Catheterization and Cardiovascular Interventions最新文献

{"title":"Anatomical Predictors of Access-Related Vascular Complications Following Transfemoral Transcatheter Aortic Valve Replacement.","authors":"Gökhan Demirci, Serkan Aslan, Ahmet Anıl Şahin, Ali R Demir, Yunus Emre Erata, İrem Türkmen, Mehmet Kanyılmaz, Aysel Türkvatan, Mehmet Ertürk","doi":"10.1002/ccd.31422","DOIUrl":"https://doi.org/10.1002/ccd.31422","url":null,"abstract":"<p><strong>Background: </strong>Access-related vascular complications (VCs) after percutaneous transfemoral transcatheter aortic valve replacement (TAVR) are associated with poor clinical outcomes and remain a significant challenge despite technological advances. The aim of this study was to identify anatomic predictors of access-related VCs after TAVR on preprocedural contrast-enhanced multidetector computed tomography (MDCT).</p><p><strong>Aims: </strong>The aim of this study was to identify anatomical predictors of access-related VCs after TAVR on preprocedural contrast-enhanced MDCT.</p><p><strong>Methods: </strong>A total of 348 consecutive patients with symptomatic severe AS who underwent transfemoral TAVR were included retrospectively. The primary endpoint of the study was the composite of minor and major access site complications as defined by the Valve Academic Research Consortium-3 (VARC-3) criteria. The study population was divided into two groups according to the VC including VC (+) and VC (-).</p><p><strong>Results: </strong>A total of 101 patients (29%) developed VC (8.7% major, 20.3% minor) following TAVR. Regression analysis identified severe CFA calcification (p = 0.004), CFA depth (p < 0.001), minimum CFA diameter (p < 0.001), CFA depth-to-diameter ratio ≥ 5.6 (p < 0.001), and sheath-to-femoral artery ratio (SFAR) (p < 0.001) as significant predictors of VC. ROC curves generated for the occurrence of VC, the AUC for the femoral artery depth-to-diameter ratio (0.720) was higher than the AUC for the SFAR and the depth of the femoral artery (0.636, 0.630).</p><p><strong>Conclusion: </strong>Complications related to vascular access sites continue to be a significant concern for patients undergoing TF-TAVR. The CFA depth-to-diameter ratio has demonstrated superior predictive performance for VC compared to SFAR as expressed in the literature. Utilizing this criterion may enhance risk stratification for VC in high-risk patients, potentially reducing associated morbidity and mortality.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Technique of \"Drag-Drill\" for Retrograde Chronic Total Occlusion Revascularization in Heavily Calcified Tortuous Lesions: A Case Report.","authors":"Shengwen Yang, Lin Zhao, Tao Zhang","doi":"10.1002/ccd.31424","DOIUrl":"https://doi.org/10.1002/ccd.31424","url":null,"abstract":"<p><p>We report the case of a 73-year-old male with a history of recurrent coronary interventions who presented with progressive angina and was diagnosed with a chronic total occlusion (CTO) of a heavily calcified and tortuous right coronary artery (RCA). Standard antegrade and retrograde techniques were attempted but failed due to the complexity of the lesion. A novel \"Drag-Drill\" technique was employed, utilizing a retrogradely externalized RG3 guidewire as a rotational atherectomy wire, enabling successful rotational atherectomy and percutaneous coronary intervention (PCI). The technique involved protecting the distal tip of the guidewire with a retrograde microcatheter to maintain stability and prevent vascular injury. At the 3-month follow-up, the patient remained angina-free. This case highlights the \"Drag-Drill\" strategy as an innovative and effective approach for the treatment of severely calcified and tortuous CTO lesions, underscoring the importance of tailored techniques in complex cases.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beaware of Intracardiac Potentials Induced by Intravascular Lithotripsy.","authors":"Daiki Niizeki, Masataka Nakano","doi":"10.1002/ccd.31425","DOIUrl":"https://doi.org/10.1002/ccd.31425","url":null,"abstract":"<p><strong>Background: </strong>Intravascular lithotripsy (IVL), that generates shockwaves through spark gap discharge between emitters, has been increasingly used to treat severely calcified coronary artery lesions. However, there is a question as to whether IVL has no electrical effects on endocardial tissues or cardiac implantable devices (CIEDs).</p><p><strong>Aims: </strong>The aim of this study was to investigate the effects of IVL-induced intracardiac potentials on cardiac electrophysiology and CIEDs. Specifically, we examined how spark gap discharge of IVL influence myocardial electrical activity and the sensing function of CIEDs.