Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.02.010
Pierfrancesco Agostoni , Jan-Peter Van Kuijk , Paul Knaapen , Farhat Fouladvand , Martin Hudec , Antonino Nicosia , Kari Kervinen , Salvatore Davide Tomasello , Ramesh Singh Arjan Singh , Girish N. Vishwanathan , Béla Merkely , Houng Bang Liew , Khalid Al Faraidy , Clive Corbett , Saleem Dawood , Anirban Choudhury , Imad Abdelhafiz Alhaddad , Azfar Zaman , Adriaan O. Kraaijeveld , Martino Pepe
Background
Percutaneous coronary intervention (PCI) of long coronary artery lesions (CAL) presents a puzzle, often requiring multiple stents. As the arteries twist and narrow, this becomes even more challenging with issues like potential distal overexpansion and proximal under expansion, and edge dissections. The study aims to assess the safety and performance of BioMime™ Morph sirolimus-eluting stent (SES) in individuals with long CAL.
Methods
This prospective, single-arm, multi-center, observational, real-world registry, included 565 patients with long CAL (length 30 to ≤56 mm) in native coronary arteries (reference vessel diameters: 2.25 mm to 3.50 mm). Based on lesion length, patients were implanted with 30 mm, 40 mm, 50 mm, or 60 mm BioMime™ Morph SES. Primary endpoint was freedom of target lesion failure (TLF) at 6-month and up to 36-month.
Results
Over 65 % of patients had lesions requiring 50 mm and 60 mm stents. The follow-up length was up to 24-month for the whole cohort and up to 36-month only for 211 patients from seven selected centers. The freedom from TLF rate was 97.86 %, 97.26 %, 96.27 %, and 95.15 % at 6-, 12-, 24-, and 36-month follow-ups, respectively. The cumulative rates of major adverse cardiac events (MACE) were 2.74 % at 12-month, 3.73 % at 24-month and 4.85 % at 36-month. Additionally, the rates of ischemia-driven target lesion revascularization were 2.01 % at 12-month, 2.16 % at 24-month, and 3.88 % at 36-month. Lastly, stent thrombosis (ST) was reported in only 2 cases (0.97 %) at 36-month.
Conclusion
The lower incidences of MACE and ST up to three-year follow-up indicate BioMime™ Morph SES is an effective and safe option for PCI in long CAL.
{"title":"Clinical outcomes of the BioMime™ morph coronary stent system for long (30 to ≤56 mm length) coronary lesions: Three-year follow-up of the Morpheus Global Registry","authors":"Pierfrancesco Agostoni , Jan-Peter Van Kuijk , Paul Knaapen , Farhat Fouladvand , Martin Hudec , Antonino Nicosia , Kari Kervinen , Salvatore Davide Tomasello , Ramesh Singh Arjan Singh , Girish N. Vishwanathan , Béla Merkely , Houng Bang Liew , Khalid Al Faraidy , Clive Corbett , Saleem Dawood , Anirban Choudhury , Imad Abdelhafiz Alhaddad , Azfar Zaman , Adriaan O. Kraaijeveld , Martino Pepe","doi":"10.1016/j.carrev.2025.02.010","DOIUrl":"10.1016/j.carrev.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous coronary intervention (PCI) of long coronary artery lesions (CAL) presents a puzzle, often requiring multiple stents. As the arteries twist and narrow, this becomes even more challenging with issues like potential distal overexpansion and proximal under expansion, and edge dissections. The study aims to assess the safety and performance of BioMime™ Morph sirolimus-eluting stent (SES) in individuals with long CAL.</div></div><div><h3>Methods</h3><div>This prospective, single-arm, multi-center, observational, real-world registry, included 565 patients with long CAL (length 30 to ≤56 mm) in native coronary arteries (reference vessel diameters<span>: 2.25 mm to 3.50 mm). Based on lesion length, patients were implanted with 30 mm, 40 mm, 50 mm, or 60 mm BioMime™ Morph SES. Primary endpoint was freedom of target lesion failure (TLF) at 6-month and up to 36-month.</span></div></div><div><h3>Results</h3><div><span>Over 65 % of patients had lesions requiring 50 mm and 60 mm stents. The follow-up length was up to 24-month for the whole cohort and up to 36-month only for 211 patients from seven selected centers. The freedom from TLF rate was 97.86 %, 97.26 %, 96.27 %, and 95.15 % at 6-, 12-, 24-, and 36-month follow-ups, respectively. The cumulative rates of major adverse cardiac events (MACE) were 2.74 % at 12-month, 3.73 % at 24-month and 4.85 % at 36-month. Additionally, the rates of ischemia-driven </span>target lesion revascularization<span> were 2.01 % at 12-month, 2.16 % at 24-month, and 3.88 % at 36-month. Lastly, stent thrombosis (ST) was reported in only 2 cases (0.97 %) at 36-month.</span></div></div><div><h3>Conclusion</h3><div>The lower incidences of MACE and ST up to three-year follow-up indicate BioMime™ Morph SES is an effective and safe option for PCI in long CAL.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 39-47"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.06.031
Mohammad Reza Movahed
