Clinical Efficacy and Safety of Reduced-Dose Prasugrel After Percutaneous Coronary Intervention for Taiwanese Patients with Acute Coronary Syndromes.

: The efficacy and safety of reduced-dose prasugrel (loading dose/maintenance dose: 20/3.75 mg) in preventing major adverse cardiovascular events (MACEs) among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) have been well-estab-lished. However, long-term real-world data for this population remains limited in Taiwan.

A risk stratification model modified from the U.S. guideline could be applied in an Asian population with or without ASCVD: Validation study.

Background: This study aimed to evaluate the performance of a modified U.S. (MUS) model for risk prediction of cardiovascular (CV) events in Asian patients and compare it to European and Japanese models.

Association of Major Adverse Cardiac Events and Beta-Blockers in Patients with and without Atherosclerotic Cardiovascular Disease: Long-Term Follow-Up Results of the T-SPARCLE and T-PPARCLE Registry in Taiwan.

Beta-blockers are widely used, but the benefit is now challenged in patients at risk of atherosclerotic cardiovascular disease (ASCVD) in the present coronary reperfusion era. We aimed to identify the risk factors of a major adverse cardiac event (MACE) and the long-term effect of beta-blockers in two large cohorts in Taiwan. Two prospective observational cohorts, including patients with known atherosclerosis cardiovascular disease (T-SPARCLE) and patients with at least one risk factor of ASCVD but without clinically evident ASCVD (T-PPARCLE), were conducted in Taiwan.

Combined Left Ventricular Ejection Fraction and N-Terminal pro-B-type Natriuretic Peptide after Sacubitril/Valsartan for Predicting Outcomes in Patients with Heart Failure with Reduced Ejection Fraction.

Background: The aim of this study was to determine whether a combined increase of ≥ 10% in left ventricular ejection fraction (LVEF) and decrease in N-terminal pro-B-type natriuretic peptide (NT pro-BNP) to < 1000 pg/mL after treatment with sacubitril/valsartan (SAC/VAL) in patients with heart failure with reduced ejection fraction (HFrEF) translated to better treatment outcomes in a real-world Taiwanese population.

Methods: This is a single-center, prospective, non-randomized, observational study. Consecutive patients with HFrEF were treated with SAC/VAL and followed up for at least 12 months.

Impact of the Dual Antiplatelet Therapy Score on Clinical Outcomes in Acute Coronary Syndrome Patients Receiving P2Y12 Inhibitor Monotherapy.

Background: Dual antiplatelet therapy (DAPT) score is used to stratify ischemic and bleeding risk for antiplatelet therapy after percutaneous coronary intervention (PCI). This study assessed the association between the DAPT score and clinical outcomes in acute coronary syndrome (ACS) patients who were treated with P2Y12 inhibitor monotherapy.

Methods: A total of 498 ACS patients, with early aspirin discontinuation for various reasons and who received P2Y12 inhibitor monotherapy after PCI, were enrolled during the period from January 1, 2014 to December 31, 2018.

Long-Term Clinical Outcomes of New-Generation Drug-Eluting Stents in Coronary Artery Disease: A Real-World Observational Study.

Background: Treating vessels with a very small reference vessel diameter (RVD) in coronary artery disease is challenging.

Objective: Long-term evaluation of new-generation drug-eluting stents (DESs) for the treatment of coronary lesions with different RVDs.

Methods: From April 2009 to March 2019, 780 patients who underwent single coronary stenting were divided into ≤ 2.

Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.

Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy.

P2Y12 Inhibitor Monotherapy with Clopidogrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

Background: P2Y12 inhibitor monotherapy is an alternative antiplatelet strategy in patients undergoing percutaneous coronary intervention (PCI). However, the ideal P2Y12 inhibitor for monotherapy is unclear.

Methods And Results: We performed a multicenter, retrospective, observational study to compare the efficacy and safety of monotherapy with clopidogrel versus ticagrelor in patients with acute coronary syndrome (ACS) undergoing PCI.

Sacubitril/Valsartan Improves Left Ventricular Ejection Fraction and Reverses Cardiac Remodeling in Taiwanese Patients with Heart Failure and Reduced Ejection Fraction.

Background: The angiotensin receptor-neprilysin inhibitor sacubitril/valsartan is known to improve outcomes of cardiac death and hospitalization due to heart failure in patients with heart failure and reduced ejection fraction (HFrEF). However, data on improvements in ejection fraction after using sacubitril/valsartan are still lacking in Taiwan.

Methods: We conducted this prospective, single armed, observation cohort study to evaluate changes in left ventricular ejection fraction (LVEF) in patients with heart failure and reduced LVEF treated with sacubitril/valsartan.

Changing Treatment Patterns in Patients With Venous Thromboembolism in Taiwan.

Background: In Asia, little information is available about contemporary real-world treatment patterns for venous thromboembolism (VTE).

Methods and results: Consecutive patients (n=11,414) from the Taiwan National Health Insurance Research Database with initial VTE and taking oral anticoagulants between May 1, 2014 and June 30, 2016 were included. The temporal trends of using oral anticoagulants and pharmacomechanical therapy during the study period were evaluated.