</p><p><strong>Methods and results: </strong>We conducted a preliminary in vitro experiment using an IVL and a pacemaker placed in a saline-filled container, where we observed that the pacemaker did indeed detect the discharge of IVL, leading to pacing inhibition. Then, 13 patients undergoing PCI with IVL were investigated with real-time monitoring of in vivo intracardiac electrogram (EGM) synchronized with body surface ECG, with an external temporary pacing lead placed in the right ventricle. Similar to the above experiment, we found that IVL pulses were indeed detected on the EGM and sensed by the temporary pacemaker. Of the 287 IVL pulses outside the range of absolute refractory period, 59 (20.6%) captured the ventricle, while the remaining 228 (79.4%) did not elicit any electrical myocardial activity.</p><p><strong>Conclusions: </strong>Our observations indicate concerns about the use of IVL: the risk of inducing fatal arrhythmia and the occurrence of cardiac arrest or bradycardia in the CIED-dependent patients. IVL users should be aware of the potential risk of such events.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Main Coronary Occlusion During TAVI Procedure: Calcium Embolization Matters.","authors":"Rajesh Vijayvergiya, Basant Kumar, Arghadip Bose, Sunder Negi","doi":"10.1002/ccd.31426","DOIUrl":"https://doi.org/10.1002/ccd.31426","url":null,"abstract":"<p><p>Acute coronary occlusion during transcatheter aortic valve implantation (TAVI) is an unwarranted complication associated with high mortality. The current TAVI practices recommend a multidetector computed tomography (MDCT) evaluation of the aortic valve, the left ventricular outflow tract, and the aortic root to determine the conventional risk factors for coronary obstruction like low-lying coronary ostia and narrow sinuses of Valsalva, mandating prophylactic coronary protection or native valve leaflet modification in high-risk patients. Despite optimal anatomy, acute coronary occlusion can still occur due to multiple mechanisms, one of which is coronary embolism due to thrombus, calcium, or native aortic valve fragments. A sudden hemodynamic collapse during a TAVI procedure in the absence of apparent causes always raises the suspicion of coronary occlusion, which requires a prompt percutaneous coronary intervention (PCI) to save the patient's life. This report describes a case of acute coronary occlusion during TAVI in a seemingly low-risk patient salvaged with an emergent left main (LM) bifurcation PCI.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-Based Analysis of Correlation Between Valve Stent Deformation and Valve Function in Transcatheter Aortic Valve Replacement.","authors":"Min Jin, Qing Zhou, Shuchun Li, Haitao Zhang, Dongjin Wang","doi":"10.1002/ccd.31421","DOIUrl":"https://doi.org/10.1002/ccd.31421","url":null,"abstract":"<p><strong>Background and objectives: </strong>Currently, there remains a paucity of research on the deformation and valve function of transcatheter heart valves (THV) in patients with aortic regurgitation (AR) following transcatheter aortic valve replacement (TAVR). This study aimed to thoroughly explore the correlation between THV deformation and postoperative hemodynamics in these patients.</p><p><strong>Methods: </strong>In this study, we assessed 39 AR patients treated with the J-Valve THV system during TAVR. We utilized postoperative cardiac-enhanced computed tomography angiography (CTA) to examine the extent of stent deformation, correlating these measurements with concurrent echocardiographic data.</p><p><strong>Results: </strong>Among patients with AR, the J-Valve exhibited three distinct configurations: rectangular, trapezoidal, and inverted trapezoidal shapes. The rectangular configuration showed a trend toward a larger effective orifice area (EOA) compared to the trapezoidal and inverted trapezoidal configurations (rectangular: 2.20 ± 0.11 cm², trapezoidal: 1.88 ± 0.08 cm², inverted trapezoidal: 2.04 ± 0.08 cm²; p = 0.068). Stratified analysis of the degree of inclined commissural posts indicated that THVs with all three commissural angles < 5° exhibited the highest standard EOA (sEOA). An increase in the number and degree of inclined commissural posts correlated with a decrease in sEOA. Furthermore, a higher EOA was observed when the expansion in the mid and transition level exceeded 80%.</p><p><strong>Conclusions: </strong>During the TAVR procedure, ensuring sufficient expansion in the mid and transition level of the stent, maintaining the stent in a rectangular configuration, and avoiding tilting of the commissural posts contribute to achieving favorable postoperative hemodynamics.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platform Selection for Patients Undergoing Transcatheter Aortic Valve Replacement: A Practical Approach.","authors":"Roberto Valvo, Antonio Popolo Rubbio, Antonio Sisinni, Mattia Squillace, Francesco Bedogni, Luca Testa","doi":"10.1002/ccd.31420","DOIUrl":"https://doi.org/10.1002/ccd.31420","url":null,"abstract":"<p><p>Transfemoral transcatheter aortic valve Replacement (TAVR) has become the standard therapy for patients with severe aortic stenosis in patients over 75 years old in Europe or 65 years old in the United States, regardless of the surgical risk. Furthermore, iterations of existing transcatheter aortic valves (TAVs), as well as devices with novel concepts, have provided substantial improvements with respect to the limitations of previous-generation devices. Hence, treatment of a broader spectrum of patients has become feasible, and a sophisticated selection of the appropriate TAV tailored to patients' anatomy and comorbidities is now possible. Anatomy, patient characteristics, and operator experience must all inform proper device selection. This review describes the features and performance of the current generation of TAVs with the aim of providing a practical approach for clinicians when selecting the appropriate TAV for a specific patient.