{"title":"True bifurcation lesions should only be studied in bifurcation research","authors":"Mohammad Reza Movahed","doi":"10.1016/j.carrev.2025.06.031","DOIUrl":"10.1016/j.carrev.2025.06.031","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Page 135"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.06.023
Sant Kumar , George Bcharah , Mahmoud Abdelnabi , Linnea M. Baudhuin , Ramzi Ibrahim , Hussein Abdul Nabi , Girish Pathangey , Hend Bcharah , Estefana Bcharah , Yuxiang Wang , Mayo A. Osundiji , Fadi E. Shamoun
Background
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction, frequently associated with connective tissue disorder (CTD) features such as joint hypermobility and scoliosis. However, the clinical impact of these features in patients with SCAD remains poorly characterized. This study aimed to investigate the prevalence of CTD features among SCAD patients and evaluate their influence on adverse cardiovascular outcomes, including recurrent myocardial infarction, stroke, and mortality, to facilitate better risk stratification and targeted clinical management.
Methods
This retrospective study analyzed 1380 patients diagnosed with SCAD from Mayo Clinic sites (2018–2024). Patients were stratified based on the presence or absence of CTD features identified through ICD-10 codes and manual chart review. The primary composite outcome included recurrent MI, stroke, and all-cause mortality. Univariable and multivariable logistic regression models were utilized to identify independent predictors of adverse outcomes. Propensity score matching was employed to balance baseline characteristics, and Kaplan-Meier survival analysis assessed time-to-event outcomes.
Results
CTD features were observed in 26.7 % (368/1380) of SCAD patients, with joint conditions (20 %) being the most prevalent. Patients with CTD features exhibited significantly higher rates of the composite outcome than those without (57.9 % vs. 41.0 %, p < 0.001) in propensity-matched analysis. Joint conditions (OR: 3.19; 95 % CI: 2.17–4.68, p < 0.001) and grouped CTD features (OR: 2.77; 95 % CI: 2.01–3.82, p < 0.001) independently predicted worse outcomes. Recurrent MI specifically was significantly more frequent in patients with CTD features (55.3 % vs. 35.5 %, p < 0.001).
Conclusion
CTD features are common among SCAD patients and are associated with significantly higher rates of adverse cardiovascular outcomes, notably recurrent MI. Recognizing CTD features in SCAD patients could enhance risk stratification and inform targeted management strategies.
{"title":"Impact of connective tissue disease features on patients with spontaneous coronary artery dissection","authors":"Sant Kumar , George Bcharah , Mahmoud Abdelnabi , Linnea M. Baudhuin , Ramzi Ibrahim , Hussein Abdul Nabi , Girish Pathangey , Hend Bcharah , Estefana Bcharah , Yuxiang Wang , Mayo A. Osundiji , Fadi E. Shamoun","doi":"10.1016/j.carrev.2025.06.023","DOIUrl":"10.1016/j.carrev.2025.06.023","url":null,"abstract":"<div><h3>Background</h3><div><span>Spontaneous coronary artery dissection<span> (SCAD) is an increasingly recognized cause of myocardial infarction, frequently associated with connective tissue disorder (CTD) features such as </span></span>joint hypermobility<span> and scoliosis<span>. However, the clinical impact of these features in patients with SCAD remains poorly characterized. This study aimed to investigate the prevalence of CTD features among SCAD patients and evaluate their influence on adverse cardiovascular outcomes, including recurrent myocardial infarction, stroke, and mortality, to facilitate better risk stratification and targeted clinical management.</span></span></div></div><div><h3>Methods</h3><div><span>This retrospective study analyzed 1380 patients diagnosed with SCAD from Mayo Clinic sites (2018–2024). Patients were stratified based on the presence or absence<span> of CTD features identified through ICD-10 codes and manual chart review. The primary composite outcome included recurrent MI, stroke, and all-cause mortality. Univariable and multivariable logistic regression models were utilized to identify independent predictors of </span></span>adverse outcomes<span>. Propensity score matching was employed to balance baseline characteristics, and Kaplan-Meier survival analysis assessed time-to-event outcomes.</span></div></div><div><h3>Results</h3><div>CTD features were observed in 26.7 % (368/1380) of SCAD patients, with joint conditions (20 %) being the most prevalent. Patients with CTD features exhibited significantly higher rates of the composite outcome than those without (57.9 % vs. 41.0 %, <em>p</em> < 0.001) in propensity-matched analysis. Joint conditions (OR: 3.19; 95 % CI: 2.17–4.68, <em>p</em> < 0.001) and grouped CTD features (OR: 2.77; 95 % CI: 2.01–3.82, p < 0.001) independently predicted worse outcomes. Recurrent MI specifically was significantly more frequent in patients with CTD features (55.3 % vs. 35.5 %, <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>CTD features are common among SCAD patients and are associated with significantly higher rates of adverse cardiovascular outcomes, notably recurrent MI. Recognizing CTD features in SCAD patients could enhance risk stratification and inform targeted management strategies.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 32-38"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.04.007
