Predictors and Long-Term Prognostic Significance of Bailout Stenting During Percutaneous Coronary Interventions With Sirolimus-Coated Balloon: A Subanalysis of the Eastbourne Study.

Percutaneous coronary intervention (PCI) with drug-coated balloon (DCB) has been expanding progressively in recent years. Convincing evidence demonstrated the ability of some DCB to promote positive vessel remodeling, with potential clinical benefits at follow-up. When PCI with DCB results in suboptimal angiographic results (residual stenosis >30% or type C to F dissection), bailout stenting (BS) implantation is recommended to mitigate the risk of abrupt vessel occlusion or restenosis.

Advancing Cardiac Amyloidosis Care Through Insights from Cardiopulmonary Exercise Testing.

Cardiac amyloidosis, encompassing both transthyretin (ATTR) and light-chain (AL) types, poses considerable challenges in patient management due to its intricate pathophysiology and progressive course. This narrative review elucidates the pivotal role of cardiopulmonary exercise testing (CPET) in the assessment of these patients. CPET is essential for evaluating disease progression by measuring cardio-respiratory performance and providing prognostic insights.

Clot-in-transit and pulmonary embolism: an urgent call for awareness and action.

Patients with acute pulmonary embolism (PE) have a wide spectrum of clinical presentations, from incidental findings to sudden cardiac death. Management and treatment recommendations in currently available guidelines vary according to patient risk and haemodynamic profile. A clot-in-transit (CiT) in the right heart chambers may be occasionally identified and is, therefore, an under-recognised but challenging condition, often preceding an abrupt clinical deterioration, and associated with increased mortality.

Polygenic Prediction of Recurrent Events After Early-Onset Myocardial Infarction.

Background: Myocardial infarction (MI) is a complex disease caused by both lifestyle and genetic factors. This study aims to investigate the predictive value of genetic risk, in addition to traditional cardiovascular risk factors, for recurrent events following early-onset MI.

Methods: The Italian Genetic Study of Early-Onset Myocardial Infarction is a cohort study enrolling patients with MI before 45 years.

Transcatheter aortic-valve implantation with or without on-site cardiac surgery: The TRACS trial.

Background: Transcatheter aortic valve implantation (TAVI) has emerged as an effective and safe treatment for patients with symptomatic aortic stenosis. The indication to TAVI should be agreed upon by a Heart Team, and the procedure should be performed in centers with on-site cardiac surgery. However, TAVI complications requiring emergent cardiac surgery (ECS) have become very rare.

Lipids and Inflammation: Novel Molecular Targets and Therapeutic Implications.

Atherosclerotic cardiovascular disease represents the most common cause of death worldwide. Altered cholesterol metabolism and inflammation are major cardiovascular risk factors that underpin atherosclerotic plaque growth and destabilization. While initial evidence considered dyslipidemia and inflammation as independent atherogenic actors, growing evidence has revealed that several molecular mechanisms implicated in cholesterol metabolism participate in multiple inflammatory signalling pathways.

How to better prevent sudden cardiac death? Recent advances.

Sudden cardiac death (SCD) is a global public health problem. Despite efforts of the scientific community, it is characterized by low survival (<10%). Strategies used to prevent this catastrophic event are divided into those aimed at individual and populational level.

Angiographic and clinical impact of balloon inflation time in percutaneous coronary interventions with sirolimus-coated balloon: A subanalysis of the EASTBOURNE study.

Introduction: Percutaneous coronary intervention (PCI) with drug-coated balloon (DCB) is an attractive strategy for the treatment of obstructive coronary artery disease (CAD). The implantation technique strongly influences the outcome of DCB PCI: accurate and adequate lesion preparation, short delivery time and sufficient DCB inflation time are deemed crucial to warrant adequate drug transfer and mitigate the risk of immediate vessel recoil and flow-limiting dissections. However, the optimal DCB inflation time is unclear, current consensus documents suggesting 30-60 s based on Experts' opinion.

Sudden cardiac death after early-onset myocardial infarction: a multicentre longitudinal cohort study with a 20-year follow-up.

Aims: Sudden cardiac death (SCD) is a serious consequence of a myocardial infarction (MI), but identifying patients at risk of developing SCD remains a major clinical challenge, especially in the case of juvenile MI. The aim of this study is to identify predictors of SCD after early-onset MI using long-term follow-up data relating to a large nationwide patient cohort.

Methods And Results: The Italian Genetic Study on Early-onset MI enrolled 2000 patients experiencing a first MI before the age of 45 years, who were followed up for a median of 19.

Lessons from a geriatric clinical case from the 19th century: a bridge to modern geriatric medicine.

Count Neipperg (1775-1829), the morganatic husband of Maria Luigia of Habsburg, Napoleon's former wife, presented with typical heart failure symptoms and died of bilateral bronchopneumonia. Neipperg's case is an example of the conflict in the medical field, which led to the birth of modern evidence-based medicine (EBM), and although Neipperg died almost 200 years ago, his case presents the same critical issues that more complex geriatric patients face today. First, the attending physicians provided divergent opinions without reaching an agreement.

Polymer-free stents for percutaneous coronary intervention in diabetic patients: a systematic review and meta-analysis.

To compare the efficacy of polymer-free drug-eluting stents (PF-DES) versus other stents in diabetic patients with coronary artery disease undergoing percutaneous coronary interventions. A systematic review and meta-analysis were performed to identify pertinent randomized controlled trials. The primary end point was the occurrence of target lesion failure.

Effects of left bundle branch block on echocardiographic coronary flow assessment: A systematic review.

This systematic review investigates the diagnostic and prognostic utility of coronary flow reserve (CFR) assessment through echocardiography in patients with left bundle branch block (LBBB), a condition known to complicate the clinical evaluation of coronary artery disease (CAD). The literature search was performed on PubMed, EMBASE, Web of Science, Scopus, and Google Scholar, was guided by PRISMA standards up to March 2024, and yielded six observational studies that met inclusion criteria. These studies involved a diverse population of patients with LBBB, employing echocardiographic protocols to clarify the impact of LBBB on coronary flow dynamics.

Coronary Microvascular Dysfunction: A Guide for Clinicians.

Dysfunction of the coronary microvasculature has become increasingly recognized as an important mechanism of myocardial ischemia in patients without obstructive coronary artery disease. The causes and management of coronary microvascular dysfunction remain poorly understood and are still largely based on extrapolation of epicardial coronary artery disease data. Quantification of myocardial blood flow and flow reserve have improved diagnosis, though important questions remain.

Cardiovascular Disease from Pathophysiology to Risk Estimation: Is Inflammation Estimated through Perivascular Attenuation on Computed Tomography the Key?

(1) Background: Systemic inflammation stands as a well-established risk factor for ischemic cardiovascular disease, as well as a contributing factor in the development of cardiac arrhythmias, notably atrial fibrillation. Furthermore, scientific studies have brought to light the pivotal role of localized vascular inflammation in the initiation, progression, and destabilization of coronary atherosclerotic disease. (2) Methods: We comprehensively review recent, yet robust, scientific evidence elucidating the use of perivascular adipose tissue attenuation measurement on computed tomography applied to key anatomical sites.

Effects of Static Meditation Practice on Blood Lipid Levels: A Systematic Review and Meta-Analysis.

This review aims to delineate the potential impact of static meditation practice on cholesterol and triglyceride levels. PubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar were systematically screened up until December 2023 to identify pertinent studies. After searching the scientific literature, 16 clinical studies (11 trials and 5 observational experiments) met the criteria for inclusion, involving a total of 1147 participants.