Image-guided percutaneous revascularization of the coronary arteries.

The European Society of Cardiology recently updated guidelines on the management of chronic coronary syndromes upgrading the use of intracoronary imaging for complex percutaneous coronary interventions (PCI) to a class 1A recommendation. It is essential that the interventional community appreciate the additive value of intracoronary imaging over angiography alone-not only to obtain optimal acute PCI results but also to improve longer-term cardiovascular outcomes. The purpose of this manuscript is to review the latest evidence that informed the recent guideline recommendations and expand on the specific role of the different imaging modalities before, during, and after PCI.

Unraveling the gut: the pivotal role of intestinal mechanisms in Kawasaki disease pathogenesis.

Kawasaki disease (KD), an acute systemic vasculitis that primarily affects children under 5 years of age, is the leading cause of acquired heart disease in this age group. Recent studies propose a novel perspective on KD's etiology, emphasizing the gastrointestinal (GI) tract, particularly the role of gut permeability. This review delves into how disruptions in gut barrier function trigger systemic inflammatory responses, exacerbate vascular inflammation, and contribute to coronary artery aneurysms.

Decoding the Lipid-Angiogram Link: Can Serum Lipid Profile Help Predict Your Clogged Arteries?

Objective In this study, we aimed to analyze the correlation between lipid profile and angiographic profile in terms of vessel involvement, segment involvement, and angiographic severity in patients with acute coronary syndrome (ACS). Methods One hundred patients diagnosed with ACS for the first time and undergoing coronary catheterization were included. Fasting samples for lipids profile were obtained.

Oesophageal submucosal haematoma in a patient with acute coronary syndrome.

A man in his mid-70s presented with recent-onset angina. An ECG revealed ST-segment depression, and he was started on treatment under the diagnosis of acute coronary syndrome. 12 hours after admission, he developed haematemesis and dysphagia.

Biomarker diagnostics of endothelial dysfunction in patients with acute coronary syndrome and non-alcoholic fatty liver disease.

Objective: Aim: To determine the severity of endothelial dysfunction (ED) in patients with acute coronary syndromes (ACS) in non-alcoholic fatty liver disease (NAFLD).

Patients And Methods: Materials and Methods: The study included 124 patients with ACS. Group 1 included 74 patients after ACS and NAFLD, and group 2 consisted of 50 patients after ACS without liver damage.

Myocardial Infarction with ST Elevation and Reperfusion Therapy in Brazil: Data from the ACCEPT Registry.

Background: There is a lack of information from Brazil regarding therapies used and outcomes in patients with acute coronary syndrome with ST elevation (STEMI).

Objectives: To evaluate evidence-based therapies, occurrence of outcomes, reperfusion use, and predictors of not receiving reperfusion in patients with STEMI in a national multicenter registry.

Methods: Patients with STEMI from the ACCEPT registry, with up to 12 hours of symptoms, were followed for 1 year for the occurrence of major adverse cardiovascular events.

Free-Breathing Ungated Radial Simultaneous Multi-Slice Cardiac T1 Mapping.

Background: Modified Look-Locker imaging (MOLLI) T1 mapping sequences are acquired during breath-holding and require ECG gating with consistent R-R intervals, which is problematic for patients with atrial fibrillation (AF). Consequently, there is a need for a free-breathing and ungated framework for cardiac T1 mapping.

Purpose: To develop and evaluate a free-breathing ungated radial simultaneous multi-slice (SMS) cardiac T1 mapping (FURST) framework.

Risk Factors Favoring Plaque Erosion.

Purpose Of Review: Plaque erosion is the second leading cause of coronary thrombosis following plaque rupture and represents a key pathophysiological process underlying acute coronary syndromes that can culminate in sudden coronary death. While the precise mechanisms and risk factors driving plaque rupture are well-established, those for erosion have only recently been explored. This review summarizes current literature on the characteristics and risk factors favoring plaque erosion.

Intravascular Ultrasound-Guided Versus Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Control Trials.

