Artificial Intelligence based fractional flow reserve.

Fractional flow reserve (FFR) - a physiological indicator of coronary stenosis significance - has now become a widely used parameter also in the guidance of percutaneous coronary intervention (PCI). Several studies have shown the superiority of FFR compared to visual assessment, contributing to the reduction in clinical endpoints. However, the current approach to FFR assessment requires coronary instrumentation with a dedicated pressure wire and thus increasing invasiveness, cost, and duration of the procedure.

Validation of the COAPT risk score in Polish patients undergoing transcatheter edge-to-edge repair of severe, functional mitral regurgitation: a multicenter, observational study.

Background: The COAPT risk score, developed based on the COAPT trial, is a tool to predict the risk of death or hospitalization for heart failure (HFH) within two years after transcatheter edge-to-edge repair (TEER) of mitral regurgitation using a MitraClip device. We aimed to validate the Score in a Polish population.

Methods: Patients with severe mitral regurgitation who underwent TEER with MitraClip at three cardiology centers in Poland between November 2015 and February 2023 were included.

Long-term safety and efficacy of self-apposing Stentys drug-eluting stent in left main stem percutaneous coronary intervention: final results of multicentre LM-STENTYS registry.

Background: Stentys drug-eluting stent (Stentys DES) was proposed to possess potential benefits over balloon-expandable platforms in large bifurcations, mainly distal left main stem (LMS). Several registries demonstrated favourable one-year clinical results of percutaneous coronary intervention (PCI) using Stentys DES for LMS disease. However, long-term follow- up data have been lacking hitherto.

Extended dual antithrombotic therapy in patients with chronic coronary syndrome - which agent should be added to aspirin?

According to the 2024ESC Guidelines for the management of chronic coronary syndromes dual antithrombotic treatment comprising aspirin and a second antithrombotic drug for extended long-term prevention should be considered in patients at increased ischemic risk without high bleeding risk. However, no clear indications regarding the choice of a second antithrombotic agent are provided. It was therefore decided to discuss the available evidence regarding this issue.

Lipoproteins predicting coronary lesion complexity in premature coronary artery disease: a supervised machine learning approach.

Introduction: We aimed to assess the usefulness of lipoprotein(a) [Lp(a)] and LDL-C levels as potential predictors of coronary lesions' complexity in patients with premature coronary artery disease (pCAD).

Methods: This study enrolled 162 consecutive patients with pCAD undergoing coronary angiography. The SYNTAX score (SS) was used to assess coronary lesions' complexity.

The impact of the COVID-19 pandemic on ST-segment elevation myocardial infarction treatment strategy and outcomes.

Background: The most reliable care quality indicators for STEMI patients undergoing primary percutaneous coronary intervention (pPCI) include onset-to-door time (OTDT), time from admission to wire crossing and in-hospital mortality.

Aims: Our study aimed to evaluate the impact of the COVID-19 pandemic on these selected care quality indicators in pre-pandemic and pandemic groups of STEMI patients.

Methods: This single-centre, retrospective study, enrolled 480 STEMI patients, aged 63.

Hemodynamic, echocardiographic, and demographic profiles of patients with chronic thromboembolic pulmonary hypertension and atrial fibrillation: A multicenter cohort study.

Background: Atrial fibrillation (AFib) reduces the quality of life and increases hospitalization frequency in patients with pulmonary hypertension (PH). Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of PH with a specific pathophysiology, treatment methods, and demographics; however, the factors that correlate with AFib in this population have not yet been determined. This study aimed to investigate the variables that influence the AFib development in patients with CTEPH and assess the impact of arrhythmia on the mortality rate in this population.

Diagnostic and prognostic value of cystatin C in acute coronary syndrome: An up-to-date meta-analysis.

Background: The role of Cystatin C (CysC) in the diagnosis and prognosis of cardiovascular disease, particularly acute coronary syndrome (ACS), is increasingly significant. The goal of this meta-analysis was to assess the diagnostic and prognostic value of CysC in patients with ACS, as well as its association with major adverse cardiovascular events (MACE), defined as mortality, myocardial infarction, heart failure, and stroke.

Methods: The present study is a systematic review and meta-analysis.

