Revista espanola de cardiologia最新文献

{"title":"Consecuencias clínicas de los límites superiores de referencia ajustados al sexo de la troponina cardiaca I ultrasensible en el diagnóstico del infarto agudo de miocardio","authors":"María Rubini Giménez ,&nbsp;Luca Koechlin ,&nbsp;Pedro López-Ayala ,&nbsp;Carlos Spagnuolo ,&nbsp;Jasper Boeddinghaus ,&nbsp;Karin Wildi ,&nbsp;Thomas Nestelberger ,&nbsp;Hanna Tkachenko ,&nbsp;Daniel Basic ,&nbsp;Emel Kaplan ,&nbsp;Jude Formambuh ,&nbsp;Paolo Bima ,&nbsp;Jonas Glaeser ,&nbsp;Luca Crisanti ,&nbsp;Óscar Miró ,&nbsp;F. Javier Martín-Sánchez ,&nbsp;Michael Christ ,&nbsp;Dagmar I. Keller ,&nbsp;Danielle M. Gualandro ,&nbsp;Damian Kawecki ,&nbsp;Arnold von Eckardstein","doi":"10.1016/j.recesp.2025.05.001","DOIUrl":"10.1016/j.recesp.2025.05.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>It is unclear whether applying sex-specific rather than uniform upper reference limits (URLs) for high-sensitivity cardiac troponin I (hs-cTnI) improves diagnostic equity between women and men with suspected myocardial infarction (MI). We compared the diagnostic performance of these 2 approaches.</div></div><div><h3>Methods</h3><div>In an international, prospective, multicenter study of patients presenting with suspected MI, the final diagnosis was centrally adjudicated twice by 2 independent cardiologists using all available information, including serial measurements of hs-cTnI-Architect, once using the uniform URL (26.2 ng/L) and once using sex-specific URLs (women: 15.6 ng/L; men: 34.2 ng/L). The primary outcome was the diagnostic performance of uniform vs sex-specific URLs at presentation for MI.</div></div><div><h3>Results</h3><div>Among 7137 eligible patients, 2434 were women (34%), median age 65 years, and 4703 were men (66%), median age 59 years. Using the uniform URL, 348 women and 880 men were adjudicated as having MI. At presentation, the sensitivity and specificity of hs-cTnI were high and similar in women (77%; 95%CI, 72-81, and 93%; 95%CI, 92-94, respectively) and men (79%; 95%CI, 77-82, and 94%; 95%CI, 93-94). Using sex-specific URLs, the sensitivity and specificity were 85% (95%CI, 81-89) and 91% (95%CI, 89-92) in women vs 74% (95%CI, 71-77), and 95% (95%CI, 94-95) in men (<em>P</em> <!-->&lt;<!--> <!-->.001). Using sex-specific URLs, diagnostic reclassification occurred in 27 patients, 12 women (upgrade to MI) and 15 men (downgrade from MI), representing 0.4%, (95%CI, 0.3-0.6) of all patients.</div></div><div><h3>Conclusions</h3><div>Using a uniform URL for hs-cTnI provides high and similar diagnostic sensitivity and specificity in women and men. Contrary to expectations, sex-specific URLs introduced sex-related disparities. These findings support the use of a uniform rather than sex-specific URL in the diagnosis of MI.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1064-1075"},"PeriodicalIF":5.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registro español de marcapasos. XXII informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2024)","authors":"Francisco Javier García-Fernández ,&nbsp;Rocío Cózar-León ,&nbsp;Josep Navarro-Manchón ,&nbsp;Manuel Molina-Lerma ,&nbsp;David Calvo ,&nbsp;en representación de los colaboradores del Registro español de marcapasos","doi":"10.1016/j.recesp.2025.07.006","DOIUrl":"10.1016/j.recesp.2025.07.006","url":null,"abstract":"<div><h3>Introduction</h3><div>This report presents data on cardiac pacing system implants in Spain during 2024.</div></div><div><h3>Methods</h3><div>The registry is based on data voluntarily submitted by implanting centers to the Heart Rhythm Association of the Spanish Society of Cardiology via the national online platform, <em>CardioDispositivos</em>. Additional data sources included: <em>a)</em> data provided by device manufacturers and distributors, <em>b)</em> the European pacemaker patient card, and <em>c)</em> local databases submitted by implanting centers.