Predictors of lipoprotein(a) variability in clinical practice and their impact on cardiovascular risk.

Background: Lipoprotein(a) (Lp[a]) is an established cardiovascular risk marker; however, its intraindividual variability and implications for risk stratification remain poorly understood. This study investigated the clinical and biochemical predictors of high Lp(a) levels and evaluated their potential roles in cardiovascular risk assessment to inform evidence-based public health strategies for cardiovascular disease prevention.

Methods: This retrospective multicenter observational study was conducted using data from three tertiary university hospitals in Korea.

Prognostic significance of diastolic hypotensive episodes in patients stabilized after acute heart failure.

Background: Optimal blood pressure (BP) management is important for improving clinical outcome for patients with heart failure. While systolic BP has traditionally guided therapy, the prognostic value of transient diastolic hypotension in chronic heart failure is unclear. This study aimed to evaluate whether a single episode of diastolic BP (DBP) <60 mmHg predicts adverse cardiovascular events in heart failure patients who achieved clinical stability after acute decompensation.

Differential Effects of Antihypertensive Drugs on Central Blood Pressure: A Randomized Comparison between Nebivolol and Telmisartan.

Background: Central blood pressure (CBP) is a better predictor of cardiovascular outcomes than peripheral blood pressure. First- and second-generation beta-blockers have poor CBP-lowering effects. However, nebivolol, a third-generation beta-blocker with vasodilatory effects, may be beneficial in lowering CBP.

Proportion and Clinical Impact of Stent Optimization During Imaging-Guided Percutaneous Coronary Intervention: The OCTIVUS Trial.

Background: Data regarding the proportion and clinical impact of achieving stent optimization by intravascular ultrasound (IVUS)- or optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) remain limited.

Objectives: The authors assessed the proportion and cardiovascular outcomes in patients with and without stent optimization using imaging guidance.

Methods: This secondary analysis of the OCTIVUS (Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided Percutaneous Coronary Intervention) trial classified patients into optimized (meeting all prespecified optimization criteria) or nonoptimized groups.

Potassium-competitive acid blocker vs proton-pump inhibitor in patients receiving antithrombotic therapy who are at high risk for gastrointestinal bleeding: Rationale and design of the randomized PROTECT- HBR trial.

Background: Concomitant use of proton pump inhibitor (PPI) is recommended in patients receiving chronic antithrombotic therapy who are at high risk of gastrointestinal (GI) bleeding. However, long-term safety and efficacy of chronic PPI use have been concerned. Potassium-competitive acid blocker (P-CAB) is a novel class of acid suppressants, providing more acid stability, rapid onset of action, less variability with CYP2C19 polymorphisms, and longer duration of action than PPI.

Diastolic blood pressure variability predicts adverse outcomes in stabilized acute heart failure patients.

Blood pressure variability; heart failure; Cardiovascular outcome; Diastolic blood pressure.

Impact of Diabetes on Long-Term Outcomes of Percutaneous Coronary Intervention for Coronary Bifurcation Lesions.

Background: Diabetes mellitus (DM) is a well-known risk factor for cardiovascular diseases, including coronary artery diseases (CAD). Complex percutaneous coronary intervention (PCI) such as PCI for bifurcation lesions often yields poor outcomes, especially in DM patients.

Aims: The effect of DM on cardiovascular outcomes in bifurcation PCI was investigated in this retrospective, multicenter, observational, real-world registry of 2648 patients with coronary bifurcation lesions undergoing PCI with contemporary drug-eluting stents (DES).

Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients.

Chlorthalidone (CLTD) and hydrochlorothiazide (HCTZ) are widely used thiazide diuretics for hypertension management. This study aimed to evaluate and compare the cardiovascular outcomes of patients treated with CLTD versus HCTZ. This multicenter, retrospective cohort study utilized data from the Korea University Medical Center, derived from electronic health records.

Minimum number of readings necessary for determining long-term visit-to-visit blood pressure variability to predict cardiovascular outcomes in people with diabetes.

Background: People with diabetes often have increased blood pressure (BP) variability because of autonomic dysfunction and arterial stiffness, making it a critical factor in predicting clinical outcomes. We investigated the reproducibility of long-term visit-to-visit BP variability (VVV) and the minimum number of BP readings to reliably determine VVV in people with diabetes.

Methods: This multicenter retrospective study used data from electronic health records of the Korea University Medical Center database.

Deep learning model for identifying acute heart failure patients using electrocardiography in the emergency room.

Aims: Acute heart failure (AHF) poses significant diagnostic challenges in the emergency room (ER) because of its varied clinical presentation and limitations of traditional diagnostic methods. This study aimed to develop and evaluate a deep learning model using electrocardiogram (ECG) data to enhance AHF identification in the ER.

