Pub Date : 2024-05-30DOI: 10.1097/MCA.0000000000001392
Ahmet Güner, Fatih Uzun, Ahmet Yaşar Çizgici, Serkan Kahraman, Gökhan Demirci, Koray Çiloğlu, Kaan Gökçe, Abdullah Doğan, Cemalettin Akman, Hande Uysal, Ezgi Gültekin Güner, İbrahim Faruk Aktürk, Mustafa Yildiz, Berkay Serter, Ahmet Arif Yalçin, Berhan Keskin, Mehmet Ertürk
Background: Mini-crush (MC) and T-stenting and small protrusion (TAP) techniques are frequently used, but the long-term comparison of both techniques in patients with complex bifurcation lesions (CBLs) is still a debatable issue. This study sought to retrospectively evaluate the long-term outcomes of MC and TAP techniques in patients with CBLs.
Methods: A total of 271 patients [male: 202 (78.9%), mean age: 58.90 ± 10.11 years] patients in whom complex bifurcation intervention was performed between 2014 and 2023 were involved. The primary endpoint was major cardiovascular events (MACE) as the combination of cardiac death, target vessel myocardial infarction, or clinically driven-target lesion revascularization. The Cox proportional hazard models were adjusted by the inverse probability weighting approach to reduce treatment selection bias.
Results: The initial management strategy was MC in 146 patients and TAP in 125 cases. MACE occurred in 52 patients (19.2%) during a mean follow-up period of 32.43 ± 16 months. The incidence of MACE (13 vs. 26.4%, P = 0.005) and major cardiovascular and cerebral events (15.1 vs. 28.8%, P = 0.006) were significantly lower in the MC group than in the TAP group. Additionally, the incidence of definite or probable stent thrombosis was numerically lower in the MC group compared with the TAP group but did not differ significantly (2.7 vs. 8%, P = 0.059). The long-term MACE was notably higher in the TAP group than the MC group [adjusted hazard ratio (inverse probability weighted): 1.936 (95% confidence interval: 1.053-3.561), P = 0.033].
Conclusion: In this study involving patients with CBLs, percutaneous coronary intervention with the MC technique had better long-term outcomes than the TAP technique.
背景:迷你粉碎(MC)和T型支架及小突起(TAP)技术经常被使用,但这两种技术在复杂分叉病变(CBL)患者中的长期效果比较仍是一个值得商榷的问题。本研究旨在回顾性评估 MC 和 TAP 技术在 CBL 患者中的长期疗效:共有 271 名患者[男性:202 人(78.9%),平均年龄:58.90 ± 10.11 岁]在 2014 年至 2023 年期间接受了复杂分叉介入治疗。主要终点是主要心血管事件(MACE),即心源性死亡、靶血管心肌梗死或临床驱动的靶病变血运重建。Cox比例危险模型采用反概率加权法进行调整,以减少治疗选择偏差:146例患者的初始治疗策略为MC,125例患者的初始治疗策略为TAP。在平均 32.43 ± 16 个月的随访期间,52 例患者(19.2%)发生了 MACE。MC组的MACE发生率(13% vs. 26.4%,P = 0.005)和主要心脑血管事件发生率(15.1% vs. 28.8%,P = 0.006)明显低于TAP组。此外,MC 组与 TAP 组相比,明确或可能的支架血栓形成发生率在数量上更低,但差异不大(2.7% 对 8%,P = 0.059)。TAP组的长期MACE明显高于MC组[调整后危险比(反概率加权):1.936(95% 置信度)]:1.936(95% 置信区间:1.053-3.561),P = 0.033]:在这项涉及 CBLs 患者的研究中,采用 MC 技术进行经皮冠状动脉介入治疗的长期疗效优于 TAP 技术。
{"title":"Long-term cardiovascular outcomes after mini-crush or T and minimal protrusion techniques in complex bifurcation lesions: the EVOLUTE-CRUSH III study.","authors":"Ahmet Güner, Fatih Uzun, Ahmet Yaşar Çizgici, Serkan Kahraman, Gökhan Demirci, Koray Çiloğlu, Kaan Gökçe, Abdullah Doğan, Cemalettin Akman, Hande Uysal, Ezgi Gültekin Güner, İbrahim Faruk Aktürk, Mustafa Yildiz, Berkay Serter, Ahmet Arif Yalçin, Berhan Keskin, Mehmet Ertürk","doi":"10.1097/MCA.0000000000001392","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001392","url":null,"abstract":"<p><strong>Background: </strong>Mini-crush (MC) and T-stenting and small protrusion (TAP) techniques are frequently used, but the long-term comparison of both techniques in patients with complex bifurcation lesions (CBLs) is still a debatable issue. This study sought to retrospectively evaluate the long-term outcomes of MC and TAP techniques in patients with CBLs.