</div></div><div><h3>Results</h3><div>A total of 128 hospitals submitted data to the registry (16 more than in 2023 and 46 more than in 2022). In total, 26 412 units were reported (an 8.5% increase compared with 2023 and 60.8% compared with 2022), vs 47 162 units reported by Eucomed (European Confederation of Medical Suppliers Associations). Among these, 1715 were cardiac resynchronization pacemakers. Leadless pacemaker use continued to rise (1049 devices), accounting for 2.2% of all pacemakers. The most common indication was atrioventricular block, followed by atrial tachyarrhythmia with slow ventricular response. Devices included in remote monitoring also increased: the most notable growth was observed in high-energy resynchronization devices (87%) and leadless pacemakers (38%). Moderate increases were also noted for conventional cardiac resynchronization pacemakers (59%) and standard pacemakers (39%).</div></div><div><h3>Conclusions</h3><div>Participation in the pacemaker registry continues to grow, reaching 56% of the number of units reported by manufacturers to Eucomed. Remote monitoring maintains the slow but steady growth trend observed in recent years.</div><div><em>Full English text available from</em>:<span><span>www.revespcardiol.org/en</span><svg><path></path></svg></span></div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1076-1087"},"PeriodicalIF":5.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevención primaria en personas mayores: diferencias por sexo en la persistencia al tratamiento con estatinas y el control del colesterol","authors":"Sara Malo ,&nbsp;María José Rabanaque ,&nbsp;Adriana Gamba ,&nbsp;José Manuel Vinuesa-Hernando ,&nbsp;Aida Moreno-Juste ,&nbsp;María Jesús Lallana ,&nbsp;Jesús Cebollada ,&nbsp;Isabel Aguilar-Palacio","doi":"10.1016/j.recesp.2025.05.007","DOIUrl":"10.1016/j.recesp.2025.05.007","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>This study aimed to analyze sex differences in statin persistence and associated factors among individuals aged 70 years and older in Spain who initiated statin therapy for primary prevention of cardiovascular disease. Additionally, it assessed the role of sex in low-density lipoprotein cholesterol (LDL-C) control based on the intensity of statin therapy used.</div></div><div><h3>Methods</h3><div>This was an observational longitudinal study conducted within the CARhES (Cardiovascular risk factors for health services research) cohort. Individuals aged ≥ 70 years who initiated statin therapy for primary prevention of cardiovascular disease between 2018 and 2020 were included. Two-year statin persistence was assessed by sex. Considering major cardiovascular events and death as competing risks, the risk of statin discontinuation and its associated factors were estimated using cumulative incidence functions and Fine and Gray analysis. The proportion of men and women achieving LDL-C target levels was also calculated.</div></div><div><h3>Results</h3><div>A total of 4936 older adults (61.7% women) were included. Compared with men, women had higher mean LDL-C levels prior to statin initiation, a greater pharmacological burden, were less likely to receive high-intensity statins, and demonstrated lower persistence. No variables were statistically associated with discontinuation among women. In men, the adjusted HR for discontinuation was 1.03 (95%CI: 1.00-1.06) per 10<!--> <!-->mg/dL increase in baseline LDL-C level. Among persistent statin users, women were less likely than men to achieve LDL-C targets, particularly when treated with low- to moderate-intensity statins.</div></div><div><h3>Conclusions</h3><div>Significant sex differences exist in statin persistence, associated factors, and achievement of LDL-C targets among older adults. These findings highlight the importance of considering sex-specific factors when evaluating the appropriateness of statin use in this population.