Temporal modulation of antiplatelet therapy in high-risk patients undergoing complex percutaneous coronary intervention: the TAILORED-CHIP randomized clinical trial.

Background And Aims: Limited data exist on optimal antiplatelet strategies for high-risk patients undergoing complex percutaneous coronary intervention (PCI). This study aimed to investigate the efficacy and safety of tailored antiplatelet treatment with temporal modulation of the intensity of platelet inhibition in patients undergoing complex high-risk PCI.

Methods: We randomly assigned 2018 patients with high-risk anatomical or clinical characteristics undergoing complex PCI to a tailored antiplatelet strategy with early escalation (low-dose ticagrelor at 60 mg twice daily plus aspirin <6 months) and late de-escalation (clopidogrel monotherapy >6 months) or dual antiplatelet therapy (clopidogrel plus aspirin for 12 months).

Long-term clinical outcomes according to first responsive dose of acetylcholine in patients with coronary artery spasm.

Background: Coronary artery spasm (CAS) has become a focus of recent prognostic studies. However, research evaluating prognosis based on the initial dose of acetylcholine (ACH) at which patients first respond is lacking. This study aims to investigate long-term clinical outcomes according to the first responsive dose of ACH in patients with CAS.

Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome.

Background: Antiplatelet therapy is pivotal in managing elderly patients with Acute Coronary Syndrome (ACS) following Percutaneous Coronary Intervention (PCI). While aspirin remains a cornerstone of this therapy, its use is sometimes limited by the risk of gastrointestinal (GI) complications or allergic reactions in certain patients.

Purpose: This study aims to assess the safety and efficacy of Indobufen as an alternative to aspirin when used in combination with clopidogrel in elderly ACS patients post-PCI.

Prognostic value of the six-minute walk test in patients with cardiovascular disease.

The six-minute walk test (6MWT) is a convenient method for evaluating functional capacity in daily living. We evaluated the prognostic value of the 6MWT in patients with cardiovascular disease to predict the incidence of MACE. Patients with prevalent cardiovascular diseases were enrolled in the cardiac rehabilitation registry.

Comparison of High-Dose versus Low-Dose Paclitaxel Drug-Coated Balloons for Native Femoropopliteal Artery Disease: An Analysis of the K-VIS ELLA Registry.

Purpose: Drug-coated balloons (DCBs) have demonstrated favorable outcomes in the treatment of femoropopliteal artery (FPA) disease. A variety of DCBs are currently available, with differing doses of antiproliferative agents and types of excipients. The objective of this study was to compare the efficacy and safety of high-dose versus low-dose paclitaxel DCBs for the treatment of FPA disease.

Impact of diabetes and ejection fraction on non-ST-Segment elevation myocardial infarction outcomes.

Given the limited published data, we examined three-year outcomes in patients with and without diabetes mellitus (DM) in non-ST-segment elevation myocardial infarction (NSTEMI), according to left ventricular ejection fraction (LVEF). A total of 4594 patients were classified into DM (n = 1608) and non-DM (n = 2986) groups. They were further classified into heart failure with reduced EF (HFrEF, LVEF ≤ 40%), HF with mildly reduced EF (HFmrEF, LVEF 41-49%), and HF with preserved EF (HFpEF, LVEF ≥ 50%) subgroups.

Long-term outcomes of intravascular ultrasound-guided percutaneous coronary intervention versus coronary artery bypass grafting for multivessel coronary artery disease.

Background: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) has been shown to improve outcomes in complex coronary artery disease compared with angiography-guided PCI. However, long-term comparisons between IVUS-guided PCI and coronary artery bypass grafting (CABG) for multivessel disease (MVD) remain limited.

Methods: This post hoc analysis of the Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment Extended Follow-up study included 880 patients with MVD, excluding 15 patients who received medical therapy.

Development and validation of a risk prediction model for adverse outcomes in patients with suspected coronary artery disease and no significant stenosis on angiography: a retrospective cohort study.

Objectives: To develop and validate a risk prediction model for adverse outcomes in patients with angina with non-obstructive coronary arteries (ANOCA) confirmed by invasive coronary angiography.

Design: Retrospective cohort study.

Setting: A tertiary cardiovascular care centre in China.

Impact of PCSK9 inhibitors on bleeding and adverse outcomes in post-PCI patients undergoing antiplatelet therapy: A real-world cohort study.

Background: The relationship between low-density lipoprotein cholesterol (LDL-C) levels and bleeding risk during antiplatelet therapy post-percutaneous coronary intervention (PCI) is uncertain, and the effect of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) on bleeding risk is unknown.

Methods: This retrospective cohort study analyzed data from 85,464 PCI patients on oral antiplatelet therapy across 82 Tianjin hospitals from 2017 to 2023, using 1:1 PSM. The primary outcome was Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding within one year.

Association Between Vasomotor Response to Ergonovine Provocation Test and Non-Severe Coronary Artery Stenosis.

Background: Coronary artery spasm (CAS) causes vasospastic angina in patients without significant coronary artery stenosis. However, there has been limited investigation regarding the CAS patterns within this population. This study aims to evaluate the incidence and patterns of CAS in patients with non-severe coronary artery stenosis using intracoronary ergonovine (ERG) provocation test.

Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial.

Background: The optimal strategy for long-term antiplatelet maintenance for patients who underwent percutaneous coronary intervention (PCI) remains uncertain. This study aimed to compare the efficacy and safety of clopidogrel versus aspirin monotherapy in patients who completed a standard duration of dual antiplatelet therapy (DAPT) following PCI with drug-eluting stents.

