Cardiovascular Intervention and Therapeutics最新文献

{"title":"Efficacy and safety of low-dose prasugrel as dual antiplatelet therapy in patients with ischemic heart disease: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Toshiharu Fujii, Kazushige Amano, Satoshi Kasai, Yota Kawamura, Fuminobu Yoshimachi, Yuji Ikari","doi":"10.1007/s12928-025-01129-2","DOIUrl":"https://doi.org/10.1007/s12928-025-01129-2","url":null,"abstract":"<p><p>Low-dose prasugrel could provide a better balance between adverse ischemic and bleeding events compared to other P2Y12 receptor inhibitors as part of dual antiplatelet therapy (DAPT) for patients with ischemic heart disease. This study evaluated these risks of adverse events associated with low-dose prasugrel and other P2Y12 receptor inhibitors. A network meta-analysis was conducted, searching for randomized controlled trials (RCTs) comparing clopidogrel (75 mg), low-dose (3.75 mg) and standard-dose (10 mg or 5 mg) prasugrel, or ticagrelor (180 mg). The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, or stroke. The secondary endpoint was major bleeding, cardiovascular death, myocardial infarction, and stroke. Across 13 RCTs, neither low-dose prasugrel, standard-dose prasugrel, nor ticagrelor showed a statistically significant difference in MACE compared to clopidogrel [risk ratio (RR): 0.73, 95% confidence interval (CI) 0.49-1.09; RR: 0.86, 95% CI 0.68-1.09; RR: 1.02, 95% CI 0.62-1.67, respectively]. However, the standard dose of prasugrel was associated with a significantly higher risk of bleeding events compared to clopidogrel (RR, 0.72; 95% CI 0.35-1.49; RR, 1.26; 95% CI 1.01-1.58; RR, 1.26; 95% CI 0.82-1.96). The surface under the cumulative ranking curves was highest for low-dose prasugrel for both MACE and bleeding events (17.3 and 64.6 for clopidogrel, 84.5 and 84.9 for low-dose prasugrel, 62.0 and 11.8 for standard-dose prasugrel, and 36.2 and 38.7 for ticagrelor, respectively). Low-dose prasugrel may be a viable option in addition to standard P2Y12 receptor inhibitors.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246596","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":"Long-term bleeding events post-percutaneous coronary intervention in patients with malignancy with and without anticoagulant therapy.","authors":"Yasuhiro Otsuka, Masanobu Ishii, So Ikebe, Tatsuya Tokai, Taishi Nakamura, Kenichi Tsujita, Naoyuki Akashi, Hideo Fujita, Yasuhiro Nakano, Tetsuya Matoba, Takahide Kohro, Yusuke Oba, Tomoyuki Kabutoya, Kazuomi Kario, Yasushi Imai, Arihiro Kiyosue, Yoshiko Mizuno, Kotaro Nochioka, Masaharu Nakayama, Takamasa Iwai, Yoshihiro Miyamoto, Hisahiko Sato, Ryozo Nagai","doi":"10.1007/s12928-025-01151-4","DOIUrl":"https://doi.org/10.1007/s12928-025-01151-4","url":null,"abstract":"<p><p>The prevalence of malignancies in patients undergoing percutaneous coronary intervention (PCI) is increasing with aging. Active malignancy is a significant contributor to high bleeding risk. For cancer patients requiring oral anticoagulant (OAC) therapy, the choice between direct oral anticoagulants (DOAC) and warfarin is critical. The aim of this study was to investigate long-term bleeding events in patients with malignancy undergoing PCI. The CLIDAS (Clinical Deep Data Accumulation System) multicenter database includes data from seven tertiary medical hospitals in Japan. This retrospective analysis included 6451 patients who underwent PCI between April 2013 and March 2019 and completed 3-year follow-up. The patients were divided into two groups; No malignancy (n = 5787) and Malignancy group (n = 664). Malignancy was defined by a history of cancer treatment. These groups were further subcategorized based on OAC therapy; (1) No malignancy without OAC (n = 5134), (2) No malignancy with DOAC (n = 261), (3) No malignancy with warfarin (n = 392), (4) Malignancy without OAC (n = 589), (5) Malignancy with DOAC (n = 38), and (6) Malignancy with warfarin (n = 37). The primary outcome was the incidence of bleeding events, defined according to the Global Use of Streptokinase and t-PA for Occluded Coronary Arteries classification of moderate and severe bleeding. The secondary outcomes were major adverse cardiac events (MACE) and net adverse clinical events (NACE). Multivariable Cox regression analysis showed that the malignancy with warfarin group had a significantly higher risk of bleeding events compared to the malignancy without OAC group (hazard ratio [HR], 3.64; 95% confidence interval [CI], 1.38-9.61, p value = 0.009). No significant differences were observed for MACE (HR, 1.39; 95% CI 0.59-3.25, p value = 0.454) or NACE (HR, 1.62; 95% CI, 0.80-3.29; p value = 0.184). Malignancy patients receiving warfarin were associated with a higher risk of bleeding events. DOACs may represent a preferable alternative to warfarin with regard to bleeding risk in patients with malignancy undergoing PCI.