Cardiovascular diagnosis and therapy最新文献

{"title":"Non-pharmacological nursing interventions in patients with myocardial infarction: a systematic review.","authors":"Yunjing Du, Qi Wang, Yueqin Shen","doi":"10.21037/cdt-2025-493","DOIUrl":"10.21037/cdt-2025-493","url":null,"abstract":"<p><strong>Background: </strong>Multiple interventions have been implemented with varying degrees of effectiveness. A comprehensive analysis is necessary to evaluate and characterize the efficacy of each intervention. This study aimed to examine the impact of non-pharmacological nursing interventions on patients with myocardial infarction.</p><p><strong>Methods: </strong>A literature search was conducted across five databases: Scopus, PubMed, Web of Science, Embase, and MEDLINE. Each database was last searched on May 13, 2024. The PICO (population, intervention, comparator, and outcome) approach was used to create a comprehensive and well-structured research question. The quality of the studies included was assessed using the critical appraisal tools from the Joanna Briggs Institute (JBI).</p><p><strong>Results: </strong>This review included 52 studies. A total of eighteen distinct non-pharmacological interventions were assessed to evaluate their efficacy in improving outcomes for patients with myocardial infarction. The findings of this review highlight that various types of nursing interventions can, to some extent, impact patient outcomes. Regarding intervention types, telephone follow-up/remote management were used in 8 studies; psychological interventions in 8 studies; nursing care pathways in 8 studies; rehabilitation nursing care in 4 studies; home-care nursing in 4 studies; exercise nursing care and evidence-based nursing in 3 studies each; nurse-led individualized self-management program, educational interventions, and targeted nursing care in 2 studies each; and structured team nursing model, whole-course nursing care, acupressure, spiritual nursing care, systematic nursing care, high-quality nursing, ice bag application, and music intervention were each reported in 1 study. Regarding outcome types, death/complications/readmission were investigated in 16 studies; quality of life (QOL) in 12 studies; cardiac function in 14 studies; anxiety/depression/stress in 6 studies; adherence in 2 studies; and pain in 2 studies. The studies were predominantly limited in scale and demonstrated substantial variability in the types of interventions implemented as well as in the outcomes assessed. Furthermore, most of the included studies were rated as moderate to low quality.</p><p><strong>Conclusions: </strong>The findings of this review highlight that non-pharmacological nursing interventions can, to some extent, impact patient outcomes. However, due to the methodological constraints, the results should be interpreted with prudence. Further investigation employing larger sample sizes and improved methodological rigor is necessary to more conclusively ascertain the effectiveness of these nursing interventions.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"72"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioresorbable patent foramen ovale closure-is less more?","authors":"Stefan Toggweiler, Mathias Wolfrum","doi":"10.21037/cdt-2026-0209","DOIUrl":"10.21037/cdt-2026-0209","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"58"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term high-sensitivity C-reactive protein trajectories and risk of major adverse cardiovascular events in statin-treated patients: a retrospective cohort.","authors":"Qin Ma, Shaoping Wang, Hua Chen","doi":"10.21037/cdt-2026-1-0047","DOIUrl":"10.21037/cdt-2026-1-0047","url":null,"abstract":"<p><strong>Background: </strong>High-sensitivity C-reactive protein (hs-CRP) is a key inflammatory marker in atherosclerosis; however, the association between its long-term patterns and cardiovascular prognosis under statin therapy remains incompletely understood. This study characterized hs-CRP trajectories and their prognostic value for MACE in statin users, aiming to refine risk assessment and tailored therapy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at the Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University (Beijing, China), using data from patients who received statin therapy for at least 12 months between January 2023 