Acute and short-term outcome of Intravascular Coronary Lithotripsy and Excimer Laser Coronary Atherectomy for Severe Stent Underexpansion: The Multicenter IVL-ELCA DRAGON Registry.

Background: Intravascular lithotripsy (IVL) and excimer laser-coronary atherectomy (ELCA) could be both used in the percutaneous treatment of coronary stent underexpansion.

Aims: To investigate the effectiveness and safety of IVL vs. ELCA for the treatment of stent underexpansion related to heavy calcifications.

Maintenance therapy with a P2Y12 receptor inhibitor after cangrelor in patients with acute coronary syndrome. The ELECTRA-SIRIO 2 investigators' viewpoint.

According to the ESC guidelines, cangrelor may be considered in P2Y12-inhibitor-naïve acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The aim of this review is to summarize available evidence on the optimal maintenance therapy with P2Y12 receptor inhibitor after cangrelor. Transitioning from cangrelor to a thienopyridine, but not ticagrelor, can be associated with a drug-drug interaction (DDI); therefore, a ticagrelor loading dose (LD) can be given any time before, during, or at the end of a cangrelor infusion, while a LD of clopidogrel or prasugrel should be administered at the time the infusion of cangrelor ends or within 30 minutes before the end of infusion in the case of a LD of prasugrel.

Management and predictors of event-free survival in nonagenarians with myocardial infarction: A nationwide analysis.

Background: Myocardial infarction (MI) remains the leading cause of death, especially in the elderly.

Aims: To characterize management and factors related to event-free survival in patients with acute MI aged at least 90 years.

Methods: We included all patients aged at least 90 years hospitalized for MI in Poland between 2014 and 2020 and followed them for one year.

Prolonged antithrombotic treatment after de-escalation of dual antiplatelet therapy in patients after acute coronary syndrome - which strategy should be applied? The ELECTRA-SIRIO 2 investigators standpoint.

De-escalation of dual antiplatelet (DAPT) intensity may be considered in patients with high risk of bleeding after acute coronary syndrome. Some high risk patients after de-escalation may require antithrombotic therapy prolonged over 12 months. With the current guideline recommended strategies, there are some doubts and uncertainties with respect to the transition period.

Effects of β-Blockers on the Outcomes in Patients With Pulmonary Arterial Hypertension Stratified by the Presence of Comorbid Conditions: A Multicenter Prospective Cohort Study: The Database of Pulmonary Hypertension in the Polish Population (BNP-PL).

Background: Current guidelines do not recommend β-blockers in pulmonary arterial hypertension (PAH) unless indicated by comorbidities. However, the evidence regarding the role of β-blockers in PAH is contradictory.

Research Question: What are the effects of β-blockers on clinical outcomes in patients newly diagnosed with PAH, and how do these outcomes differ based on the presence of cardiovascular comorbidities that are standard indications for β-blocker use?

Study Design And Methods: We analyzed data from 806 patients newly diagnosed with PAH enrolled prospectively in the Database of Pulmonary Hypertension in the Polish Population (BNP-PL).

Drug-Eluting Balloons and Drug-Eluting Stents in Diabetic Patients Undergoing Percutaneous Coronary Intervention Due to Restenosis-DM-Dragon Registry.

: The rate of in-stent restenosis (ISR) is decreasing; however, it is still a challenge for contemporary invasive cardiologists. Therapeutic methods, including drug-eluting balloons (DEBs), intravascular lithotripsy, excimer laser coronary atherectomy, and imaging-guided percutaneous coronary intervention (PCI) with drug-eluting stents (DES), have been implemented. Patients with diabetes mellitus (DM) are burdened with a higher risk of ISR than the general population.

Long-Term Outcomes Following Sirolimus-Coated Balloon or Drug-Eluting Stents for Treatment of In-Stent Restenosis.

Background: Evidence suggests that drug-coated balloons may benefit in-stent restenosis (ISR) treatment. However, the efficacy of new-generation sirolimus-coated balloon (SCB) compared with the latest generation drug-eluting stents (DESs) has not been studied in this setting.

Methods: All patients in the EASTBORNE (The All-Comers Sirolimus-Coated Balloon European Registry) and DEB-DRAGON (DEB vs Thin-DES in DES-ISR: Long Term Outcomes) registries undergoing percutaneous coronary intervention for DES-ISR were included in the study.