Background: Intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) allows better assessment of coronary artery lesion characteristics than angiography alone. This systematic review and meta-analysis aimed to comprehensively synthesize the available evidence regarding the efficacy of IVUS guidance compared to angiography-guided PCI.

Methods: A comprehensive literature search of major bibliographic databases from inception until April 2024 was conducted to identify randomized control trials (RCTs) comparing IVUS-guided PCI versus angiography-guided PCI.

Inflammation Biomarker-Driven Vertical Visualization Model for Predicting Long-Term Prognosis in Unstable Angina Pectoris Patients with Angiographically Intermediate Coronary Lesions.

Objective: Angina, a prevalent manifestation of coronary artery disease, is primarily associated with inflammation, an established contributor to the pathogenesis of atherosclerosis and acute coronary syndromes (ACS). Various inflammatory markers are employed in clinical practice to predict patient prognosis and optimize clinical decision-making in the management of ACS. This study investigated the prognostic significance of integrating commonly used, easily repeatable inflammatory biomarkers within a multimodal preoperative prediction model in patients presenting with unstable Angina Pectoris (UAP) and intermediate coronary lesions.

Task Shifting in Cardiac Catheterization to Sustain Physicians and Acute Coronary Syndrome Response Centers - Findings From the 2024 Japanese Circulation Society Chugoku-Shikoku Regional Survey.

Background: Sustainability of the 24/7 acute coronary syndrome response system is at risk due to the Work Style Reform for physicians.

Methods And Results: A survey of 93 facilities in Chugoku-Shikoku region found that 30% of facilities expected acute coronary syndrome services to be restricted due to the Work Style Reform. Approximately 35% had implemented task shifting, which reduced physicians' workload by 30% and improved team care.

Impact of Nutritional Status and Cardiopulmonary Exercise Testing-Based Exercise Education on Long-Term Outcomes in Acute Coronary Syndrome - Insights From the Mie ACS Registry.

Background: Exercise training based on cardiopulmonary exercise testing (CPET) improves outcomes in patients with acute coronary syndrome (ACS), while nutritional status is also crucial. This study evaluated CPET implementation and the impacts of clinical parameters, including CPET and nutritional status, on 2-year outcomes in ACS patients.

Methods And Results: Data from 2,621 ACS patients enrolled in the Mie ACS registry were analyzed.

Elevated cardiac troponin secondary to heterophile antibodies: a case series highlighting an underrecognized differential.

Background: Heterophile antibody presence confounds troponin assay results, causing falsely elevated troponin levels. This rare phenomenon is an important differential to consider when evaluating patients with suspected acute coronary syndrome. We present a case series of three patients with similar clinical presentations where the presence of heterophile antibodies was confirmed.

Embolic myocardial infarction secondary to marantic endocarditis in a patient with ulcerative colitis: case report.

Background: Nonbacterial thrombotic endocarditis (NBTE) is an uncommon and often underdiagnosed condition characterized by a state of hypercoagulability. We present a case of a patient with ulcerative colitis who experienced a non-ST-segment elevation myocardial infarction as a rare complication of NBTE.

Case Summary: We report a case of a 16-year-old male with a history of ulcerative colitis who presented to the emergency department with chest pain at rest.

Comparison of Multivessel Versus Culprit-Vessel-Only Revascularization in Patients With STEMI and Multivessel Disease During Primary PCI: In-Hospital Outcomes From the CCC-ACS Project in China.

Background: The consensus on whether acute ST-segment elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease (MVD) benefit from complete revascularization during primary percutaneous coronary intervention (PCI) is unclear.

Aims: This study aims to assess the impact of multivessel PCI (MV-PCI) versus culprit-vessel-only PCI (CV-PCI) on in-hospital outcomes in a Chinese population.

Methods: We evaluated STEMI patients with MVD undergoing PCI, registered in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) project, from November 2014 to December 2019.

The impact of sleep deprivation on the occurrence of acute coronary syndrome depending on obesity status.

