education/degree) and explored its implications for cardiovascular prevention.</p><p><strong>Methods: </strong>An international online survey (PoLA/ILEP) of 668 adults was conducted using the CAWI method. The questionnaire included 17 items assessing knowledge in five domains - cardiovascular, metabolic, renal, neuropsychiatric, and bone health - as well as awareness of dietary salt sources and self-monitoring of personal health parameters. Associations between domain-specific knowledge and medical education were analyzed using proportional odds logistic regression (POLR), adjusting for age, sex, place of residence, and number of cardiovascular risk factors.</p><p><strong>Results: </strong>Knowledge of cardiovascular and neuropsychiatric consequences was strongly associated with medical education (OR = 21.7 and 1.66; p < 0.05). In contrast, a better understanding of metabolic, renal, and bone effects was linked with lower odds of medical education (OR = 0.28-0.54). The strongest predictor was self-awareness of personal cardiovascular parameters (OR = 37.97; p < 0.0001). Among rural residents, these relationships were particularly pronounced.</p><p><strong>Conclusions: </strong>Medical professional identity is associated with structured, domain-specific knowledge about the health effects of salt consumption, particularly in relation to CVD. Expanding educational efforts to address under-recognized consequences of sodium excess may improve salt-reduction strategies and enhance cardiovascular disease prevention.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":" ","pages":"e00226023"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bartosz Krzowski, Maja Jabłońska, Michał Gawlik, Maria Zaborska-Dworak, Monik Gawałko, Michał Marchel, Piotr Lodziński, Paweł Balsam, Marcin Grabowski, Michał Peller
{"title":"Perioperative parameters and myocardial necrosis: a real-world comparison of Farapulse and Varipulse.","authors":"Bartosz Krzowski, Maja Jabłońska, Michał Gawlik, Maria Zaborska-Dworak, Monik Gawałko, Michał Marchel, Piotr Lodziński, Paweł Balsam, Marcin Grabowski, Michał Peller","doi":"10.5603/cj.106769","DOIUrl":"10.5603/cj.106769","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) has emerged as a promising method for pulmonary vein isolation (PVI) due to its myocardial-selective mechanism and a favorable safety profile. Among the available technologies, Farapulse (Boston Scientific Corporation, Marlborough, USA) and Varipulse (Biosense Webster Inc, New Brunswick, USA) are the two leading PFA systems. However, comparative data regarding their perioperative performance and impact on myocardial injury remain limited. This study aimed to evaluate and compare perioperative outcomes and myocardial injury, assessed by postprocedural troponin I levels, in patients undergoing first-time PVI with the Farapulse or Varipulse system in a real-world clinical setting.</p><p><strong>Methods: </strong>In this prospective analysis of 50 patients with symptomatic atrial fibrillation (AF) undergoing first-time PVI, Farapulse (n = 25) and Varipulse (n = 25) systems were compared by assessing procedure duration, fluoroscopy time, 12-hour postprocedural troponin I levels, first-pass isolation (FPI) rates, and periprocedural complications (atrial-esophageal fistula, periprocedural stroke, pseudoaneurysm, vascular complications, and AF recurrence before discharge).</p><p><strong>Results: </strong>Farapulse-based procedures were shorter than those performed using the Varipulse system (median duration 50 vs. 55 min; p <0.001) but were associated with longer fluoroscopy times (median, 646 vs.177 s; p <0.001) and higher median troponin levels (15386 vs. 9937 ng/L; p <0.001). No significant differences were observed in FPI (76% vs. 56%; p = 0.23) or complication rates.</p><p><strong>Conclusions: </strong>In a real-world cohort, Farapulse was associated with shorter procedure times, while Varipulse, aided by 3D mapping, was linked to reduced fluoroscopy exposure and lower troponin release. These findings highlight the need for further studies on long-term outcomes and optimization across different PFA systems.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226036"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marc Ramos-Jovani, Ángela López-Sainz, Magí Brufau, Juan José Rodríguez-Arias, Eduard Solé, Eduard Quintana, Marta Farrero, María Angeles Castel, Pedro Caravaca, Elena Arbelo, Elena Sandoval, Daniel Pereda, Manel Castellà, Marta Sitges, Ana García-Álvarez