</p><p><strong>Methods: </strong>A total of 271 patients [male: 202 (78.9%), mean age: 58.90 ± 10.11 years] patients in whom complex bifurcation intervention was performed between 2014 and 2023 were involved. The primary endpoint was major cardiovascular events (MACE) as the combination of cardiac death, target vessel myocardial infarction, or clinically driven-target lesion revascularization. The Cox proportional hazard models were adjusted by the inverse probability weighting approach to reduce treatment selection bias.</p><p><strong>Results: </strong>The initial management strategy was MC in 146 patients and TAP in 125 cases. MACE occurred in 52 patients (19.2%) during a mean follow-up period of 32.43 ± 16 months. The incidence of MACE (13 vs. 26.4%, P = 0.005) and major cardiovascular and cerebral events (15.1 vs. 28.8%, P = 0.006) were significantly lower in the MC group than in the TAP group. Additionally, the incidence of definite or probable stent thrombosis was numerically lower in the MC group compared with the TAP group but did not differ significantly (2.7 vs. 8%, P = 0.059). The long-term MACE was notably higher in the TAP group than the MC group [adjusted hazard ratio (inverse probability weighted): 1.936 (95% confidence interval: 1.053-3.561), P = 0.033].</p><p><strong>Conclusion: </strong>In this study involving patients with CBLs, percutaneous coronary intervention with the MC technique had better long-term outcomes than the TAP technique.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-20DOI: 10.1097/MCA.0000000000001389
Yan-Li Zheng, Ping-Yu Cai, Jun Li, De-Hong Huang, Wan-da Wang, Mei-Mei Li, Jing-Ru Du, Yao-Guo Wang, Yin-Lian Cai, Rong-Cheng Zhang, Chun-Chun Wu, Shu Lin, Hui-Li Lin
Background: Previous reports have suggested that coronary computed tomography angiography (CCTA)-based radiomics analysis is a potentially helpful tool for assessing vulnerable plaques. We aimed to investigate whether coronary radiomic analysis of CCTA images could identify vulnerable plaques in patients with stable angina pectoris.
Methods: This retrospective study included patients initially diagnosed with stable angina pectoris. Patients were randomly divided into either the training or test dataset at an 8 : 2 ratio. Radiomics features were extracted from CCTA images. Radiomics models for predicting vulnerable plaques were developed using the support vector machine (SVM) algorithm. The model performance was assessed using the area under the curve (AUC); the accuracy, sensitivity, and specificity were calculated to compare the diagnostic performance using the two cohorts.
Results: A total of 158 patients were included in the analysis. The SVM radiomics model performed well in predicting vulnerable plaques, with AUC values of 0.977 and 0.875 for the training and test cohorts, respectively. With optimal cutoff values, the radiomics model showed accuracies of 0.91 and 0.882 in the training and test cohorts, respectively.
Conclusion: Although further larger population studies are necessary, this novel CCTA radiomics model may identify vulnerable plaques in patients with stable angina pectoris.