Methods: In this multicentre, randomised, open-label trial, patients aged 19 years or older at high risk of recurrent ischaemic events (previous myocardial infarction at any time before enrolment, medication-treated diabetes, or complex coronary lesions) who completed a standard duration of DAPT after PCI were randomly assigned (1:1) to receive clopidogrel (75 mg once a day) or aspirin (100 mg once a day) oral monotherapy at 26 sites in South Korea.

Interpreting clinical outcomes using different strut thickness in coronary artery disease: insights from vascular imaging analysis.

Background: Coronary artery disease is a global health concern that necessitates treatments, such as percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Recent advancements in biodegradable polymer-coated DES have improved long-term outcomes by reducing neointimal hyperplasia. Superior long-term outcomes in patients with ultrathin-strut sirolimus-eluting Orsiro stent (BP-SES) compared with those with thick-strut biolimus-eluting BioMatrix stent (BP-BES) have been shown.

Association of Handgrip Strength With Readmission, Mortality, and Exercise Capacity in Patients With Heart Failure.

Background: Patients with heart failure (HF) experience a marked reduction in overall skeletal muscle strength and exercise capacity, which is detrimental to their prognosis. This study examined the clinical implications of handgrip strength (HGS) in patients with HF.

Methods: Overall, 173 patients (mean age, 62 years; 81.

A Prospective Randomized Trial Comparing 2 Different Paclitaxel-Coated Balloons in De Novo Coronary Artery Disease.

Background: The Genoss paclitaxel-coated balloon (PCB) is a novel PCB with shellac and vitamin E as excipients, enhancing drug delivery to the target lesion and minimizing restenosis.

Objectives: This study aimed to compare quantitative coronary angiographic outcomes at 6 months after treatment of de novo coronary artery disease (CAD) with 2 different types of PCBs.

Methods: This prospective, multicenter, noninferiority trial randomized 204 patients with chronic coronary syndrome or stabilized acute coronary syndrome to treatment with the shellac and vitamin E-based PCB or the reference PCB (SeQuent Please NEO) in a 1:1 ratio.

A Multi-Center, Prospective, Observational Study to Evaluate the Therapeutic Effectiveness and Safety of an Olmesartan/Amlodipine Plus Rosuvastatin Combination Treatment in Patients with Concomitant Hypertension and Dyslipidemia.

This study assessed the therapeutic effectiveness of a single-pill combination (SPC) of olmesartan/amlodipine plus rosuvastatin for blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) in patients with hypertension and dyslipidemia. Adult patients with hypertension and dyslipidemia who were decided to be treated with the study drug were eligible. The primary endpoint was the proportion of patients who achieved BP, LDL-C and both BP and LDL-C treatment goals at weeks 24-48.

Phase angle in bioelectrical impedance analysis for assessing congestion in acute heart failure.

Background: The phase angle (PhA) in bioelectrical impedance analysis (BIA) reflects the cell membrane integrity or body fluid equilibrium. We examined how the PhA aligns with previously known markers of acute heart failure (HF) and assessed its value as a screening tool.

Methods: PhA was measured in 50 patients with HF and 20 non-HF controls along with the edema index (EI), another BIA parameter suggestive of edema.

Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.

Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention.

Coronary vasomotor response incidence to intracoronary acetylcholine provocation test according to the severity of insignificant coronary artery stenosis in Korean population.

Background: Coronary artery spasm (CAS) is a cause of variant angina. However, the understanding of CAS patterns in the presence of mild-to-moderate coronary artery stenosis is limited. This study aimed to evaluate the incidence and patterns of CAS in patients with insignificant coronary artery stenosis using intracoronary acetylcholine (ACH) provocation test.

Beta-blockers after percutaneous coronary intervention for acute myocardial infarction and non-reduced left ventricular ejection fraction.

Background: Data on the clinical impact of beta-blockers (BBs) in patients with myocardial infarction (MI) who had non-reduced left ventricular ejection fraction (LVEF) after percutaneous coronary intervention are limited.

Methods: From 2016 to 2020, we evaluated a cohort of 12,101 myocardial infarction patients with a non-reduced LVEF (≥40%) from the Korean Acute Myocardial Infarction Registry V. Patients were divided into two groups based on their BB (carvedilol, bisoprolol, or nebivolol) treatment at discharge: with beta-blocker treatment (BB,  = 9,468) and without beta-blocker treatment (non-BB,  = 2,633).

Impact of complete revascularization on long-term clinical outcomes in patients with multi-vessel disease, including chronic total occlusion.

To compare the long-term prognostic effect of complete percutaneous coronary intervention (PCI) on cardiovascular events in chronic total occlusion (CTO) patients with the multi-vessel disease (MVD) compared with medical therapy (MT). We enrolled 441 patients with CTO and MVD who underwent PCI. The study population was divided into the CTO-PCI (n = 231) and the CTO-MT (n = 210) groups.

Impact of symptom-to-balloon time in patients with non-ST-segment elevation myocardial infarction and complex lesions.

Aims: Considering the limited data regarding clinical outcomes of patients with non-ST-segment on the ECG elevation myocardial infarction (NSTEMI), this study compared the outcomes of patients undergoing percutaneous coronary intervention with newer-generation drug-eluting stents stratified by the presence/absence of complex lesions and symptom-to-balloon time (SBT; <48 h or ≥48 h).

Methods: We enrolled 4373 patients with NSTEMI from the Korea Acute Myocardial Infarction Registry-National Institute of Health dataset and stratified them into the complex group (2106 patients; SBT < 48 h, n  = 1365; SBT ≥48 h, n  = 741) and the noncomplex group (2267 patients; SBT < 48 h, n  = 1573; SBT ≥48 h, n  = 694). The primary outcome was the 3-year all-cause mortality rate.