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246611","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":"Plaque rupture and calcified nodules: major contributors to out-of-hospital cardiac arrest in acute myocardial infarction.","authors":"Takato Hirose, Kenichi Fujii, Kenta Hashimoto, Kazunori Bando, Shun Morishita, Masanao Taniichi, Keita Horitani, Ichiro Shiojima","doi":"10.1007/s12928-025-01146-1","DOIUrl":"https://doi.org/10.1007/s12928-025-01146-1","url":null,"abstract":"<p><p>Since patients with cardiac arrest associated with acute myocardial infarction (MI) may not be successfully resuscitated, the underlying mechanisms of acute MI leading to out-of-hospital cardiac arrest (OHCA) have not been elucidated. This study evaluated whether there are differences in the plaque characteristics of infarct-related lesions between acute MI patients with OHCA and those without OHCA. This study analyzed 604 consecutive patients with a diagnosis of acute MI who underwent intravascular ultrasound (IVUS) evaluation of the infarct-related lesion before coronary intervention. All study patients were divided into two groups based on whether they presented with OHCA. The underlying mechanisms of acute MI were classified into four categories according to pre-interventional angiographic and IVUS images: plaque rupture, plaque erosion, calcified nodule, and embolization. Of the 604 patients diagnosed with acute MI, 69 (11%) suffered from OHCA. The OHCA group had a higher frequency of plaque rupture and calcified nodules than the non-OHCA group. Multivariate logistic regression analysis showed that an infarct-related lesion in the left main artery, the underlying plaque morphology of a calcified nodule, and plaque rupture were significantly associated with OHCA. In patients with acute MI, plaque morphology of infarct-related lesions with plaque rupture or a calcified nodule has a higher risk of leading to OHCA than other morphological types.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233283","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":"Doppler extremity arterial diagnosis for optimization of treatment in the emergency department (DEAD FOOT).","authors":"Jesse M Schafer, Brian Q Gacioch, Tyler Beals, Daniel S Balk, Stephen H Thomas, Beatrice Hoffmann","doi":"10.1007/s12928-025-01150-5","DOIUrl":"https://doi.org/10.1007/s12928-025-01150-5","url":null,"abstract":"<p><p>Outcomes in acute limb ischemia (ALI) depend on early recognition. Rapid evaluation methods in the emergency department (ED) include physical exam, hand-held Doppler (HH), or spectral Doppler (SD) using point-of-care ultrasound (POCUS). This study aims to estimate performance characteristics of HH versus emergency medicine (EM)-performed SD compared to angiography along with clinician confidence when evaluating for ALI. This was a prospective observational pilot study. A convenience sample of patients presenting to an urban, academic ED with concern for ALI who underwent angiography were eligible. The primary aim evaluated diagnostic performance of HH and SD in correctly classifying flow in posterior tibial (PT) and dorsalis pedis (DP) arteries in patients with 100% angiographic occlusion of the proximal vasculature. Binomial exact 95% confidence intervals (CIs) and Fisher's exact tests were used. Twenty-six patients were enrolled. Three cases (11.5% of 26) had normal angiography, five (19.2%) had partial occlusion, and 18 (69.2%) had 100% occlusion. For cases with 100% occlusion, HH always classified PT or DP as abnormal (sensitivity 100, 95% CI 81.5-100%). SD also showed high sensitivity (94.4, 95% CI 72.7-99.9%). Limited utility of specificity calculations was due to low true negatives (n = 3), but these measures were low for HH (66.7, 95% CI 9.4-99.2%) and SD (33.3, 95% CI 0.8-90.6%). There was no association (p = .305) between sonographer confidence and correct diagnostic classification for either HH or SD. In a patient population with suspected ALI, EM-performed HH and SD performed extremely well at identifying abnormal PT or DP flow in patients with complete (100%) angiographic occlusion. These results are useful to power larger trials to determine the role that SD may play in complementing HH evaluation for ALI.