{"title":"A novel radiomics-based technique for identifying vulnerable coronary plaques: a follow-up study.","authors":"Yan-Li Zheng, Ping-Yu Cai, Jun Li, De-Hong Huang, Wan-da Wang, Mei-Mei Li, Jing-Ru Du, Yao-Guo Wang, Yin-Lian Cai, Rong-Cheng Zhang, Chun-Chun Wu, Shu Lin, Hui-Li Lin","doi":"10.1097/MCA.0000000000001389","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001389","url":null,"abstract":"<p><strong>Background: </strong>Previous reports have suggested that coronary computed tomography angiography (CCTA)-based radiomics analysis is a potentially helpful tool for assessing vulnerable plaques. We aimed to investigate whether coronary radiomic analysis of CCTA images could identify vulnerable plaques in patients with stable angina pectoris.</p><p><strong>Methods: </strong>This retrospective study included patients initially diagnosed with stable angina pectoris. Patients were randomly divided into either the training or test dataset at an 8 : 2 ratio. Radiomics features were extracted from CCTA images. Radiomics models for predicting vulnerable plaques were developed using the support vector machine (SVM) algorithm. The model performance was assessed using the area under the curve (AUC); the accuracy, sensitivity, and specificity were calculated to compare the diagnostic performance using the two cohorts.</p><p><strong>Results: </strong>A total of 158 patients were included in the analysis. The SVM radiomics model performed well in predicting vulnerable plaques, with AUC values of 0.977 and 0.875 for the training and test cohorts, respectively. With optimal cutoff values, the radiomics model showed accuracies of 0.91 and 0.882 in the training and test cohorts, respectively.</p><p><strong>Conclusion: </strong>Although further larger population studies are necessary, this novel CCTA radiomics model may identify vulnerable plaques in patients with stable angina pectoris.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-15DOI: 10.1097/MCA.0000000000001385
Sandra Zendjebil, Athanasios Koutsoukis, Thomas Rodier, Fabien Hyafil, Xavier Halna du Fretay, Patrick Dupouy, Jean-Michel Juliard, Reza Farnoud, Phalla Ou, Jean-Pierre Laissy, Camille Couffignal, Pierre Aubry
Background: The prevalence and location of coronary artery disease (CAD) in anomalous aortic origin of a coronary artery (AAOCA) remain poorly documented in adults. We sought to assess the presence of CAD in proximal (or ectopic) and distal (or nonectopic) segments of AAOCA. We hypothesized that the representation of CAD may differ among the different courses of AAOCA.
Methods: The presence of CAD was analyzed on coronary angiography and/or coronary computed tomography angiography in 390 patients (median age 64 years; 73% male) with AAOCA included in the anomalous coronary arteries multicentric registry.
Results: AAOCA mainly involved circumflex artery (54.4%) and right coronary artery (RCA) (31.3%). All circumflex arteries had a retroaortic course; RCA mostly an interarterial course (98.4%). No CAD was found in the proximal segment of interarterial AAOCA, whereas 43.8% of retroaortic AAOCA, 28% of prepulmonic AAOCA and 20.8% subpulmonic AAOCA had CAD in their proximal segments (P < 0.001). CAD was more prevalent in proximal than in distal segments of retroaortic AAOCA (OR: 3.1, 95% CI: 1.8-5.4, P < 0.001). On multivariate analysis, a retroaortic course was associated with an increased prevalence of CAD in the proximal segment (adjusted OR 3.4, 95% CI: 1.3-10.7, P = 0.022).
Conclusion: Increased prevalence of CAD was found in the proximal segment of retroaortic AAOCA compared to the proximal segments of other AAOCA, whereas no CAD was observed in the proximal segment of interarterial AAOCA. The mechanisms underlying these differences are not yet clearly identified.