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Coated Balloon-Based Treatment of Left Main True Bifurcation Lesion.","authors":"Ae-Young Her, Tae Hyun Kim, Eun-Seok Shin, Sunwon Kim, Bitna Kim, Yong Hoon Kim, Ki Hong Choi, Yun-Kyeong Cho, Hyun-Jong Lee, Young Bin Song, Chang-Wook Nam, Hyeon-Cheol Gwon","doi":"10.1002/ccd.31416","DOIUrl":"https://doi.org/10.1002/ccd.31416","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data regarding drug-coated balloon (DCB) treatment in the context of left main (LM) true bifurcation lesions.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the safety and efficacy of DCB-based treatment for unprotected LM true bifurcation lesions.</p><p><strong>Methods: </strong>A total of 39 patients with LM true bifurcation lesion (Medina: 1,1,1/0,1,1/1,0,1) who were successfully treated with DCB alone or in combination with drug-eluting stent (DES) were retrospectively enrolled into the DCB-based group. They were compared with 39 propensity-matched patients who were treated with second-generation DES from the COBIS III registry (n = 2648). Major adverse cardiovascular events (MACE) were defined as cardiac death, myocardial infarction, stent or target lesion thrombosis, and target lesion revascularization at the 2-year follow-up.</p><p><strong>Results: </strong>Baseline clinical characteristics were similar between the groups, except for the prevalence of in-stent restenosis (ISR) lesions (41.0% in DCB-based group vs. 17.9% in DES-only group, p = 0.047). In the DCB-based group, 59.0% of the patients (n = 23) underwent DCB-only treatment. There were no cases of abrupt vessel closure requiring treatment following DCB application. The MACE were comparable between both groups (12.8% in DCB-based group vs. 17.9% in DES-only group, p = 0.861) after 2 years.</p><p><strong>Conclusions: </strong>In patients with unprotected LM true bifurcation lesions, DCB-based treatment demonstrated comparable clinical outcomes at the 2-year follow-up when compared to DES-only treatment. DCB-based treatment could be considered a safe and effective alternative to DES for carefully selected patients who have achieved satisfactory predilation results (Impact of DCB Treatment in De Novo Coronary Lesion; NCT04619277).</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and Late Outcomes of Transcatheter Aortic Valve Replacement in Patients With Prior Chest Radiation: A Systematic Review and Meta-Analysis.","authors":"Andreas Tzoumas, Ioannis Kyriakoulis, Athina Ntoumaziou, Marios Sagris, Polydoros N Kampaktsis","doi":"10.1002/ccd.31417","DOIUrl":"https://doi.org/10.1002/ccd.31417","url":null,"abstract":"<p><strong>Background: </strong>Patients with prior history of chest or mediastinal radiation are deemed high risk for surgical AVR. Transcatheter aortic valve replacement (TAVR) has emerged as a promising alternative for these patients, however, this patient population was underrepresented in prior TAVR trials.</p><p><strong>Aims: </strong>To compare the outcomes of TAVR in patients with versus without a history of prior chest or mediastinal radiation.</p><p><strong>Methods: </strong>This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Systematic search of electronic databases was conducted up to September 2023. We compared early and late mortality as well as complications. A meta-analysis was conducted with the use of a random effects model. The I-square statistic was used to assess heterogeneity.</p><p><strong>Results: </strong>Seven studies comprising 6358 patients were included in this meta-analysis. Patients undergoing TAVR in the radiation group had a higher risk for heart failure exacerbation (OR: 2.06; 95% CI: 1.18-3.59) and aortic valve reintervention (OR: 5.68; 95% CI: 1.83-17.67) in the early postoperative period compared to the nonradiation group. Analysis revealed similar short-term (in-hospital or 30-day) all-cause-mortality (OR: 1.63; 95% CI: 0.89-2.98) between the two groups. Other perioperative complications including myocardial infarction (MI), stroke, pacemaker insertion requirement, major bleeding as well as access-related complications were not significantly different between the two groups. TAVR in the radiation group was not associated with increased all-cause mortality compared to the nonradiation group (OR: 1.40; 95% CI: 0.93-2.11) after a mean follow-up of 17.6 months. Other endpoints including MI, stroke, need for pacemaker insertion, heart failure readmission rate, and need for aortic valve reintervention were similar in the mid-term follow-up between the two groups.