Enrico Poletti , Kathleen E. Kearney , Christine J. Chung , David Elison , Zachary Steinberg , William L. Lombardi , James M. McCabe , Lorenzo Azzalini
Background
Intravascular imaging (IVI) improves the outcomes of percutaneous coronary intervention (PCI). However, the benefit of a systematic approach versus an already higher usage rate remains unclear. This study investigates the short-term impact of systematic IVI utilization during PCI in a complex higher-risk interventional PCI (CHIP-PCI) center.
Methods
This retrospective study analyzed all patients undergoing PCI at a single center between April 2018 and March 2024. Participants were divided into groups based on IVI usage (systematic IVI: ≥80 % of procedures; non-systematic IVI: <80 %). Study endpoints included procedural metrics and in-hospital outcomes.
Results
We analyzed 5547 PCI procedures: 2529 in the non-systematic IVI group (2018–2020) and 3018 in the systematic IVI group (2021–2024). PCI was performed for multivessel disease in 835 patients (15.1 %), left main disease in 957 (17.3 %), and chronic total occlusion in 2040 (36.8 %). Mechanical circulatory support was used in 385 (6.9 %). Atherectomy and intravascular lithotripsy were performed in 1409 (25.4 %) and 249 (4.5 %), respectively. After propensity score matching, –2,305 pairs were evaluated. Procedural and fluoroscopy time were similar between groups, while air kerma (577 vs. 688 mGy, p < 0.001) and contrast volume (96 ± 45 vs. 100 ± 47 ml, p = 0.005) were lower in the systematic IVI group. Systematic IVI was also associated with reduced cardiac tamponade rates (0.8 % vs. 1.6 %, p = 0.015) without differences in other cardiac-related complications.
Conclusions
In this large cohort of CHIP-PCI procedures performed at a highly specialized center, systematic IVI implementation was associated with lower radiation dose and contrast volume, as well as lower incidence of cardiac tamponade, at the expense of a slightly prolonged procedural time.
{"title":"Impact of systematic intravascular imaging on the outcomes of complex and higher-risk percutaneous coronary intervention","authors":"Enrico Poletti , Kathleen E. Kearney , Christine J. Chung , David Elison , Zachary Steinberg , William L. Lombardi , James M. McCabe , Lorenzo Azzalini","doi":"10.1016/j.carrev.2025.04.007","DOIUrl":"10.1016/j.carrev.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Intravascular imaging (IVI) improves the outcomes of percutaneous coronary intervention (PCI). However, the benefit of a systematic approach versus an already higher usage rate remains unclear. This study investigates the short-term impact of systematic IVI utilization during PCI in a complex higher-risk interventional PCI (CHIP-PCI) center.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed all patients undergoing PCI at a single center between April 2018 and March 2024. Participants were divided into groups based on IVI usage (systematic IVI: ≥80 % of procedures; non-systematic IVI: <80 %). Study endpoints included procedural metrics and in-hospital outcomes.</div></div><div><h3>Results</h3><div>We analyzed 5547 PCI procedures: 2529 in the non-systematic IVI group (2018–2020) and 3018 in the systematic IVI group (2021–2024). PCI was performed for multivessel disease in 835 patients (15.1 %), left main disease in 957 (17.3 %), and chronic total occlusion in 2040 (36.8 %). Mechanical circulatory support was used in 385 (6.9 %). Atherectomy and intravascular lithotripsy were performed in 1409 (25.4 %) and 249 (4.5 %), respectively. After propensity score matching, –2,305 pairs were evaluated. Procedural and fluoroscopy time were similar between groups, while air kerma (577 vs. 688 mGy, <em>p</em> < 0.001) and contrast volume (96 ± 45 vs. 100 ± 47 ml, <em>p</em> = 0.005) were lower in the systematic IVI group. Systematic IVI was also associated with reduced cardiac tamponade rates (0.8 % vs. 1.6 %, <em>p</em> = 0.015) without differences in other cardiac-related complications.</div></div><div><h3>Conclusions</h3><div>In this large cohort of CHIP-PCI procedures performed at a highly specialized center, systematic IVI implementation was associated with lower radiation dose and contrast volume, as well as lower incidence of cardiac tamponade, at the expense of a slightly prolonged procedural time.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 70-77"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.02.004