and December 2024. Eligible participants had three or more hs-CRP measurements and were free from major adverse cardiovascular events (MACEs) six months before enrollment. Latent class growth modeling was applied to categorize hs-CRP trajectories. The primary composite outcome included cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or rehospitalization for unstable angina. Event-free survival was compared across trajectory groups using Kaplan-Meier curves with log-rank testing. Multivariable Cox proportional hazards regression evaluated the association between hs-CRP trajectories and MACE, with adjustments for age, sex, hypertension, diabetes, baseline lipids, and statin intensity.</p><p><strong>Results: </strong>This study included 210 patients with a median follow-up of 11.9 months. Latent class growth modeling identified three distinct hs-CRP trajectories: persistently low (45.2%, <2 mg/L), moderately fluctuating (40.0%, 2-5 mg/L), and persistently high (14.8%, ≥5 mg/L). Over follow-up, 38 patients (18.1%) experienced a MACE. Kaplan-Meier analysis revealed significantly higher cumulative MACE incidence in persistently high compared to persistently low (38.7% <i>vs.</i> 5.3%, P<0.001), with moderately fluctuating also showing elevated risk (25.0% <i>vs.</i> 5.3%, P<0.001). Following multivariable adjustment, both persistently high [hazard ratio (HR) 4.21, P=0.02] and moderately fluctuating (HR 3.46, P=0.02) hs-CRP trajectories remained independent predictors of MACE in patients receiving statins.</p><p><strong>Conclusions: </strong>Statin-treated patients with rising hs-CRP levels face elevated MACE risk. Longitudinal patterns show prognostic promise but need validation in future trials.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"60"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: \"Comparative hemodynamic effects of mavacamten and septal myectomy in HOCM: important methodological considerations\".","authors":"Yinzhu Chen, Xinyi Luo, Yuelong Yang, Jiehao Ou, Hui Liu","doi":"10.21037/cdt-2026-0288","DOIUrl":"10.21037/cdt-2026-0288","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"78"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-driven radiomics and functional imaging integration for intelligent identification of coronary high-risk plaques and prediction of cardiovascular events.","authors":"Lei Yu, Ying Cao, Xinyue Li, Manli Zhang, Chunpeng Yang, Junzhi Sang, Yuguang Wang, Tan Xue, Kexin Pang, Guangwei Li","doi":"10.21037/cdt-2025-1-653","DOIUrl":"10.21037/cdt-2025-1-653","url":null,"abstract":"<p><strong>Background: </strong>Accurate identification of high-risk coronary plaques and prediction of cardiovascular events are essential for improving the management of coronary artery disease (CAD). Although coronary computed tomography angiography (CTA) is widely used in clinical practice, conventional assessment methods remain limited by subjective interpretation and suboptimal prognostic accuracy. This study aimed to develop and validate a deep learning (DL)-based radiomics model integrating coronary CTA and computed tomography-derived fractional flow reserve (CT-FFR) for automated identification of high-risk coronary plaques and prediction of cardiovascular events.</p><p><strong>Methods: </strong>In this retrospective study, 800 coronary CTA scans from patients with stable plaques, vulnerable plaques, and acute coronary syndrome (ACS) were analyzed. Clinical characteristics and follow-up outcome labels were incorporated for annotation of major adverse cardiovascular events (MACE) during follow-up. After image preprocessing, coronary arteries were automatically segmented using a U-Net-based DL model. Radiomics features describing plaque morphology, texture, and attenuation, including surrogates for fibrous cap integrity, were extracted and combined with CT-FFR to incorporate functional hemodynamic information. A multimodal fusion model integrating convolutional neural networks (CNNs) and Transformer architecture was developed and internally validated using cross-validation.</p><p><strong>Results: </strong>In the independent test cohort, the multimodal model achieved an accuracy of 90.8%, sensitivity of 91.2%, specificity of 89.4%, F1-score of 0.91, and area under the curve (AUC) of 0.927 [95% confidence interval (CI): 0.902-0.948], outperforming the structural-only model (AUC =0.864) and functional-only model (AUC =0.878). Feature importance analysis indicated that the radiomics-derived fibrous cap surrogate, plaque attenuation, and CT-FFR were among the most influential predictors of adverse cardiovascular outcomes.