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Long-Term Prognostic Implications of Non-Culprit Lesions in Patients Presenting With an Acute Myocardial Infarction: Is It the Angiographic Stenosis Severity or the Underlying High-Risk Morphology?
Circulation
January 2025
Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China (J.D., J.Z., X.X., Y.C., S.S., S.L., L.C., Y.W., L.L., R.G., D.H., X.M., R.Z., H.Y., T.C., J.T., X.L., S.J., J.H., C.F.B.Y.).
Background: Patients with acute myocardial infarction and angiographically obstructive non-culprit lesions are at high risk for recurrent major adverse cardiac events (MACEs). However, it remains largely unknown whether events are due to stenosis severity or due to the underlying high-risk lesion morphology.
Methods: Between January 2017 and December 2021, 1312 patients with acute myocardial infarction underwent optical coherence tomography of all the 3 main epicardial arteries after successful percutaneous coronary intervention.
Coronary CTA-Guided Bifurcation PCI: Role of FFR Virtual PCI and Myocardial Mass for Preprocedural Planning.
JACC Case Rep
January 2025
Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
Coronary computed tomography angiography (CTA) analysis can help in the planning of percutaneous coronary intervention (PCI). Fractional flow reserve derived from coronary CTA (FFR), coronary CTA-derived regional myocardial mass, and FFR virtual PCI planner can facilitate decisions concerning sheath and guide catheter selection, stent lengths on the basis of predicted post-PCI FFR, optimal fluoroscopic angles, evaluation of provisional vs 2-stent bifurcation PCI techniques, and assessment of the magnitude of jeopardized myocardial mass in cases with side branch compromise. This case series illustrates the emerging opportunities for coronary CTA-based planning of bifurcation PCI.
View Article and Find Full Text PDFUnmasking Culprit Complex Infero-Posterior STEMI: Navigating Ad Hoc RCA CTO PCI.
JACC Case Rep
January 2025
Section of Cardiovascular Diseases, White River Health, Batesville, Arkansas, USA.
Patients presenting with acute coronary syndrome with ST-segment elevation myocardial infarction require rapid and decisive interventions to restore blood flow to the affected myocardium, minimizing ischemic damage. This case report is particularly unique because it involves a patient presenting with ST-segment elevation myocardial infarction, where the culprit lesion was an occluded coronary artery graft with an extensive thrombus burden. The complexity of this case necessitated a strategic shift to revascularize the chronically occluded native vessel instead of the graft.
View Article and Find Full Text PDFCirculating ANGPTL3/8 Concentrations Are Associated With an Atherogenic Lipoprotein Profile and Increased CHD Risk in Swedish Population-Based Studies.
Arterioscler Thromb Vasc Biol
January 2025
Cardiovascular Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden. (A.S., R.M.F., F.M.v.H.).
Background: Binding of ANGPTL (angiopoietin-like protein)-3 to ANGPTL8 generates a protein complex (ANGPTL3/8) that strongly inhibits LPL (lipoprotein lipase) activity, as compared with ANGPTL3 alone, suggesting that ANGPTL3/8 concentrations are critical for the regulation of circulation lipoprotein concentrations and subsequent increased coronary heart disease (CHD) risk. To test this hypothesis in humans, we evaluated the associations of circulating free ANGPTL3 and ANGPTL3/8 complex concentrations with lipoprotein concentrations and CHD risk in 2 prospective cohort studies.
Methods: Fasting blood samples were obtained in conjunction with the baseline evaluation of 9479 subjects from 2 population-based Swedish cohorts of middle-aged men and women.
Current Status and Prospects of Regional Collaborative Pathways for Management of Acute Coronary Syndrome in Japan - A Nationwide Survey.
Circ J
January 2025
Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo.
Background: Comprehensive management of acute coronary syndrome (ACS) requires seamless treatment across institutions, including intensive care centers and local clinics. However, maintaining guideline-directed medical therapy remains challenging. One promising option to improve the situation may be the implementation of regional collaborative clinical pathways.
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