Elsa Hebbo , Madeleine Barker , Daniel A. Gold , Malika Elhage Hassan , Mariem Sawan , Tanveer Rab , William J. Nicholson , Michael E. Halkos , Wissam A. Jaber , Pratik B. Sandesara
Background
The current recommended intervention for significant left main (LM) stenosis, especially in patients with complex and high SYNTAX score disease, is coronary artery bypass grafting (CABG). Hybrid coronary revascularization (HCR) combines robotic coronary artery bypass and percutaneous coronary intervention, offering a less invasive approach for patients with LM disease.
Objectives
We compare clinical outcomes between HCR and CABG in patients with LM disease.
Methods
We retrospectively screened all patients treated for LM disease between 2019 and 2023 at a single institution. Propensity matching was used for baseline characteristics. The primary outcome was major adverse cardiovascular events (MACE) at 30 days, 6 months and 1 year. Secondary outcomes included death, myocardial infarction, repeat revascularization and stroke.
Results
Out of a total of 761 patients treated for LM disease, 59 HCR patients were propensity matched to 59 CABG patients and were included in the final analysis. SYNTAX score was >33 for 49.1 % of HCR patients and 67.3 % of CABG patients (p = 0.15). Hospital length of stay was significantly shorter for HCR patients compared to CABG (4.07 days vs. 7.58 days, p < 0.001). MACE were significantly lower in the HCR group at 30 days (0 % vs 10.2 %; p = 0.01), 6 months (0 % vs 17 %; p = 0.002) and 1 year (2.4 % vs 20.5 %; p = 0.01) compared to CABG group. Additionally, there was a lower rate of repeat revascularization at 6 months in the HCR group (0 % vs 10.9 %; p = 0.02).
Conclusions
This retrospective study demonstrates that HCR is a safe and viable alternative to CABG in patients with LM disease. Randomized clinical trials comparing the two treatment modalities are needed to confirm these findings.
{"title":"Hybrid coronary revascularization versus traditional coronary artery bypass grafting for left main coronary artery disease","authors":"Elsa Hebbo , Madeleine Barker , Daniel A. Gold , Malika Elhage Hassan , Mariem Sawan , Tanveer Rab , William J. Nicholson , Michael E. Halkos , Wissam A. Jaber , Pratik B. Sandesara","doi":"10.1016/j.carrev.2025.02.004","DOIUrl":"10.1016/j.carrev.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>The current recommended intervention for significant left main (LM) stenosis, especially in patients with complex and high SYNTAX score<span> disease, is coronary artery bypass grafting<span> (CABG). Hybrid coronary revascularization (HCR) combines robotic coronary artery bypass and percutaneous coronary intervention, offering a less invasive approach for patients with LM disease.</span></span></div></div><div><h3>Objectives</h3><div>We compare clinical outcomes between HCR and CABG in patients with LM disease.</div></div><div><h3>Methods</h3><div>We retrospectively screened all patients treated for LM disease between 2019 and 2023 at a single institution. Propensity matching was used for baseline characteristics. The primary outcome was major adverse cardiovascular events (MACE) at 30 days, 6 months and 1 year. Secondary outcomes included death, myocardial infarction, repeat revascularization and stroke.</div></div><div><h3>Results</h3><div>Out of a total of 761 patients treated for LM disease, 59 HCR patients were propensity matched to 59 CABG patients and were included in the final analysis. SYNTAX score was >33 for 49.1 % of HCR patients and 67.3 % of CABG patients (p = 0.15). Hospital length of stay was significantly shorter for HCR patients compared to CABG (4.07 days vs. 7.58 days, p < 0.001). MACE were significantly lower in the HCR group at 30 days (0 % vs 10.2 %; p = 0.01), 6 months (0 % vs 17 %; p = 0.002) and 1 year (2.4 % vs 20.5 %; p = 0.01) compared to CABG group. Additionally, there was a lower rate of repeat revascularization at 6 months in the HCR group (0 % vs 10.9 %; p = 0.02).</div></div><div><h3>Conclusions</h3><div>This retrospective study demonstrates that HCR is a safe and viable alternative to CABG in patients with LM disease. Randomized clinical trials comparing the two treatment modalities are needed to confirm these findings.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 11-15"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.05.006
Jason Z. Li , Meredith M. Njus , Connor P. Oates , Tania A. Vora , Ajay Kadakkal , Nana Afari-Armah , Rachel M. Barish , Farooq H. Sheikh
Background
The clinical characteristics and outcomes of Black patients with wild type transthyretin cardiac amyloidosis (ATTRwt-CA) are not well described in the literature.