</p><p><strong>Conclusions: </strong>This study presents an interpretable multimodal framework for quantitative assessment of high-risk coronary plaques and cardiovascular risk prediction using CTA. The proposed approach improves risk stratification and supports the integration of artificial intelligence (AI) into clinical management of CAD.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"63"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U-shaped relationship between coronary artery calcification and underestimation of moderate coronary stenosis by coronary computed tomography angiography.","authors":"Yu Xie, Chengzhuo Wang, Xuzhe Wang, Wenyu Wang, Ruifeng Liu","doi":"10.21037/cdt-2026-0118","DOIUrl":"10.21037/cdt-2026-0118","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Coronary computed tomography angiography (CCTA) is crucial for diagnosing coronary artery disease (CAD). However, its diagnostic accuracy is frequently influenced by factors such as coronary artery calcification (CAC), which can lead to both overestimation and critically, underestimation of stenosis severity. Underestimation of stenosis, particularly in the clinically ambiguous 50-70% range, may delay necessary invasive coronary angiography (ICA). Previous studies have lacked a systematic understanding of the entire spectrum of CAC score (CS) in relation to the risk of CCTA underestimation in this critical 50-70% stenosis range. Therefore, this study aimed to: (I) quantify the non-linear relationship between CS and CCTA underestimation of moderate coronary stenosis; (II) identify optimal CS thresholds for risk stratification of underestimation; and (III) determine clinical and imaging predictors to improve CCTA diagnostic accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 216 patients who underwent both CCTA and ICA. Patients with CCTA-reported 50-70% stenosis were classified into an underestimation group (n=63; ICA stenosis &gt;70%) and a non-underestimation group (n=153; ICA stenosis ≤70%). Demographic, clinical, and laboratory data were systematically collected, and CS was quantified using the Agatston method. Logistic regression and restricted cubic spline (RCS) analyses evaluated the association between CS and CCTA underestimation, identified non-linear relationships, and determined optimal CS cutoffs. Diagnostic performance and subgroup analyses were also conducted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The underestimation group exhibited significantly higher median CS (P=0.08), higher diabetes prevalence (P=0.007), elevated triglycerides (TG) (P=0.004) and fasting glucose (P=0.03), and lower high-density lipoprotein cholesterol (HDL-C) (P=0.004). RCS analysis revealed a significant U-shaped non-linear relationship between CS and underestimation risk (P-nonlinearity &lt;0.05). Distinct cutoffs were identified: a lower threshold around 118 Agatston units (AU) and an upper threshold between 253 and 330 AU. Patients with CS &lt;118 or &gt;330 AU had the highest underestimation risk, whereas those with intermediate CS (118-330 AU) were prone to overestimation. In the fully adjusted model, higher CS remained an independent predictor of underestimation [adjusted odds ratio (OR) =1.002; 95% confidence interval (CI): 1.000-1.003, P=0.02]. Diagnostic models utilizing these thresholds demonstrated high sensitivity (82.5-87.3%) but limited specificity (24.8-30.7%). Subgroup analyses confirmed robustness, with pronounced effects in females, elderly patients, and those with calcified plaques (P=0.002).