{"title":"Prevalence and location of coronary artery disease in anomalous aortic origin of coronary arteries.","authors":"Sandra Zendjebil, Athanasios Koutsoukis, Thomas Rodier, Fabien Hyafil, Xavier Halna du Fretay, Patrick Dupouy, Jean-Michel Juliard, Reza Farnoud, Phalla Ou, Jean-Pierre Laissy, Camille Couffignal, Pierre Aubry","doi":"10.1097/MCA.0000000000001385","DOIUrl":"https://doi.org/10.1097/MCA.0000000000001385","url":null,"abstract":"<p><strong>Background: </strong>The prevalence and location of coronary artery disease (CAD) in anomalous aortic origin of a coronary artery (AAOCA) remain poorly documented in adults. We sought to assess the presence of CAD in proximal (or ectopic) and distal (or nonectopic) segments of AAOCA. We hypothesized that the representation of CAD may differ among the different courses of AAOCA.</p><p><strong>Methods: </strong>The presence of CAD was analyzed on coronary angiography and/or coronary computed tomography angiography in 390 patients (median age 64 years; 73% male) with AAOCA included in the anomalous coronary arteries multicentric registry.</p><p><strong>Results: </strong>AAOCA mainly involved circumflex artery (54.4%) and right coronary artery (RCA) (31.3%). All circumflex arteries had a retroaortic course; RCA mostly an interarterial course (98.4%). No CAD was found in the proximal segment of interarterial AAOCA, whereas 43.8% of retroaortic AAOCA, 28% of prepulmonic AAOCA and 20.8% subpulmonic AAOCA had CAD in their proximal segments (P < 0.001). CAD was more prevalent in proximal than in distal segments of retroaortic AAOCA (OR: 3.1, 95% CI: 1.8-5.4, P < 0.001). On multivariate analysis, a retroaortic course was associated with an increased prevalence of CAD in the proximal segment (adjusted OR 3.4, 95% CI: 1.3-10.7, P = 0.022).</p><p><strong>Conclusion: </strong>Increased prevalence of CAD was found in the proximal segment of retroaortic AAOCA compared to the proximal segments of other AAOCA, whereas no CAD was observed in the proximal segment of interarterial AAOCA. The mechanisms underlying these differences are not yet clearly identified.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1097/mca.0000000000001382
Ömer Furkan Demir, Fatih Koca
The SYNTAX score is a score that grades the severity and complexity of coronary lesions. In this study, we aimed to investigate the relationship between triglyceride/high-density lipoprotein cholesterol (triglyceride/HDL-C) ratio and SYNTAX scores in patients presenting with non-ST elevation myocardial infarction (NSTEMI).
SYNTAX 评分是对冠状动脉病变的严重性和复杂性进行分级的评分。本研究旨在探讨非 ST 段抬高型心肌梗死(NSTEMI)患者的甘油三酯/高密度脂蛋白胆固醇(甘油三酯/高密度脂蛋白胆固醇)比率与 SYNTAX 评分之间的关系。
{"title":"The relationship between triglyceride/high-density lipoprotein cholesterol ratio and the severity of coronary artery disease in patients presenting with acute coronary syndrome.","authors":"Ömer Furkan Demir, Fatih Koca","doi":"10.1097/mca.0000000000001382","DOIUrl":"https://doi.org/10.1097/mca.0000000000001382","url":null,"abstract":"The SYNTAX score is a score that grades the severity and complexity of coronary lesions. In this study, we aimed to investigate the relationship between triglyceride/high-density lipoprotein cholesterol (triglyceride/HDL-C) ratio and SYNTAX scores in patients presenting with non-ST elevation myocardial infarction (NSTEMI).","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140837753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-20DOI: 10.1097/MCA.0000000000001341
Nick S R Lan, Jacinda Harty, Shaun Liow, Justin Taheri-Chivers, Abdul Rahman Ihdayhid, Graham S Hillis, Carl J Schultz
{"title":"Cardiovascular risk factors in younger versus older patients with acute coronary syndrome.","authors":"Nick S R Lan, Jacinda Harty, Shaun Liow, Justin Taheri-Chivers, Abdul Rahman Ihdayhid, Graham S Hillis, Carl J Schultz","doi":"10.1097/MCA.0000000000001341","DOIUrl":"10.1097/MCA.0000000000001341","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-01-08DOI: 10.1097/MCA.0000000000001325
Altuğ Ösken, Fuat Polat, Bilal Çakir, Ahmet Zengin, Ali Nazmi Çalik, Şennur Ünal Dayi, Neşe Çam
Objective: This study aims to assess the predictive value of the Systemic Immune Inflammation Index (SII) in determining in-stent restenosis (ISR) likelihood in patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI).