Methods
We conducted a single center retrospective cohort study of 186 patients with cardiac amyloidosis, of which 62 had ATTRwt-CA, diagnosed at our institution between 2/2010 and 4/2023. We compared clinical, laboratory, electrocardiographic, and echocardiographic characteristics between Black and non-Black ATTRwt-CA patients. Our primary outcome of interest was all cause mortality.
Results
Of the 62 patients with ATTRwt-CA, 19 patients self-identified as Black. Black ATTRwt-CA patients had higher rates of chronic kidney disease (63.2 % vs 23.3 %; p = 0.002), lower glomerular filtration rate (50.8 ± 18.0 vs 63.3 ± 18.4; p = 0.019), and lower rates of carpal tunnel syndrome (36.8 % vs 67.4 %; p = 0.024). There were no significant differences in disease stage (p = 0.058), frequency of NYHA III or IV symptoms (35.3 % vs 35.5 %; p = 0.990), or LVEF (41.2 ± 17.1 vs 49.1 ± 13.2; p = 0.074) at the time of CA diagnosis. Black ATTRwt-CA patients demonstrated higher rates of mortality on both univariate (HR: 5.52; CI 2.05–14.81; p = 0.001) and multivariate (HR: 4.85; CI 1.53–15.41; p = 0.007) Cox regression analysis.
Conclusion
Black patients with ATTRwt-CA demonstrate phenotypic differences and worse survival compared to non-Black patients. The reasons underlying this survival difference warrant further investigation.
背景：黑人野生型转甲状腺素型心脏淀粉样变性（ATTRwt-CA）患者的临床特征和预后在文献中没有很好的描述。方法：我们对186例心脏淀粉样变性患者进行了单中心回顾性队列研究，其中62例为attrt - ca，于2010年2月至2023年4月在我院诊断。我们比较了黑人和非黑人attrt - ca患者的临床、实验室、心电图和超声心动图特征。我们感兴趣的主要结局是全因死亡率。结果：62例attrt - ca患者中，有19例自认为为Black。黑色attrt - ca患者的慢性肾脏疾病发生率更高(63.2% vs 23.3%；P = 0.002)，肾小球滤过率较低(50.8±18.0 vs 63.3±18.4；P = 0.019)，腕管综合征发生率较低(36.8% vs 67.4%；p = 0.024)。两组在疾病分期（p = 0.058）、出现NYHA III或IV症状的频率(35.3% vs 35.5%；p = 0.990)，或LVEF(41.2±17.1 vs 49.1±13.2；p = 0.074)。黑色attrt - ca患者在两项单因素上均表现出较高的死亡率(HR: 5.52；可信区间2.05 - -14.81;p = 0.001)和多变量(HR: 4.85；可信区间1.53 - -15.41;p = 0.007) Cox回归分析。结论：与非黑人患者相比，黑人患者attrt - ca表现出表型差异和更差的生存率。这种生存差异背后的原因值得进一步调查。
{"title":"Characteristics and outcomes of Black patients with wild type transthyretin cardiac amyloidosis","authors":"Jason Z. Li , Meredith M. Njus , Connor P. Oates , Tania A. Vora , Ajay Kadakkal , Nana Afari-Armah , Rachel M. Barish , Farooq H. Sheikh","doi":"10.1016/j.carrev.2025.05.006","DOIUrl":"10.1016/j.carrev.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div><span>The clinical characteristics and outcomes of Black patients with wild type transthyretin </span>cardiac amyloidosis (ATTRwt-CA) are not well described in the literature.</div></div><div><h3>Methods</h3><div>We conducted a single center retrospective cohort study<span> of 186 patients with cardiac amyloidosis, of which 62 had ATTRwt-CA, diagnosed at our institution between 2/2010 and 4/2023. We compared clinical, laboratory, electrocardiographic, and echocardiographic characteristics between Black and non-Black ATTRwt-CA patients. Our primary outcome of interest was all cause mortality.