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study reveals a U-shaped non-linear relationship between CS and CCTA underestimation of moderate stenosis. Patients with CS &lt;118 or &gt;253-330 AU are at higher underestimation ri","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"70"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers in plasma and extracellular vesicles for early detection of asymptomatic ischemic heart disease: a retrospective case-control study.","authors":"Chris Lenselink, Daan Ties, Geert H D Voordes, Adriaan A Voors, Dominique P V de Kleijn, Rozemarijn Vliegenthart, Pim van der Harst, Erik Lipsic","doi":"10.21037/cdt-2025-1-678","DOIUrl":"10.21037/cdt-2025-1-678","url":null,"abstract":"<p><strong>Background: </strong>Asymptomatic ischemic heart disease (aIHD) often precedes acute coronary syndrome (ACS). Early detection of aIHD with evidence-based treatment may reduce the risk of ACS and sudden cardiac death. Current risk prediction modalities may not fully capture at-risk patients. We aimed to explore whether plasma and extracellular vesicle (EV) proteins could help predict aIHD in at-risk individuals.</p><p><strong>Methods: </strong>We performed a pilot case-control study in asymptomatic individuals with a coronary artery calcium (CAC) score of >300 who underwent stress-perfusion cardiac magnetic resonance (CMR) imaging in three Dutch hospitals between May 2019 and September 2020. In total, 44 participants demonstrated the presence of aIHD (myocardial ischemia or infarction), and 43 did not. Plasma and EV protein concentrations were measured using the Olink Cardiovascular III panel (92 proteins). Differential expression was used to identify potential biomarkers with correction for multiple testing using the Benjamini-Hochberg method. Forward and backward logistic regression analysis was performed to identify independent clinical and proteomic predictors for aIHD. The trial was registered at ClinicalTrials.gov (NCT04680338; date registered 2020-12-22).</p><p><strong>Results: </strong>Baseline patient characteristics between patients with and without aIHD were similar; only hypertension was more prevalent in patients with aIHD (P=0.02). After Benjamini-Hochberg correction for multiple testing, no proteins were differentially expressed in groups with and without ischemia. However, in logistic regression models, higher plasma aminopeptidase-N [AP-N, odds ratio (OR) 8.74, 1.12-68.37, P=0.04], retinoic acid receptor responder protein 2 (RARRES2, OR 12.64, 1.88-85.15, P=0.009), and chitinase-3-like protein (CHI3L1, OR 0.54, 0.30-0.96, P=0.04) were independently associated with aIHD. After determining threshold values with the Youden index, the sensitivity for aIHD was 0.84 for AP-N, 0.93 for RARRES2, and 0.93 for CHI3L1. Positive predictive value was 0.62, 0.62, and 0.52, respectively. In an EV model, AP-N was able to predict the presence of aIHD (OR 7.24, 1.34-39.14, P=0.02). In a combined plasma and EV model, RARRES2 in plasma (OR 12.77,1.76-92.73, P=0.01) and AP-N in EVs (OR 13.27, 2.04-86.37, P=0.007) remained independently associated with aIHD. Established clinical risk scores [Systematic Coronary Risk Evaluation (SCORE), Framingham Heart Study (FHS)] did not discriminate aIHD (area under the curve <0.60).</p><p><strong>Conclusions: </strong>In this exploratory study, selected protein biomarkers showed potential to help identify aIHD in asymptomatic individuals with a high CAC score. These preliminary findings support further validation of AP-N and RARRES2 as gatekeepers for non-invasive risk stratification.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"62"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visceral artery aneurysms: a literature review of etiology, natural history, diagnosis and treatment paradigms.","authors":"Mehreet Kaur Chahal, Amrit Khooblall, Ramanpreet Singh, Amanjit Gill, Sameer Gadani","doi":"10.21037/cdt-2025-1-666","DOIUrl":"10.21037/cdt-2025-1-666","url":null,"abstract":"<p><strong>Background and objective: </strong>Visceral artery aneurysms (VAAs) are rare but clinically significant vascular lesions associated with high mortality following rupture, estimated at 25-75%. Increased use of modern imaging has improved incidental detection of asymptomatic aneurysms. This review summarizes the etiology, natural history, diagnosis, and evolving management strategies of VAAs, with emphasis on territory-specific endovascular and surgical approaches.</p><p><strong>Methods: </strong>A structured literature review was conducted using PubMed/MEDLINE, EBSCO, and the Cochrane Library to identify studies published between 2010 and 2025 on the diagnosis and management of VAAs. Original studies, systematic reviews, meta-analyses, and selected case reports were reviewed and synthesized.