Methods And Results: In this retrospective cohort study, we analysed the ECG data of 19 285 patients who visited ERs of three hospitals between 2016 and 2020; 9119 with available left ventricular ejection fraction and N-terminal prohormone of brain natriuretic peptide level data and who were diagnosed with AHF were included in the study.

Sex Differences in Procedural Characteristics and Clinical Outcomes Among Patients Undergoing Bifurcation PCI.

Background And Objectives: The risk profiles, procedural characteristics, and clinical outcomes for women undergoing bifurcation percutaneous coronary intervention (PCI) are not well defined compared to those in men.

Methods: COronary BIfurcation Stenting III (COBIS III) is a multicenter, real-world registry of 2,648 patients with bifurcation lesions treated with second-generation drug-eluting stents. We compared the angiographic and procedural characteristics and clinical outcomes based on sex.

Comparative Effectiveness of Lercanidipine and Amlodipine on Major Adverse Cardiovascular Events in Hypertensive Patients.

Background: Lercanidipine, a newer-generation calcium channel blocker, is recognized for its effective antihypertensive properties and reduced side effects. This study aims to compare the effectiveness of lercanidipine and amlodipine in preventing major adverse cardiovascular events (MACE) in hypertensive patients.

Methods: A multicenter, retrospective observational study was conducted using the electronic medical records database from 3 tertiary hospitals in South Korea between 2017 and 2021.

Alternative LDL Cholesterol-Lowering Strategy vs High-Intensity Statins in Atherosclerotic Cardiovascular Disease: A Systematic Review and Individual Patient Data Meta-Analysis.

Importance: In patients with atherosclerotic cardiovascular disease (ASCVD), intensive lowering of low-density lipoprotein (LDL) cholesterol levels with high-intensity statins is generally recommended. However, alternative approaches considering statin-related adverse effects and intolerance are needed.

Objective: To compare the long-term efficacy and safety of an alternative LDL cholesterol-lowering strategy vs high-intensity statin strategy in patients with ASCVD in randomized clinical trials.

Comparison of Statin With Ezetimibe Combination Therapy Versus Statin Monotherapy for Primary Prevention in Middle-Aged Adults.

Background And Objectives: Lipid lowering therapy is essential to reduce the risk of major cardiovascular events; however, limited evidence exists regarding the use of statin with ezetimibe as primary prevention strategy for middle-aged adults. We aimed to investigate the impact of single pill combination therapy on clinical outcomes in relatively healthy middle-aged patients when compared with statin monotherapy.

Methods: Using the Korean National Health Insurance Service database, a propensity score match analysis was performed for baseline characteristics of 92,156 patients categorized into combination therapy (n=46,078) and statin monotherapy (n=46,078) groups.

Association of Age- and Body Mass Index-Stratified High On-Treatment Platelet Reactivity With Coronary Intervention Outcomes in East Asian Patients.

Background: Although age and body mass index (BMI) significantly affect platelet reactivity units and clinical outcomes after percutaneous coronary intervention, there are limited data on the relationship between high on-treatment platelet reactivity (HPR) and clinical outcomes on age and BMI differences. Thus, we investigated the association of HPR with clinical outcomes according to age and BMI.

Methods And Results: The study analyzed 11 714 patients who underwent platelet function tests after percutaneous coronary intervention.

The Use of Coronary Imaging for Predicting Future Cardiovascular Events.

Background: Despite advancements in coronary artery disease (CAD) treatment with drug-eluting stent, its morbidity and mortality remain high. In context, intravascular imaging-guided percutaneous coronary intervention (PCI) is increasingly recommended for better clinical outcomes in patient with CAD. Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS), as one of the intravascular imaging methods, is effective in detecting lipid-rich plaques, which is crucial for identifying high-risk or vulnerable plaques employing near-infrared light.

Quantitative Coronary Angiography vs Intravascular Ultrasonography to Guide Drug-Eluting Stent Implantation: A Randomized Clinical Trial.

Importance: Although intravascular ultrasonography (IVUS) guidance promotes favorable outcomes after percutaneous coronary intervention (PCI), many catheterization laboratories worldwide lack access.

Objective: To investigate whether systematic implementation of quantitative coronary angiography (QCA) to assist angiography-guided PCI could be an alternative strategy to IVUS guidance during stent implantation.

Design, Setting, And Participants: This randomized, open-label, noninferiority clinical trial enrolled adults (aged ≥18 years) with chronic or acute coronary syndrome and angiographically confirmed native coronary artery stenosis requiring PCI.