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246595","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":"Impella insertion through fenestrated thoracic stent graft.","authors":"Masataka Hirota, Yuki Ichihara, Takashi Azuma, Satoru Domoto, Hiroshi Niinami","doi":"10.1007/s12928-025-01149-y","DOIUrl":"https://doi.org/10.1007/s12928-025-01149-y","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233282","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":"Efficacy of transcatheter patent foramen ovale closure for drug-resistant migraine: initial experience in Japan and long-term outcome.","authors":"Teiji Akagi, Yoichi Takaya, Takashi Miki, Rie Nakayama, Koji Nakagawa, Mitsuki Nakashima, Yoshiaki Takahashi, Nozomi Hishikawa, Shinsuke Yuasa","doi":"10.1007/s12928-025-01135-4","DOIUrl":"https://doi.org/10.1007/s12928-025-01135-4","url":null,"abstract":"<p><p>This study evaluates the efficacy and safety of transcatheter patent foramen ovale (PFO) closure for the treatment of drug-resistant migraine in Japan. Previous studies have suggested a potential benefit for migraine with aura, although large-scale trials in the United States and Europe have failed to confirm efficacy as a primary endpoint. The study included 27 patients (mean age 36.4 years, 15 female, 21 with aura) who had more than two migraine attacks per month despite medication. All had PFO confirmed by transesophageal echocardiography and underwent transcatheter closure with the Amplatzer PFO Occluder. Patients were followed up to 12 months with migraine severity monitored by headache specialist. The procedure was successful and without complications in all cases. One patient required a larger occluder (35 mm) due to the size of PFO. At 12 months, 22 of 27 (81%) patients reported either complete resolution or improvement of migraine. Specifically, 10 of 21 (48%) patients with aura experienced complete resolution of migraine at one year. Patients without aura had a lower response rate, with only one case of complete resolution. Despite limitations such as the lack of a control group and potential patient selection bias, the study demonstrated that PFO closure may provide significant relief for patients with drug-resistant migraine, particularly those with aura. These findings support further investigation to better define its clinical indications and potential benefits.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215005","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":"Comprehensive analysis of acute kidney injury incidence following transcatheter versus surgical aortic valve replacement in aortic stenosis: a systematic review and meta-analysis of 13,777 patients.","authors":"Ahmad Alazzam, Yacoub Aldroubi, Tariq Alhusban, Mosab Said","doi":"10.1007/s12928-025-01144-3","DOIUrl":"https://doi.org/10.1007/s12928-025-01144-3","url":null,"abstract":"<p><p>This systematic review and meta-analysis evaluate Acute Kidney Injury (AKI) differences between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) and how surgical risk stratification and diagnostic criteria influence outcomes. Following the PRISMA guidelines, we included both non-randomized studies and randomized clinical trials that reported AKI criteria and patients' surgical risk in patients with aortic stenosis by searching PubMed, Scopus, and Web of Science until late September. We executed a random-effects model in Review Manager to pool effect estimates of AKI incidence or the need for dialysis as an odds ratio (OR) and I² heterogeneity, and we utilized R for meta-regression to address any heterogeneity with subgroup analysis for surgical risk, AKI criteria, and study design. We used the Newcastle Ottawa Scale (NOS) and the Cochrane Risk of Bias Tool (RoB-1) for risk of bias assessment and GRADE for certainty assessment. Involving 17 studies and a total of 13,777 patients, we found that the AKI incidence was significantly lower in TAVR compared to SAVR (OR = 0.36; 95% CI: [0.30, 0.44], I² = 55%, P = 0.003), along with the need for dialysis (OR = 0.35; 95% CI: [0.19, 0.63], I² = 0%, P = 0.92). The study also found that intermediate and low-risk patients had more favorable outcomes. However, the retrospective study design and VARC-2 criteria were associated with unfavorable outcomes. TAVR effectively reduced the risk of AKI in all surgical risk categories and the need for dialysis compared to SAVR in patients with AS.