</span></div></div><div><h3>Results</h3><div>Of the 62 patients with ATTRwt-CA, 19 patients self-identified as Black. Black ATTRwt-CA patients had higher rates of chronic kidney disease<span> (63.2 % vs 23.3 %; p = 0.002), lower glomerular filtration rate<span> (50.8 ± 18.0 vs 63.3 ± 18.4; p = 0.019), and lower rates of carpal tunnel syndrome<span> (36.8 % vs 67.4 %; p = 0.024). There were no significant differences in disease stage (p = 0.058), frequency of NYHA III or IV symptoms (35.3 % vs 35.5 %; p = 0.990), or LVEF<span> (41.2 ± 17.1 vs 49.1 ± 13.2; p = 0.074) at the time of CA diagnosis. Black ATTRwt-CA patients demonstrated higher rates of mortality on both univariate (HR: 5.52; CI 2.05–14.81; p = 0.001) and multivariate (HR: 4.85; CI 1.53–15.41; p = 0.007) Cox regression analysis.</span></span></span></span></div></div><div><h3>Conclusion</h3><div>Black patients with ATTRwt-CA demonstrate phenotypic differences and worse survival compared to non-Black patients. The reasons underlying this survival difference warrant further investigation.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 133-134"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.06.003
Aleksandra Gąsecka , Arkadiusz Pietrasik , Tomasz Pawłowski , Jerzy Sacha , Marek Grygier , Gabriel Bielawski , Wojciech Balak , Adam Sukiennik , Paulina Burzyńska , Adam Witkowski , Mateusz Warniełło , Stanisław Bartuś , Łukasz Rzeszutko , Artur Pawlik , Mateusz Kaczyński , Robert Gil , Wiktor Kuliczkowski , Krzysztof Reczuch , Marcin Protasiewicz , Paweł Kleczyński , Janusz Kochman
Background
Impella is a catheter-based, continuous blood flow left ventricle assist device used in selected patients undergoing high-risk percutaneous coronary interventions (HR PCI). We aimed to evaluate outcomes in patients undergoing Impella-assisted HR-PCI and identify independent predictors of 12-month mortality.
Methods
Consecutive HR-PCI patients enrolled in the national, multicentre, retrospective IMPELLA-PL registry (n = 253) in 20 Polish interventional cardiological centres from October 2014 until December 2021 were included in the analysis. The main endpoints were (i) procedural success defined as revascularization of all preplanned lesions, (ii) device-related complications, (iii) 12-month mortality and major adverse cardiovascular events (MACE).
Results
The majority of patients presented with multivessel disease including left main (63.6 %). The median Syntax Score II was 43.0 (32.4–55.0). The procedural success was achieved in 83.0 % of patients. Device-related complications included access site bleeding (14.6 %), limb ischemia (2.4 %) and hemolysis (1.6 %). The in-hospital MACE included 1 cardiosurgical intervention (0.4 %), 12 exacerbations of heart failure (4.7 %), 11 myocardial infarctions (4.3 %), 32 cases of acute kidney injury (12.6 %), 35 inflammatory complications (13.8 %) and 32 major bleeding complications (13.4 %). In-hospital mortality rate was 8.3 %, 12-month mortality rate was 18.2 % and MACE rate post-discharge was 22.5 %. The 12-month-mortality was increased by pre-existing, atrial fibrillation (OR 3.50, 95 % CI 1.38–8.95) and chronic kidney disease (OR 2.77, 95 % CI 1.06–7.26) and decreased by Impella removal in the cath-lab (OR 0.11, 95 % CI 0.02–0.76) and RAAS inhibitor use (OR 0.26, 95 % CI 0.08–0.89).
Conclusions
Despite high anatomical complexity of coronary artery disease of patients included in the IMPELLA-PL registry, the procedural success rate was relatively high and the mortality relatively low.