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 15-23"},"PeriodicalIF":5.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluación mediante ecocardiografía tridimensional de la geometría del anillo tricuspídeo en niños con cardiopatías congénitas","authors":"Ramona Ghenghea ,&nbsp;Clement Karsenty ,&nbsp;Pierrick Pyra ,&nbsp;Aitor Guitarte ,&nbsp;Yves Dulac ,&nbsp;Paul Vignaud ,&nbsp;Philippe Acar ,&nbsp;Khaled Hadeed","doi":"10.1016/j.recesp.2025.05.013","DOIUrl":"10.1016/j.recesp.2025.05.013","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The tricuspid annulus (TA) in congenital heart diseases (CHD) may undergo significant changes in size, shape, and function due to hemodynamic overload. This study aimed to compare TA remodeling in children with CHD based on the type of right ventricle (RV) overload, using three-dimensional transthoracic echocardiography (3D-TTE).</div></div><div><h3>Methods</h3><div>This prospective case-control study included children with CHD who were divided into 2 groups based on the type of RV overload. Using 3D-TTE, we assessed the dimensions of the right chambers, the surface area, and the tenting volume of the TA, and analyzed the correlation among these measurements.</div></div><div><h3>Results</h3><div>A total of 90 patients were enrolled: 30 with pretricuspid overload (atrial septal defect and partial anomalous pulmonary venous connection), 33 with posttricuspid overload (pulmonary regurgitation after RV outflow tract surgery), and 27 healthy controls. 3D TA surface area was larger in the pretricuspid group than in the posttricuspid group (median 6.60<!--> <!-->cm²/m² vs 5.16<!--> <!-->cm²/m²; <em>P</em> <!-->=<!--> <!-->.01) and was correlated with right atrial (RA) volume (<em>P</em> <!-->=<!--> <!-->.0001, r<!--> <!-->=<!--> <!-->0.66) and RA surface area (<em>P</em> <!-->&lt;<!--> <!-->.0001, r<!--> <!-->=<!--> <!-->0.74) in the pretricuspid group. The tenting volume was greater in the posttricuspid group than in the control group. The 3D TA surface area and tenting volume were not correlated with RV end-diastolic volume.</div></div><div><h3>Conclusions</h3><div>3D modeling of the TA using 3D-TTE is feasible and provides insights into TA remodeling in different RV overload conditions. RA volume and surface area are key determinants of TA size, which could have an impact on therapeutic strategies in patients with tricuspid regurgitation.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 59-67"},"PeriodicalIF":5.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precisión diagnóstica del cociente cuantitativo de flujo en lesiones intermedias no culpables de pacientes con infarto agudo de miocardio con elevación del segmento ST","authors":"Emilio Alfonso Rodríguez ,&nbsp;Josep Gómez-Lara ,&nbsp;Ramón López-Palop ,&nbsp;Enrique Gutiérrez ,&nbsp;Luis Renier Goncalves Ramírez ,&nbsp;José Valencia ,&nbsp;Alfonso Jurado-Román ,&nbsp;Juan Gabriel Córdoba Soriano ,&nbsp;Antonio Gómez-Menchero ,&nbsp;Estefanía Fernández-Peregrina ,&nbsp;Carlos Cortés ,&nbsp;Paula Tejedor ,&nbsp;Raúl Millán ,&nbsp;Guillermo Sánchez-Elvira ,&nbsp;Tamara García-Camarero ,&nbsp;José Antonio Linares Vicente ,&nbsp;Eva Rúmiz ,&nbsp;Rosa María Cardenal Piris ,&nbsp;Irene Elizondo Rua ,&nbsp;Jean Paul Vílchez ,&nbsp;Joan Antoni Gómez-Hospital","doi":"10.1016/j.recesp.2025.05.010","DOIUrl":"10.1016/j.recesp.2025.05.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The reliability of quantitative flow ratio (QFR) has been questioned. Our aim was to evaluate the diagnostic accuracy of QFR in intermediate nonculprit lesions during the index ST-segment elevation myocardial infarction (STEMI) procedure compared with positive pressure wire-based fractional flow reserve (FFR ≤<!--> <!-->0.80) in a staged procedure.