Objective: To determine how sleep insufficiency affects the occurrence of acute coronary syndrome in the presence of obesity.

Methods: The observational study was conducted in South Korea on the basis of data collected by a cohort study conducted from January 2001 to December 2020, and comprised adults of either gender aged 40-69 years. During the 20-year period, 9 follow-up surveys were conducted at two-year intervals.

[Guidelines of the European Society of Cardiology on chronic coronary syndrome from 2024].

The 2024 European Society of Cardiology (ESC) guidelines on chronic coronary syndrome comprehensively summarize the symptoms, diagnostics and treatment of coronary artery disease, excluding acute coronary syndromes. The processing always begins with an estimation of the clinical probability, which should include not only the symptom profile but also the number of cardiovascular risk factors and is further modified by any conspicuous findings in electrocardiography (ECG), exercise testing, or echocardiography. For further diagnostics, coronary angiography via computed tomography is the first-line approach if the probability lies between 5% and 50%.

Sex differences in the intention and decision to use emergency medical services for acute coronary syndrome in Australia: a retrospective study.

Background: Sex-based disparities in acute coronary syndrome (ACS) presentations exist and women often have worse outcomes after an ACS event. Calling the emergency medical services (EMS) initiates prehospital diagnosis and treatment and reduces in-hospital time to treatment. This study aims to identify factors affecting the intention to call EMS and EMS usage in Australian women and men.

Malperfusion, Malperfusion Syndrome, and Mesenteric Ischemia in Aortic Dissection.

Aortic malperfusion occurs in a significant percentage of patients with acute aortic dissection, and causes malperfusion syndrome, the clinical entity defined by end organ ischemia, in 10-33% of patients. Malperfusion syndrome can be rapidly lethal and can involve the coronary, cerebral, visceral, or lower extremity vessels. Depending on presentation, it may be appropriately and well treated with endovascular fenestration prior to definitive central aortic repair.

Impact of CT-angiography derived plaque characteristics on cardiac events in patients with a negative invasive fractional flow reserve.

Background: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for chronic coronary syndromes (CCS) improves outcomes compared with angiography-guided PCI, however cardiac events still occur during long-term follow-up of FFR-negative patients. In the PREVENT study preventive PCI reduced cardiac-events in lesions which were FFR-negative (FFR > 0.80) and had intracoronary imaging defined vulnerable plaque.

Global Longitudinal Strain is a Predictor of Mortality in Patients with Cardiogenic Shock.

Aims: Cardiogenic shock (CS) is a critical manifestation of severe cardiac dysfunction, necessitating precise evaluation of left ventricular function by transthoracic echocardiography. The prognostic value of global longitudinal strain (GLS) has not been examined in patients with CS. Therefore, we aimed to assess the prognostic significance of GLS in patients with CS.

Impact of obesity on low density lipoprotein plasmatic levels 6 weeks after an acute coronary syndrome.

Introduction: Cardiovascular disease is the leading cause of death. One of the main factors is obesity, which is on the rise. LDL levels below 0.

Takotsubo Cardiomyopathy Caused by Gastritis Without Typical Stressors: A Case Report.

Takotsubo cardiomyopathy (TCM) is characterized by transient left ventricular dysfunction in the absence of significant coronary artery disease. First described in Japan in the 1990s by Sato et al., this unique reversible cardiomyopathy typically occurs in post-menopausal women and is frequently triggered by physical or physiological stress.

Genetics architecture of spontaneous coronary artery dissection in an Italian cohort.

Spontaneous coronary artery dissection (SCAD) is a relevant non-atherosclerotic cause of acute coronary syndrome with a complex genetic architecture. Recent discoveries have highlighted the potential role of miRNAs and protein-coding genes involved in the processing of small RNAs in the pathogenesis of SCAD. Furthermore, there may be a connection between SCAD and the increased cardiovascular risk observed in fragile X premutation carriers as well as a correlation with pathogenetic variants in genes encoding for collagen and extracellular matrix, which are related to connective tissue disorders (CTDs).