背景：Impella是一种基于导管的左心室持续血流辅助装置，用于接受高风险经皮冠状动脉介入治疗（HR PCI）的患者。我们的目的是评估接受impella辅助HR-PCI的患者的预后，并确定12个月死亡率的独立预测因素。方法：从2014年10月至2021年12月，在波兰20个介入性心脏病中心的全国性、多中心、回顾性IMPELLA-PL登记中心（n = 253）登记的连续HR-PCI患者纳入分析。主要终点是(i)手术成功（定义为所有预先计划病变的血运重建），（ii）器械相关并发症，（iii） 12个月死亡率和主要不良心血管事件（MACE）。结果：以左主干多支病变为主（63.6%）。句法评分II的中位数为43.0（32.4-55.0）。手术成功率为83.0%。器械相关并发症包括通路部位出血（14.6%）、肢体缺血（2.4%）和溶血（1.6%）。住院MACE包括心外科干预1例（0.4%），心衰加重12例（4.7%），心肌梗死11例（4.3%），急性肾损伤32例（12.6%），炎症并发症35例（13.8%），大出血并发症32例（13.4%）。住院死亡率为8.3%，12个月死亡率为18.2%，出院后MACE率为22.5%。先前存在的房颤（OR 3.50, 95% CI 1.38-8.95）和慢性肾脏疾病（OR 2.77, 95% CI 1.06-7.26）增加了12个月的死亡率，在导尿管实验室中移除Impella （OR 0.11, 95% CI 0.02-0.76）和使用RAAS抑制剂（OR 0.26, 95% CI 0.08-0.89）降低了死亡率。结论：尽管IMPELLA-PL登记的患者冠状动脉疾病解剖复杂性高，但手术成功率相对较高，死亡率相对较低。
{"title":"Procedural characteristics and outcomes of patients undergoing Impella-assisted high-risk percutaneous coronary interventions in the IMPELLA-PL registry","authors":"Aleksandra Gąsecka , Arkadiusz Pietrasik , Tomasz Pawłowski , Jerzy Sacha , Marek Grygier , Gabriel Bielawski , Wojciech Balak , Adam Sukiennik , Paulina Burzyńska , Adam Witkowski , Mateusz Warniełło , Stanisław Bartuś , Łukasz Rzeszutko , Artur Pawlik , Mateusz Kaczyński , Robert Gil , Wiktor Kuliczkowski , Krzysztof Reczuch , Marcin Protasiewicz , Paweł Kleczyński , Janusz Kochman","doi":"10.1016/j.carrev.2025.06.003","DOIUrl":"10.1016/j.carrev.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Impella is a catheter-based, continuous blood flow left ventricle assist device used in selected patients undergoing high-risk percutaneous coronary interventions (HR PCI). We aimed to evaluate outcomes in patients undergoing Impella-assisted HR-PCI and identify independent predictors of 12-month mortality.</div></div><div><h3>Methods</h3><div>Consecutive HR-PCI patients enrolled in the national, multicentre, retrospective IMPELLA-PL registry (<em>n</em> = 253) in 20 Polish interventional cardiological centres from October 2014 until December 2021 were included in the analysis. The main endpoints were (i) procedural success defined as revascularization of all preplanned lesions, (ii) device-related complications, (iii) 12-month mortality and major adverse cardiovascular events (MACE).</div></div><div><h3>Results</h3><div>The majority of patients presented with multivessel disease including left main (63.6 %). The median Syntax Score II was 43.0 (32.4–55.0). The procedural success was achieved in 83.0 % of patients. Device-related complications included access site bleeding (14.6 %), limb ischemia (2.4 %) and hemolysis (1.6 %). The in-hospital MACE included 1 cardiosurgical intervention (0.4 %), 12 exacerbations of heart failure (4.7 %), 11 myocardial infarctions (4.3 %), 32 cases of acute kidney injury (12.6 %), 35 inflammatory complications (13.8 %) and 32 major bleeding complications (13.4 %). In-hospital mortality rate was 8.3 %, 12-month mortality rate was 18.2 % and MACE rate post-discharge was 22.5 %. The 12-month-mortality was increased by pre-existing, atrial fibrillation (OR 3.50, 95 % CI 1.38–8.95) and chronic kidney disease (OR 2.77, 95 % CI 1.06–7.26) and decreased by Impella removal in the cath-lab (OR 0.11, 95 % CI 0.02–0.76) and RAAS inhibitor use (OR 0.26, 95 % CI 0.08–0.89).</div></div><div><h3>Conclusions</h3><div>Despite high anatomical complexity of coronary artery disease of patients included in the IMPELLA-PL registry, the procedural success rate was relatively high and the mortality relatively low.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 103-110"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.04.038
Joakim Sundström , Mohammed Mohammed , Antros Louca , Aidin Rawshani , Dan Ioanes , Oskar Angerås , Petur Petursson , Anna Myredal , Sebastian Völz , Christian Dworeck , Jacob Odenstedt , Araz Rawshani , Truls Råmunddal
Background
Chronic total occlusions (CTOs) are common in coronary artery disease (CAD) and are known to impact survival, especially in acute myocardial infarction and cardiac arrest. However, their impact on long-term survival across the broader population with CAD remains less studied. We studied the association between the number, location, and severity of CTOs and long-term survival in a large, unselected cohort.