{"title":"Warning indicators for heart transplantation requirement at the time of hypertrophic cardiomyopathy diagnosis.","authors":"Marc Ramos-Jovani, Ángela López-Sainz, Magí Brufau, Juan José Rodríguez-Arias, Eduard Solé, Eduard Quintana, Marta Farrero, María Angeles Castel, Pedro Caravaca, Elena Arbelo, Elena Sandoval, Daniel Pereda, Manel Castellà, Marta Sitges, Ana García-Álvarez","doi":"10.5603/cj.108048","DOIUrl":"10.5603/cj.108048","url":null,"abstract":"<p><strong>Background: </strong>Timely identification of hypertrophic cardiomyopathy (HCM) patients who may require a heart transplant (HT) in the future is crucial. Our study aimed to identify predictive factors associated with the need for HT in HCM patients.</p><p><strong>Methods: </strong>All patients undergoing HT due to HCM in a tertiary HT hospital from 2003 to 2020 were included and compared - matched 1:4 for similar follow-up time since diagnosis - to a control HCM cohort. Patients' clinical and imaging characteristics at HCM diagnosis and longitudinal data were assessed.</p><p><strong>Results: </strong>85 patients, 17 who required a HT and 68 HCM control patients from the HCM clinic, were included. At HCM diagnosis, patients who would later require HT had higher NT-proBNP levels (880.5 vs. 86.2 pg/mL), larger left atrium (LA) dimensions (49 vs. 40 mm), and slightly reduced left ventricle (LV) ejection fraction (50 vs. 60%), and showed higher prevalence of atrial fibrillation (AF) (47 vs. 22%). During a median follow-up of 11.6 years, patients subsequently requiring HT developed further worsening functional class and higher incidence of hospital admission for HF and incidence of sustained ventricular tachycardia or appropriate implantable cardioverter-defibrillator (ICD) ther-apy (log-rank p < 0.001 in both). This was accompanied by significant LA dilatation (8 vs. 1 mm, p = 0.037) and worsening LV diastolic function.</p><p><strong>Conclusions: </strong>Left atrium dilatation, AF, elevated NT-proBNP levels, and lower LV ejection fraction at HCM diagnosis should alert about the potential future need for HT. Progressive LA enlargement and worsening diastolic function during follow-up are warning signs that should prompt referral to a HT center.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226040"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marta Kałużna-Oleksy, Wojciech Jan Skorupski, Przemysław Mitkowski, Sylwia Iwańczyk, Sylwia Sławek-Szmyt, Michał Lesiak, Włodzimierz Skorupski, Stanisław Jankiewicz, Shrilla Banerjee, Valeria Paradies, Małgorzata Pyda, Aleksander Araszkiewicz, Maskymilian Przemysław Opolski, Michał Hawranek, Karolina Kochanowska, Aleksandra Grzelak, Maciej Lesiak, Marek Grygier
{"title":"Intravascular lithotripsy for calcified coronary lesions: contemporary trends and long-term outcomes in acute myocardial infarction patients - insights from the CLEAR registry.","authors":"Marta Kałużna-Oleksy, Wojciech Jan Skorupski, Przemysław Mitkowski, Sylwia Iwańczyk, Sylwia Sławek-Szmyt, Michał Lesiak, Włodzimierz Skorupski, Stanisław Jankiewicz, Shrilla Banerjee, Valeria Paradies, Małgorzata Pyda, Aleksander Araszkiewicz, Maskymilian Przemysław Opolski, Michał Hawranek, Karolina Kochanowska, Aleksandra Grzelak, Maciej Lesiak, Marek Grygier","doi":"10.5603/cj.107007","DOIUrl":"10.5603/cj.107007","url":null,"abstract":"<p><strong>Background: </strong>Intravascular lithotripsy (IVL) utilizes high-energy sonic waves to create controlled fractures in calcified plaques, facilitating vessel preparation and improving stent apposition.</p><p><strong>Methods: </strong>The study was designed to evaluate the safety and efficacy of IVL in a patient population that included individuals with acute myocardial infarction (MI). A total of 201 consecutive patients who underwent percutaneous coronary intervention (PCI) using IVL [Shockwave C2 or C2+ (Shockwave Medical Inc, Santa Clara, CA, US)] from April 2020 onward were included in this single-center registry. The study population comprised 76 patients with acute MI (Group 1) and 125 patients with non-MI (Group 2).</p><p><strong>Results: </strong>Left ventricular ejection fraction was lower (46.0% ± 13.1% vs. 50.9% ± 10.5%; p = 0.022), while SYNTAX Score was significantly higher (20.0 ± 11.3 vs. 16.5 ± 10.2; p = 0.059) in Group 1 than in Group 2 (46.0% ± 13.1% vs. 50.9% ± 10.5%; p = 0.022). The overall IVL success rate and procedure success rate were very high (97.5% and 99.5%, respectively). A mean increase in lumen area was observed in Group 1 and Group 2: 5.9 ± 3.7 mm2 vs. 4.5 ± 2.2 mm2 and 237% vs. 239%, respectively. In the long-term follow-up there was no difference in all-cause mortality between Group 1 and Group 2 (9.0% vs. 8.1%; p = 0.997), cardiac death (p = 0.340), repeat MI (p = 0.986) and major adverse cardiovascular events [MACE; cardiac death, myocardial infarction, stroke] (16.8% vs. 9.8%; p = 0.501). Prior chronic kidney disease (CKD), post rota-atherectomy debulking, prior coronary artery bypass graft (CABG) and longer lesions were independent predictors of long-term all-cause mortality.</p><p><strong>Conclusions: </strong>Intravascular lithotripsy is an effective treatment for the modification of calcified atherosclerotic lesions, with a high success rate and few periprocedural complications. The long-term outcomes achieved in this complex population are satisfactory.</p>","PeriodicalId":93923,"journal":{"name":"Cardiology journal","volume":"33 ","pages":"e00226047"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}