</div></div><div><h3>Methods</h3><div>This was a substudy of the multicenter, controlled, and randomized VULNERABLE trial, including 428 intermediate nonculprit lesions from 388 consecutive STEMI patients undergoing FFR assessment in a staged procedure between 1 and 60 days. Off-line QFR analyses were performed during both the index and staged procedures. The primary objective was to assess the diagnostic accuracy of index QFR compared with staged positive FFR.</div></div><div><h3>Results</h3><div>Angiographic vessel diameter (2.80<!--> <!-->±<!--> <!-->0.59 vs 2.91<!--> <!-->±<!--> <!-->0.57<!--> <!-->mm; <em>P</em> <!-->&lt;<!--> <!-->.01), stenosis severity (51.33<!--> <!-->±<!--> <!-->8.04% vs 50.54<!--> <!-->±<!--> <!-->7.63%; <em>P</em> <!-->=<!--> <!-->.053), and QFR values (0.85<!--> <!-->±<!--> <!-->0.09 vs 0.86<!--> <!-->±<!--> <!-->0.09; <em>P</em> <!-->=<!--> <!-->.120) showed minimal changes between the index and staged procedures. Moderate concordance was observed between index QFR and staged FFR (kappa index<!--> <!-->=<!--> <!-->0.629; intraclass correlation coefficient<!--> <!-->=<!--> <!-->0.641). The diagnostic accuracy of index QFR for predicting positive FFR was good (area under the curve<!--> <!-->=<!--> <!-->0.825). An index QFR cutoff ≤<!--> <!-->0.80 showed moderate sensitivity (72%) and excellent specificity (91%). An index QFR ≤<!--> <!-->0.87 achieved a sensitivity of 86% for detecting lesions with positive FFR, with 55% of lesions presenting QFR ≤<!--> <!-->0.87 at the index procedure.</div></div><div><h3>Conclusions</h3><div>Index QFR demonstrated good diagnostic accuracy for identifying lesions with positive FFR in a staged procedure. However, an index QFR cutoff value of ≤<!--> <!-->0.80 showed moderate sensitivity and may underdiagnose approximately 3 out of 10 lesions with positive FFR. An index QFR ≤<!--> <!-->0.87 provided higher sensitivity and may help avoid invasive (staged) procedures in many patients.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 49-58"},"PeriodicalIF":5.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registro español de hemodinámica y cardiología intervencionista. XXXIV informe oficial de la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (1990-2024)","authors":"Teresa Bastante ,&nbsp;Dabit Arzamendi ,&nbsp;Javier Martín-Moreiras ,&nbsp;Ana Belén Cid-Álvarez ,&nbsp;en representación de la ACI-SEC","doi":"10.1016/j.recesp.2025.07.003","DOIUrl":"10.1016/j.recesp.2025.07.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>This report presents the 2024 activity data from the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC).</div></div><div><h3>Methods</h3><div>All interventional cardiology laboratories in Spain were invited to complete an online survey. Data analysis was conducted by an external company and then reviewed and presented by the ACI-SEC board<em>.</em></div></div><div><h3>Results</h3><div>A total of 118 hospitals participated, with a marked increase in the number of catheterization laboratories. The number of diagnostic procedures rose by 3.6%. Percutaneous coronary interventions (PCI) also increased. Although PCI volumes grew compared with 2023, the trend toward a reduction in the number of stents used was confirmed, with greater use of drug-coated balloons both as standalone treatment and in hybrid strategies (14.3% of PCIs involved drug-coated balloons). Overall, the use of intracoronary diagnostic techniques increased, with 10.6% of PCIs guided by intracoronary imaging. Plaque modification techniques also continued to grow. Primary PCI increased slightly and remained the predominant treatment for myocardial infarction (98%). Structural interventions continued to expand, with substantial growth in transcatheter aortic valve implantation, percutaneous edge-to-edge mitral repair, tricuspid interventions, and left atrial appendage closure. Interventional treatment for acute pulmonary embolism increased again in 2024, especially with dedicated devices.