Methods: The study enrolled 903 ACS patients undergoing PCI, categorized into ISR (+) and ISR (-) groups based on control coronary angiography results. Demographic, clinical, laboratory, and angiographic-procedural characteristics were systematically compared.
Results: The ISR (+) group encompassed 264 individuals (29.2%), while the ISR (-) group comprised 639 individuals (70.8%). Patients had a mean age of 55.8 ± 10.2 years, with 69% being male. The ISR (+) group had higher diabetes and smoking prevalence and notably larger stent dimensions. Lab parameters showed significantly elevated creatinine, total cholesterol, red cell distribution width, white blood cell and neutrophil counts, SII index and C-reactive protein (CRP) in the ISR (+) group, while lymphocyte levels were lower. Binary logistic regression identified stent diameter (odds ratio [OR]: 0.598, 95% confidence interval [CI]: 0.383-0.935; P = 0.024), stent length (OR: 1.166, 95% CI: 1.132-1.200; P < 0.001), creatinine (OR: 0.366, 95% CI: 0.166-0.771; P = 0.003), CRP (OR: 1.075, 95% CI: 1.042-1.110; P = 0.031), and SII index (OR: 1.014, 95% CI: 1.001-1.023; P < 0.001) as independent ISR predictors.
Conclusion: The SII index exhibits potential as a predictive marker for ISR in ACS patients post-PCI, indicating systemic inflammation and heightened restenosis risk. Integrating the SII index into risk models could identify high-risk patients for targeted interventions.
{"title":"Systemic immune inflammation index and its implication on in-stent restenosis among patients with acute coronary syndrome.","authors":"Altuğ Ösken, Fuat Polat, Bilal Çakir, Ahmet Zengin, Ali Nazmi Çalik, Şennur Ünal Dayi, Neşe Çam","doi":"10.1097/MCA.0000000000001325","DOIUrl":"10.1097/MCA.0000000000001325","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the predictive value of the Systemic Immune Inflammation Index (SII) in determining in-stent restenosis (ISR) likelihood in patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>The study enrolled 903 ACS patients undergoing PCI, categorized into ISR (+) and ISR (-) groups based on control coronary angiography results. Demographic, clinical, laboratory, and angiographic-procedural characteristics were systematically compared.</p><p><strong>Results: </strong>The ISR (+) group encompassed 264 individuals (29.2%), while the ISR (-) group comprised 639 individuals (70.8%). Patients had a mean age of 55.8 ± 10.2 years, with 69% being male. The ISR (+) group had higher diabetes and smoking prevalence and notably larger stent dimensions. Lab parameters showed significantly elevated creatinine, total cholesterol, red cell distribution width, white blood cell and neutrophil counts, SII index and C-reactive protein (CRP) in the ISR (+) group, while lymphocyte levels were lower. Binary logistic regression identified stent diameter (odds ratio [OR]: 0.598, 95% confidence interval [CI]: 0.383-0.935; P = 0.024), stent length (OR: 1.166, 95% CI: 1.132-1.200; P < 0.001), creatinine (OR: 0.366, 95% CI: 0.166-0.771; P = 0.003), CRP (OR: 1.075, 95% CI: 1.042-1.110; P = 0.031), and SII index (OR: 1.014, 95% CI: 1.001-1.023; P < 0.001) as independent ISR predictors.</p><p><strong>Conclusion: </strong>The SII index exhibits potential as a predictive marker for ISR in ACS patients post-PCI, indicating systemic inflammation and heightened restenosis risk. Integrating the SII index into risk models could identify high-risk patients for targeted interventions.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-20DOI: 10.1097/MCA.0000000000001346
Won-Jang Kim, Ha Jeong Lim, Jae Youn Moon, Sang-Hoon Kim, Jung-Hoon Sung, In Jai Kim, Sang-Wook Lim, Dong-Hun Cha, Se Hun Kang
Background: Obesity is often considered a risk factor for cardiovascular disease, but recent studies have shown conflicting results regarding the effect of BMI on the prognosis of coronary artery disease (CAD). This study aimed to evaluate the relationship between BMI and clinical outcomes of CAD according to sex in a Korean population.