</p><p><strong>Key content and findings: </strong>VAAs often remain asymptomatic until rupture, whereas pseudoaneurysms carry significantly higher rupture risk and require urgent treatment regardless of size. Diagnosis relies primarily on computed tomography angiography (CTA), magnetic resonance imaging (MRI), ultrasound (US), and catheter angiography. Management depends on aneurysm morphology, location, rupture status, symptoms, and patient-specific risk factors. Endovascular therapy has become the preferred treatment modality in most anatomically suitable cases because of its minimally invasive nature and high technical success. Common techniques include coil embolization, stent-assisted and balloon-assisted embolization, liquid embolic agents, covered stents, and flow-diverting stents. Surgical and hybrid approaches remain important in cases of rupture, complex anatomy, or failed endovascular therapy.</p><p><strong>Conclusions: </strong>Advances in imaging and interventional radiology have transformed VAA management, with endovascular approaches increasingly favored over open surgery in appropriately selected patients. Individualized, multidisciplinary management remains essential for optimizing outcomes.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"71"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of safety and long-term outcomes of retrograde chronic total occlusion percutaneous coronary intervention in patients with <i>vs.</i> without diabetes mellitus: a retrospective cohort study.","authors":"Dunliang Ma, Qiheng Wan, Song Wen, Zehan Huang, Kaize Wu, Feihuang Han, Jiquan Xiao, Feng Wang, Yuqing Huang, Bin Zhang, Jun Guo","doi":"10.21037/cdt-2026-1-0060","DOIUrl":"10.21037/cdt-2026-1-0060","url":null,"abstract":"<p><strong>Background: </strong>The safety profile and long-term outcomes of retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients with diabetes mellitus (DM) remain inadequately characterized. We evaluated procedural and extended follow-up results in this cohort.</p><p><strong>Methods: </strong>This single-center retrospective study enrolled adults undergoing retrograde CTO-PCI; individuals with incomplete data, malignancy, or end-stage renal disease were excluded. Primary and secondary outcomes were all-cause mortality and major adverse cardiovascular events (MACE), respectively. Intergroup comparisons used standard univariate tests. Cumulative hazard functions were estimated via the Nelson-Aalen method, and multivariable Cox proportional hazards models were performed to adjust for clinical confounders and identify variables associated with MACE.</p><p><strong>Results: </strong>In total, 836 patients met the criteria. Success rates for collateral channel (CC) tracking (92.0% in the DM group <i>vs.</i> 95.0% in the non-DM group, P=0.08), retrograde PCI success (87.4% in the DM group <i>vs.</i> 91.3% in the non-DM group, P=0.07), and final recanalization (89.4% in the DM group <i>vs.</i> 92.0% in the non-DM group, P=0.20) were statistically similar. In-hospital complication rates were minimal and comparable (all P>0.05). Follow-up data were obtained for 767 patients (91.7%) over a median of 1,041 days. Patients with DM experienced a significantly higher risk of MACE (19.2% in the DM group <i>vs.</i> 13.9% in the non-DM group, P=0.046), primarily driven by increased all-cause mortality (9.3% in the DM group <i>vs.</i> 4.5% in the non-DM group, P=0.007) and cardiac death (7.4% in the DM group <i>vs.</i> 2.2% in the non-DM group, P<0.001). After multivariable adjustment for clinical confounders, DM remained a strong independent predictor of higher long-term all-cause and cardiac mortality.</p><p><strong>Conclusions: </strong>Retrograde PCI is technically safe and effective in CTO patients with DM. However, this cohort carries a significantly higher long-term risk of mortality and MACE than non-diabetic counterparts, necessitating intensified post-procedural risk-factor management.</p>","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"64"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could drug-eluting balloons be a routine alternative for chronic total occlusion lesions?","authors":"Mehmet U Çalışkan","doi":"10.21037/cdt-2026-0275","DOIUrl":"10.21037/cdt-2026-0275","url":null,"abstract":"","PeriodicalId":9592,"journal":{"name":"Cardiovascular diagnosis and therapy","volume":"16 4","pages":"76"},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}