</div></div><div><h3>Conclusions</h3><div>The 2024 Spanish cardiac catheterization and interventional cardiology registry showed overall growth in all procedures, both coronary and structural.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 11","pages":"Pages 992-1003"},"PeriodicalIF":5.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inteligencia artificial (IA): una de arena…","authors":"Fernando A. Navarro","doi":"10.1016/j.recesp.2025.07.001","DOIUrl":"10.1016/j.recesp.2025.07.001","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 1-2"},"PeriodicalIF":5.9,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El diagnóstico etiológico en miocarditis: ¿una asignatura aún pendiente?","authors":"Fernando Domínguez","doi":"10.1016/j.recesp.2025.06.011","DOIUrl":"10.1016/j.recesp.2025.06.011","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 12","pages":"Pages 1118-1119"},"PeriodicalIF":5.9,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aumento de la mortalidad cardiovascular en personas con discapacidad. Un nuevo reto que hay que afrontar","authors":"Pedro Armario ,&nbsp;Montserrat Martín-Baranera","doi":"10.1016/j.recesp.2025.05.014","DOIUrl":"10.1016/j.recesp.2025.05.014","url":null,"abstract":"","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 1","pages":"Pages 13-14"},"PeriodicalIF":5.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrategia de reducción de stents frente a revascularización coronaria percutánea convencional en el IAMCEST: diseño del ensayo COPERNICAN","authors":"Jorge Sanz-Sánchez ,&nbsp;Sandra Santos Martínez ,&nbsp;Eva Rumiz González ,&nbsp;Juan Francisco Oteo Domínguez ,&nbsp;David Tejada Ponce ,&nbsp;Antonio Gómez Menchero ,&nbsp;Guillermo Sánchez Elvira ,&nbsp;Georgina Fuertes Ferre ,&nbsp;Fernando Rivero Crespo ,&nbsp;Antonela Lukic Otanovic ,&nbsp;José Díaz Fernández ,&nbsp;Eladio Galindo Fernández ,&nbsp;Cristóbal Urbano Carrillo ,&nbsp;Neus Salvatella Giralt ,&nbsp;Mauricio Torres Sánchez ,&nbsp;Arturo García Touchard ,&nbsp;Borja Ibáñez Cabeza ,&nbsp;Giulio Stefanini ,&nbsp;Fernando Alfonso Manterola ,&nbsp;Héctor García García ,&nbsp;Ignacio J. Amat-Santos","doi":"10.1016/j.recesp.2025.05.006","DOIUrl":"10.1016/j.recesp.2025.05.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Primary percutaneous coronary intervention (PCI) with drug-eluting stent implantation (DES) is the standard of treatment in patients presenting with ST-segment elevation myocardial infarction (STEMI). However, target lesion failure can occur due to stent underexpansion, malapposition, hypersensitivity, fracture, and neoatherosclerosis. Drug-coated balloons (DCB) represent a potential alternative supported by the concept of “leaving nothing behind.” The aim is to compare a reduced stent strategy based on DCB- with DES-PCI in patients presenting with STEMI.</div></div><div><h3>Methods</h3><div>Prospective, pragmatic, multicenter, noninferiority, randomized clinical trial.</div></div><div><h3>Results</h3><div>A total of 1 272 patients presenting with STEMI will be randomized to any paclitaxel-DCB vs any sirolimus-DES (both with CE approval) for all culprit and nonculprit lesions during PCI. The primary endpoint will be target-lesion failure: cardiac death, target-vessel myocardial infarction, or ischemia-driven target lesion revascularization at 12-month follow-up. An independent clinical events committee masked to treatment allocation will adjudicate all suspected events. Clinical follow-up will be performed after 1 month (30 days<!--> <!-->±<!--> <!-->5 days) and 1 year (365 days<!--> <!-->±<!--> <!-->30 days). An extended follow-up at 3, 5, and 10 years is planned.</div></div><div><h3>Conclusions</h3><div>The COPERNICAN trial will be the first randomized study comparing clinical outcomes of DCB vs DES in STEMI patients.</div><div>ClinicalTrials.gov: <span><span>NCT06353594</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"79 2","pages":"Pages 100-105"},"PeriodicalIF":5.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}