Methods: A total of 3476 patients with a significant CAD who underwent percutaneous coronary intervention (PCI) were enrolled. Patients were classified as follows according to BMI using the Asia-Pacific cutoff points: underweight (<18.5 kg/m 2 ), normal weight (18.5-22.9 kg/m 2 ), overweight (23.0-24.9 kg/m 2 ) and obese (≥25 kg/m 2 ) patients. Underweight and normal weight patients were further categorized into the lower BMI group, whereas overweight and obese patients were categorized into the higher BMI group. The primary endpoint was all-cause mortality.
Results: Among women, the higher BMI group showed poor clinical features in the prevalence of hypertension and chest pain presentation, and among men, the higher BMI group had a significantly lower rate of chronic renal failure. At the end of the follow-up period (median 53.5 months), the all-cause mortality rate was lower in the higher BMI group in men, and cardiovascular death and stroke rates were significantly lower in the higher BMI group in women.
Conclusion: In Korean CAD patients treated with PCI, inverse correlations were observed between the clinical outcomes and BMI, but there were differences between men and women.
{"title":"Sex differences in the impact of body mass index on outcomes of coronary artery disease in Koreans.","authors":"Won-Jang Kim, Ha Jeong Lim, Jae Youn Moon, Sang-Hoon Kim, Jung-Hoon Sung, In Jai Kim, Sang-Wook Lim, Dong-Hun Cha, Se Hun Kang","doi":"10.1097/MCA.0000000000001346","DOIUrl":"10.1097/MCA.0000000000001346","url":null,"abstract":"<p><strong>Background: </strong>Obesity is often considered a risk factor for cardiovascular disease, but recent studies have shown conflicting results regarding the effect of BMI on the prognosis of coronary artery disease (CAD). This study aimed to evaluate the relationship between BMI and clinical outcomes of CAD according to sex in a Korean population.</p><p><strong>Methods: </strong>A total of 3476 patients with a significant CAD who underwent percutaneous coronary intervention (PCI) were enrolled. Patients were classified as follows according to BMI using the Asia-Pacific cutoff points: underweight (<18.5 kg/m 2 ), normal weight (18.5-22.9 kg/m 2 ), overweight (23.0-24.9 kg/m 2 ) and obese (≥25 kg/m 2 ) patients. Underweight and normal weight patients were further categorized into the lower BMI group, whereas overweight and obese patients were categorized into the higher BMI group. The primary endpoint was all-cause mortality.</p><p><strong>Results: </strong>Among women, the higher BMI group showed poor clinical features in the prevalence of hypertension and chest pain presentation, and among men, the higher BMI group had a significantly lower rate of chronic renal failure. At the end of the follow-up period (median 53.5 months), the all-cause mortality rate was lower in the higher BMI group in men, and cardiovascular death and stroke rates were significantly lower in the higher BMI group in women.</p><p><strong>Conclusion: </strong>In Korean CAD patients treated with PCI, inverse correlations were observed between the clinical outcomes and BMI, but there were differences between men and women.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10965134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-03-07DOI: 10.1097/MCA.0000000000001354
Seong Joon An, Woo Jin Ahn, Seung-Woon Rha, Soohyung Park, Su Jin Hyun, Jin Ah Cha, Jae Kyeong Byun, Se Yeon Choi, Cheol Ung Choi, Dong Joo Oh, Byoung Geol Choi
Background: A growing evidence on the correlation between hyperuricemia and cardiovascular disease (CVD) has been previously reported. However, there have been limited data on the impact of hyperuricemia on long-term clinical outcomes in patients with critical limb ischemia (CLI) who underwent percutaneous transluminal angioplasty (PTA).