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148943","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":"Fusion imaging-guided closure of spontaneous sinus of Valsalva aneurysm rupture.","authors":"Juan P Sandoval, Eduardo A Arias-Sanchez, José A Arias-Godínez, Veronica C Rodriguez-Esparza, Axel A Rodriguez-Mendez, Hugo Rodriguez-Zanella","doi":"10.1007/s12928-025-01142-5","DOIUrl":"https://doi.org/10.1007/s12928-025-01142-5","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157011","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":"Correlation between coronary angioscopy yellow grade and lipid plaque assessment by integrated backscatter intravascular ultrasound.","authors":"Atsushi Tanita, Shinichiro Sunamura, Tsuyoshi Ogata, Kazuki Noda, Toru Takii, Yoshio Nitta, Seijiro Yoshida, Shigeto Namiuchi","doi":"10.1007/s12928-025-01133-6","DOIUrl":"https://doi.org/10.1007/s12928-025-01133-6","url":null,"abstract":"<p><p>Coronary angioscopy (CAS) enables direct qualitative assessment of the coronary artery lumen, while integrated backscatter intravascular ultrasound (IB-IVUS) provides a quantitative evaluation of coronary plaque tissue characteristics. Despite the utility of both techniques in assessing coronary plaque status, data on the correlation between their findings remain limited. To investigate the association between CAS-derived findings and results obtained through IB-IVUS. This retrospective analysis included 36 patients who underwent both CAS and IB-IVUS during percutaneous coronary intervention (PCI) at our institution. CAS and IB-IVUS were performed on the same coronary artery treated during PCI. Plaques were categorized into four groups based on their yellow color grade using CAS. For the IB-IVUS analysis, measurements were performed at the minimum lumen diameter site of the culprit lesion. A significant correlation was observed between plaque yellowishness and plaque characteristics on IB-IVUS. Higher plaque yellowishness was associated with an increased percentage of all lipid pool (P < 0.01), a greater proportion of attenuated plaque (P < 0.01), and a larger estimated lipid plaque volume (P < 0.01). Additionally, plaques with higher yellowishness grades had significantly thinner fibrous caps (P < 0.01). The findings suggest that higher plaque yellowishness observed via CAS correlates with a larger lipid plaque volume and thinner fibrous caps, as assessed through IB-IVUS.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149119","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":"Comparable clinical characteristics and outcomes of patients undergoing endovascular treatment for aorto-iliac or femoropopliteal lesions.","authors":"Yuichi Saito, Yuji Ohno, Kayo Yamamoto, Norikiyo Oka, Masayuki Takahara, Sakuramaru Suzuki, Raita Uchiyama, Masahiro Suzuki, Tadahiro Matsumoto, Yo Iwata, Hideki Kitahara, Yoshio Kobayashi","doi":"10.1007/s12928-025-01143-4","DOIUrl":"https://doi.org/10.1007/s12928-025-01143-4","url":null,"abstract":"<p><p>Lower extremity peripheral arterial disease is usually a consequence of advanced atherosclerosis, leading to high mortality and morbidity. Although clinical characteristics and outcomes may differ among patients having peripheral disease in different arterial territories, contemporary data are scarce. From January 2019 to December 2022, this multicenter registry study included 712 patients undergoing endovascular treatment (EVT) for either aorto-iliac (AI) or femoropopliteal (FP) lesions. Patient characteristics and outcomes were compared between AI-EVT and FP-EVT groups. Clinical endpoints included major adverse cardiovascular events, major adverse limb events (MALE), and all-cause mortality, stratified by chronic limb-threatening ischemia (CLTI). Of the 712 patients, 217 (30.5%) and 495 (69.5%) underwent AI-EVT or FP-EVT. Patients undergoing AI-EVT were more likely to be men and current smokers, while diabetes was more frequent in the FP-EVT group. The prevalence of CLTI was significantly higher in the FP-EVT group. In the entire study population, the FP-EVT rather than the AI-EVT group had a significantly higher rate of MALE and mortality, but the incidence of major adverse cardiovascular events was similar between the two groups. When focusing only on patients without CLTI, the mortality risk was similar, while the MALE risk was still higher in the FP-EVT group. In conclusion, patients undergoing EVT for AI and FP lesions in contemporary settings were differently characterized by baseline factors. Although the worse clinical outcomes in the FP-EVT group were mainly driven by the higher prevalence of CLTI, the MALE risk was still increased in patients without CLTI.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136010","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}