Patterns of Acute Myocardial Infarction in Taiwan from 2009 to 2015.

Most studies about the trends of acute myocardial infarction (AMI) were based on the data from Western countries. In recent years, little information is available from Asia since 2010. This study assessed the nationwide trends of AMI in Taiwan from 2009 to 2015.

2018 Expert Consensus on the Management of Adverse Effects of Antiplatelet Therapy for Acute Coronary Syndrome in Taiwan.

Antiplatelet therapy is a key component in the treatment of acute coronary syndrome (ACS). The management of ACS has evolved considerably over recent years with the development of new and more potent antiplatelet agents. Clinical trials on ACS have demonstrated that potent antiplatelet agents can more effectively reduce cardiovascular events.

Coronary Aneurysm Formation After Bioresorbable Vascular Scaffold Implantation Resulting in Acute Myocardial Infarction.

BACKGROUND Development of a true coronary aneurysm after percutaneous coronary intervention is a rare event, and a coronary aneurysm resulting in acute myocardial infarction is even rarer. Coronary aneurysm formation after bioresorbable vascular scaffold (BVS) implantation, eventually leading to thrombosis, embolization, and myocardial infarction, has never been reported before in the literature. CASE REPORT A 62-year-old man received an elective BVS for a proximal left anterior descending lesion.

Efficacy and safety of ticagrelor versus clopidogrel in acute coronary syndrome in Taiwan: A multicenter retrospective pilot study.

Background: The efficacy and safety of ticagrelor compared with clopidogrel in acute coronary syndrome has not previously been evaluated in an Eastern Asian population, which is recognized to have a different response to P2Y12 antagonists compared with the Caucasian population in real-life situations.

Methods: A multicenter retrospective pilot study was performed to evaluate 928 consecutive patients with acute coronary syndrome, receiving aspirin and one P2Y12 antagonist (324 ticagrelor or 604 clopidogrel). Using propensity score matching, 448 patients were selected and divided into two equal groups.

Determinants for achieving the LDL-C target of lipid control for secondary prevention of cardiovascular events in Taiwan.

Background: Epidemiological and clinical studies have clearly established the link between low-density lipoprotein cholesterol (LDL-C) and atherosclerosis-related cardiovascular consequences. Although it has been a common practice for physicians to prescribe lipid-lowering therapy for patients with dyslipidemia, the achievement rate is still not satisfied in Taiwan. Therefore, the determinants for achieving the LDL-C target needed to be clarified for better healthcare of the patients with dyslipidemia.

The impact of chronic kidney disease on lipid management and goal attainment in patients with atherosclerosis diseases in Taiwan.

Background: Patients with chronic kidney disease (CKD) is a very high risk cardiovascular disease population and should be treated aggressively. We investigated lipid management in CKD patients with atherosclerosis in Taiwan.

Methods: 3057 patients were enrolled in a multi-center study (T-SPARCLE).

Gender disparities in optimal lipid control among patients with coronary artery disease.

Coronary heart disease(CHD) is the leading cause of death worldwide in both men and women. Hypercholesterolemia is a major factor contributing to the incidence of CHD. Many lipid-lowering trials have shown statins to be effective medications for the primary and secondary prevention of CHD.

Guideline-adherent therapy in patients with cardiovascular diseases in Taiwan.

Background/purpose: Aggressive and persistent control of risk factors is recommended for prevention of secondary comorbidities in patients with cardiovascular diseases. This study aimed to evaluate guideline recommendations for achieving targets for lipid and blood pressure (BP) control in patients with cardiovascular diseases in Taiwan.

Methods: This multicenter cohort study was conducted in 14 hospitals in Taiwan.

Complex AV fistulas involving three coronary arteries, aorta, left internal mammary artery, vertebral artery and left pulmonary artery--demonstration by MDCT.

We describe a rare case of complex AV fistulas involving three coronary arteries, the aorta, the left internal mammary artery, the left vertebral artery, and left pulmonary artery. Multidetector row computed tomography well depicted the complex anatomy of the fistulas by multiplanar reconstruction and three-dimensional techniques.

Coronary computed tomography angiography---a promising imaging modality in diagnosing coronary artery disease.

Background: Traditionally, information on coronary artery lesions is obtained from invasive coronary angiography (CAG). The clinical applicability and diagnostic performance of the newly developed 64-slice multislice computed tomography (MSCT) scanner in coronary angiographic evaluation is not well evaluated.

Methods: Coronary computed tomography angiography (CCTA) was performed in 345 patients (119 women, 226 men; mean age, 59.

Glycoprotein IIb/IIIa inhibitor (tirofiban) in acute ST-segment elevation myocardial infarction.

Studies have shown conflicting results for glycoprotein IIb/IIIa inhibitor (tirofiban) use in ST-segment elevation myocardial infarction (STEMI). The authors aimed to determine if an upstream conventional dose of tirofiban in addition to a standard treatment regimen improved coronary patency and clinical outcomes in patients with STEMI. A retrospective analysis of consecutive patients with STEMI, who underwent emergent percutaneous coronary intervention (PCI) in the authors' hospital from July 2000 to April 2006 was performed.