Methods: A total of 425 peripheral artery disease patients who underwent PTA for CLI were enrolled. The patients were divided into the hyperuricemia group (n = 101) and the normal group (n = 324). The primary endpoint was major adverse cerebral and cardiovascular event (MACCE), including death, myocardial infarction, any coronary revascularization, and stroke, up to 5 years. The secondary endpoint was a major adverse limb event (MALE), including any repeated PTA, and target extremity surgery. Inverse probability weighting (IPTW) analysis, derived from the logistic regression model, was performed to adjust for potential confounders.
Results: After IPTW matching analysis, compared to the normal group, the hyperuricemia group was associated with a higher incidence of MACCE (20.7% vs. 13.6%, hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.15-2.38, P = 0.006) including non-cardiac death (11.7% vs. 6.3%, HR: 1.95, 95% CI: 1.19-3.19, P = 0.006) and MALE (47.7% vs. 36.0%, HR: 1.62, 95% CI: 1.23-2.13, P = 0.001) including non-target extremity revascularization (15.0% vs. 6.8%, HR: 2.42, 95% CI: 1.52-3.84, P < 0.001).
Conclusion: In the present study, hyperuricemia was associated with worse clinical outcomes in patients with CLI following PTA during 5-year clinical follow-up. Efficacy of controlling hyperuricemia in improving clinical outcomes should be evaluated in further studies.
背景:越来越多的证据表明,高尿酸血症与心血管疾病(CVD)之间存在关联。然而,关于高尿酸血症对接受经皮腔内血管成形术(PTA)的危重肢体缺血(CLI)患者长期临床预后的影响,目前的数据还很有限:方法:共招募了425名接受经皮穿刺血管成形术治疗CLI的外周动脉疾病患者。这些患者被分为高尿酸血症组(n = 101)和正常组(n = 324)。主要终点是主要脑和心血管不良事件(MACCE),包括死亡、心肌梗死、任何冠状动脉血运重建和中风,持续时间长达5年。次要终点是肢体重大不良事件(MALE),包括任何重复 PTA 和目标肢体手术。根据逻辑回归模型进行了反概率加权(IPTW)分析,以调整潜在的混杂因素:IPTW匹配分析后,与正常组相比,高尿酸血症组的MACCE发生率更高(20.7% vs. 13.6%,危险比[HR],1.65;95%置信区间[CI],1.15-2.38,P = 0.006),包括非心源性死亡(11.7% vs. 6.3%,HR:1.95,95% CI:1.19-3.19,P = 0.006)和MALE(47.7% vs. 36.0%,HR:1.62,95% CI:1.23-2.13,P = 0.001),包括非目标肢体血运重建(15.0% vs. 6.8%,HR:2.42,95% CI:1.52-3.84,P 结论:在本研究中,高尿酸血症与PTA术后CLI患者5年临床随访期间较差的临床预后有关。控制高尿酸血症对改善临床预后的效果应在进一步的研究中进行评估。
{"title":"Impact of hyperuricemia on 5-year clinical outcomes in patients with critical limb ischemia following percutaneous transluminal angioplasty.","authors":"Seong Joon An, Woo Jin Ahn, Seung-Woon Rha, Soohyung Park, Su Jin Hyun, Jin Ah Cha, Jae Kyeong Byun, Se Yeon Choi, Cheol Ung Choi, Dong Joo Oh, Byoung Geol Choi","doi":"10.1097/MCA.0000000000001354","DOIUrl":"10.1097/MCA.0000000000001354","url":null,"abstract":"<p><strong>Background: </strong>A growing evidence on the correlation between hyperuricemia and cardiovascular disease (CVD) has been previously reported. However, there have been limited data on the impact of hyperuricemia on long-term clinical outcomes in patients with critical limb ischemia (CLI) who underwent percutaneous transluminal angioplasty (PTA).