Methods
Patients undergoing coronary angiography in Sweden between July 2015 and December 2021 were identified from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Individuals with prior CABG were excluded. Patients were categorized by the number of CTOs (none, 1, or ≥ 2) and location (LAD, LCX, or RCA). Survival was assessed using Kaplan–Meier and Cox proportional hazards models.
Results
Of 202,191 patients, 88.0 % had no CTO, 9.8 % had 1 CTO, and 2.1 % had ≥2 CTOs. Survival worsened with increasing CTOs (p < 0.0001). Compared to no CTO, hazard ratios were 1.69 (95 % CI, 1.63–1.76; p < 0.001) for 1 CTO and 2.27 (95 % CI, 2.13–2.42; p < 0.001) for ≥2 CTOs. Adjusted HRs by location were 1.31 (95 % CI, 1.24–1.38; p < 0.001) for LAD, 1.59 (95 % CI, 1.52–1.66; p < 0.001) for RCA, and 1.28 (95 % CI, 1.21–1.35; p < 0.001) for LCX.
Conclusions
The presence, number, and location of CTOs significantly influence long-term survival. This provides long-term risk stratification for patients with CTO, which may improve patient selection for interventions.
{"title":"Exploring the relationship between chronic total occlusions and mortality in coronary artery disease","authors":"Joakim Sundström , Mohammed Mohammed , Antros Louca , Aidin Rawshani , Dan Ioanes , Oskar Angerås , Petur Petursson , Anna Myredal , Sebastian Völz , Christian Dworeck , Jacob Odenstedt , Araz Rawshani , Truls Råmunddal","doi":"10.1016/j.carrev.2025.04.038","DOIUrl":"10.1016/j.carrev.2025.04.038","url":null,"abstract":"<div><h3>Background</h3><div>Chronic total occlusions (CTOs) are common in coronary artery disease (CAD) and are known to impact survival, especially in acute myocardial infarction and cardiac arrest. However, their impact on long-term survival across the broader population with CAD remains less studied. We studied the association between the number, location, and severity of CTOs and long-term survival in a large, unselected cohort.</div></div><div><h3>Methods</h3><div>Patients undergoing coronary angiography in Sweden between July 2015 and December 2021 were identified from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Individuals with prior CABG were excluded. Patients were categorized by the number of CTOs (none, 1, or ≥ 2) and location (LAD, LCX, or RCA). Survival was assessed using Kaplan–Meier and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Of 202,191 patients, 88.0 % had no CTO, 9.8 % had 1 CTO, and 2.1 % had ≥2 CTOs. Survival worsened with increasing CTOs (<em>p</em> < 0.0001). Compared to no CTO, hazard ratios were 1.69 (95 % CI, 1.63–1.76; <em>p</em> < 0.001) for 1 CTO and 2.27 (95 % CI, 2.13–2.42; <em>p</em> < 0.001) for ≥2 CTOs. Adjusted HRs by location were 1.31 (95 % CI, 1.24–1.38; <em>p</em> < 0.001) for LAD, 1.59 (95 % CI, 1.52–1.66; p < 0.001) for RCA, and 1.28 (95 % CI, 1.21–1.35; p < 0.001) for LCX.</div></div><div><h3>Conclusions</h3><div>The presence, number, and location of CTOs significantly influence long-term survival. This provides long-term risk stratification for patients with CTO, which may improve patient selection for interventions.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Pages 16-22"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.carrev.2025.07.006
Dimitrios Strepkos, Emmanouil S. Brilakis
{"title":"Response to the Letter to the Editor: The use of the Medina coronary bifurcation classification…","authors":"Dimitrios Strepkos, Emmanouil S. Brilakis","doi":"10.1016/j.carrev.2025.07.006","DOIUrl":"10.1016/j.carrev.2025.07.006","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"81 ","pages":"Page 136"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号