</p><p><strong>Conclusion: </strong>TAVR in patients with a history of prior chest or mediastinal radiation was associated with similar short-term and mid-term mortality compared to patients without radiation. The history of chest or mediastinal radiation was associated with more frequent heart failure hospitalizations and aortic valve reintervention in the postoperative period. No difference was found in mid-term complications. Future studies are warranted to validate our findings.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elastic Recoil and Deployment Asymmetry of the Transcatheter Heart Valve in Bicuspid Versus Tricuspid Anatomy.","authors":"Odette Iskandar, Habib Layoun, Shivabalan Kathavarayan Ramu, Judah Rajendran Ravi Raja Malar Vannan, Elian Abou Asala, Jaideep Singh Bhalla, Elizabeth Ghandakly, Besir Besir, James Yun, Grant Reed, Rishi Puri, Serge Harb, Amar Krishnaswamy, Samir R Kapadia","doi":"10.1002/ccd.31408","DOIUrl":"https://doi.org/10.1002/ccd.31408","url":null,"abstract":"<p><strong>Background: </strong>Data supporting the use of transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) is limited compared to tricuspid aortic valve (TAV) anatomy, as the BAV anatomy poses unique challenges to prosthesis expansion and symmetric deployment.</p><p><strong>Aims: </strong>We aim to compare the acute recoil and asymmetry of the SAPIEN-3 valve between BAV and TAV anatomies and their impact on procedural outcomes.</p><p><strong>Methods: </strong>We conducted a single-center study of patients who underwent TAVR with the SAPIEN-3 valve. We measured acute recoil, deployment asymmetry, and length asymmetry from intraprocedural angiogram before and after postdilation, as well as before and after predilation. Hemodynamic and procedural outcomes were studied.</p><p><strong>Results: </strong>Among 946 patients, 9% had BAV. In the RAO view, BAV patients had significantly higher absolute and relative acute recoil across all diameters, while in the LAO view, only central diameter relative recoil was significantly higher (p < 0.001). Deployment asymmetry was more common in BAV patients with an OR of 1.88 (CI 1.19, 2.96; p = 0.01). Predilation reduced both length and deployment asymmetry in RAO and LAO views for TAV and BAV patients (p < 0.001). Postdilation significantly reduced acute valve recoil in both groups (p = 0.002 and p = 0.032). Hemodynamic outcomes were comparable between TAV and BAV patients, and there were no significant associations between deployment or length asymmetry and procedural outcomes.</p><p><strong>Conclusions: </strong>Acute recoil, deployment asymmetry, and length asymmetry are common in BAV patients but do not affect short-term clinical outcomes or hemodynamics.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Platelet Morphological Parameters as Clinical Risk Stratification in Acute Coronary Syndrome.","authors":"Xuguang Zhang, Zhiwei Huang, Xin Wang, Han Hao, Dali Fan, Martin Cadeiras, Yusheng Liu","doi":"10.1002/ccd.31419","DOIUrl":"https://doi.org/10.1002/ccd.31419","url":null,"abstract":"<p><strong>Background: </strong>Platelet activation plays a central role in the pathogenesis of acute coronary syndrome (ACS). Platelet morphological parameters, including MPV, PDW, and P-LCR, are emerging as biomarkers for predicting the severity of ACS and prognosis.</p><p><strong>Aims: </strong>This study aims to assess the relationship between these parameters and coronary severity and to evaluate their predicting adverse outcomes.</p><p><strong>Methods: </strong>A total of 134 ACS patients and 50 healthy controls were included in this prospective observational study. Platelet morphological parameters (MPV, PDW, and P-LCR) were measured at admission, and coronary artery lesion severity was determined using the Gensini score from coronary angiography. Multivariate logistic regression analysis assessed the predictive value of these platelet parameters for adverse outcomes, and ROC curve analysis was used to evaluate their diagnostic performance.</p><p><strong>Results: </strong>MPV, PDW, and P-LCR were significantly higher in ACS patients compared to healthy controls (p < 0.001). A strong positive correlation was found between platelet parameters and the Gensini score (MPV: r = 0.778, PDW: r = 0.800, P-LCR: r = 0.761; p < 0.001). Multivariate logistic regression identified MPV (OR = 1.807, p < 0.001), PDW (OR = 1.700, p = 0.001), and P-LCR (OR = 1.287, p < 0.001) as independent predictors of advent prognosis. ROC curve analysis showed that the combined use of MPV, PDW, and P-LCR provided superior predictive accuracy (AUC = 0.927) compared to the individual parameters.</p><p><strong>Conclusion: </strong>Elevated platelet morphological parameters are strongly associated with coronary artery lesion severity and serve as independent predictors of adverse outcomes in ACS patients. The combined assessment of MPV, PDW, and P-LCR enhances risk stratification, offering a valuable tool for guiding therapeutics and improving prognosis in management.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}