</p><p><strong>Methods: </strong>A total of 425 peripheral artery disease patients who underwent PTA for CLI were enrolled. The patients were divided into the hyperuricemia group (n = 101) and the normal group (n = 324). The primary endpoint was major adverse cerebral and cardiovascular event (MACCE), including death, myocardial infarction, any coronary revascularization, and stroke, up to 5 years. The secondary endpoint was a major adverse limb event (MALE), including any repeated PTA, and target extremity surgery. Inverse probability weighting (IPTW) analysis, derived from the logistic regression model, was performed to adjust for potential confounders.</p><p><strong>Results: </strong>After IPTW matching analysis, compared to the normal group, the hyperuricemia group was associated with a higher incidence of MACCE (20.7% vs. 13.6%, hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.15-2.38, P = 0.006) including non-cardiac death (11.7% vs. 6.3%, HR: 1.95, 95% CI: 1.19-3.19, P = 0.006) and MALE (47.7% vs. 36.0%, HR: 1.62, 95% CI: 1.23-2.13, P = 0.001) including non-target extremity revascularization (15.0% vs. 6.8%, HR: 2.42, 95% CI: 1.52-3.84, P < 0.001).</p><p><strong>Conclusion: </strong>In the present study, hyperuricemia was associated with worse clinical outcomes in patients with CLI following PTA during 5-year clinical follow-up. Efficacy of controlling hyperuricemia in improving clinical outcomes should be evaluated in further studies.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-01-23DOI: 10.1097/MCA.0000000000001328
Zhanwen Xu, Yaqin Li, Yi Liu
This imaging observation underscores a rare single coronary artery anomaly, wherein the right coronary artery originates from the left anterior descending artery (LAD). The stenosis in the proximal LAD adds complexity, emphasizing the need for multidisciplinary evaluation and decision-making.
{"title":"Anomalous right coronary artery originating from the left anterior descending artery with stenosis: a highlighted imaging observation.","authors":"Zhanwen Xu, Yaqin Li, Yi Liu","doi":"10.1097/MCA.0000000000001328","DOIUrl":"10.1097/MCA.0000000000001328","url":null,"abstract":"<p><p>This imaging observation underscores a rare single coronary artery anomaly, wherein the right coronary artery originates from the left anterior descending artery (LAD). The stenosis in the proximal LAD adds complexity, emphasizing the need for multidisciplinary evaluation and decision-making.</p>","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-20DOI: 10.1097/MCA.0000000000001338
Francesco Amata, Ottavia Cozzi, Damiano Regazzoli, Gabriele Gasparini, Antonio Mangieri, Bernhard Reimers, Giulio Giuseppe Stefanini
{"title":"Anomalous common origin of the coronary arteries from a single ostium in the right sinus of Valsalva without a proper left main stem.","authors":"Francesco Amata, Ottavia Cozzi, Damiano Regazzoli, Gabriele Gasparini, Antonio Mangieri, Bernhard Reimers, Giulio Giuseppe Stefanini","doi":"10.1097/MCA.0000000000001338","DOIUrl":"10.1097/MCA.0000000000001338","url":null,"abstract":"","PeriodicalId":10702,"journal":{"name":"Coronary artery disease","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}