Computed Tomography Angiography or Standard Care After Left Main PCI?

Background: The clinical benefit of routine coronary computed tomography angiography (CCTA) after percutaneous coronary intervention (PCI) for unprotected left main (LM) disease is uncertain.

Objectives: The authors evaluated whether CCTA-guided follow-up improves clinical outcomes vs symptoms- or ischemia-driven care after LM PCI.

Methods: PULSE was a prospective, multicenter, open-label randomized trial.

Adverse cardiovascular events in coronary Plaques not undeRgoing pErcutaneous coronary intervention evaluateD with optIcal Coherence Tomography. The PREDICT-AI risk model.

Introduction: Most acute coronary syndromes (ACS) originate from coronary plaques that are angiographically mild and not flow limiting. These lesions, often characterised by thin-cap fibroatheroma, large lipid cores and macrophage infiltration, are termed 'vulnerable plaques' and are associated with a heightened risk of future major adverse cardiovascular events (MACE). However, current imaging modalities lack robust predictive power, and treatment strategies for such plaques remain controversial.

Sirolimus-Coated Balloon Versus Drug-Eluting Stent in Elderly Patients With Coronary Artery Disease: A Matched-based Comparison.

Coronary artery disease (CAD) is the leading cause of mortality in elderly patients (≥75 years). While percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) is commonly used in elderly patients with CAD, drug-coated balloons (DCB) have emerged as a promising alternative. The aim of this study was to compare the safety and efficacy of PCI with Sirolimus-Coated Balloons (SCB) and second-generation DES in this population.

Prevalence and prognostic implications of the Valve Academic Research Consortium-High Bleeding Risk criteria in patients undergoing transcatheter aortic valve implantation.

Background: The Valve Academic Research Consortium (VARC) recently proposed a definition of high bleeding risk (HBR) for patients undergoing transcatheter aortic valve implantation (TAVI). This study aims to evaluate the prevalence and distribution of the VARC-HBR criteria and their ability to predict in-hospital bleeding.

Methods: Patients undergoing TAVI at 18 European sites between 2007 and 2022 and included in the Transfusion Requirements in Transcatheter Aortic Valve Implantation (NCT03740425) registry were stratified into low, moderate, high or very high bleeding risk using the VARC-HBR criteria.

Safety and efficacy of P2Y12 inhibitors in acute coronary syndromes patients with KDIGO stage IV-V renal disfunction not on dialysis: a subanalysis of the CORALYS registry.

Background: The impact of the most potent P2Y12i ticagrelor and prasugrel after acute coronary syndrome in patients with chronic kidney disease (CKD) remains unclear. Most evidence on dual antiplatelet therapy (DAPT) comes from real-world study but is limited to glomerular filtration rate (GFR) under 60 ml/min.

Methods: Consecutive patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI) and severe CKD defined as GFR under 30 ml/min not on dialysis from the CORALYS registry were included.

Surgical ablation of atrial fibrillation with concomitant cardiac surgery: a state-of-the-art review.

Patients with preoperative atrial fibrillation (AF) undergoing cardiac surgery face a heightened risk of complications and reduced survival. Concomitant surgical ablation (SA) has shown promise in mitigating the arrhythmic burden, prompting guideline upgrades by major scientific societies. However, SA remains underutilized, with performance rates varying between 22% and 48%, depending on the type of procedure.

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.

How to treat coronary in-stent restenosis? Recent advances and their practical implications: State-of-the-Art Review.

Percutaneous coronary intervention with stent implantation has revolutionized the treatment of coronary artery disease. However, a significant drawback of this approach is the risk of in-stent restenosis (ISR), which increases each year following stent placement. This review of the current literature aims to enhance our understanding of the mechanisms behind ISR and its treatment.

Final kissing balloon dilatation in patients with coronary bifurcation lesions treated with an upfront provisional stenting strategy.

Background: The impact of final kissing balloon inflation (FKB) in patients treated with an upfront provisional strategy for coronary bifurcation lesions is controversial.

Aims: We aimed to assess the impact of FKB on patient- and lesion-oriented outcomes in a large real-world cohort.

Methods: The ULTRA-BIFURCAT registry was obtained by patient-level merging the BIFURCAT and ULTRA registries.

One-Year Prognosis for Patients Diagnosed with Acute Coronary Syndrome Compared to Those with Chronic Coronary Syndrome Following Complex Coronary Procedures.

Acute coronary syndrome (ACS) remains the primary cause of mortality worldwide. Performing complex coronary intervention in patients with ACS is considered a significant factor for worsening prognosis. This study aimed to evaluate the prognosis of patients with ACS treated with complex procedures compared to patients with chronic coronary syndrome (CCS).

Differential Prognosis of True Bifurcation Lesions According to Left Main Versus Non-Left Main Location and Treatment Strategy.

Background: Although true bifurcation lesions are associated with a high risk of procedural complications, the differential prognostic implications of percutaneous coronary intervention for true bifurcations according to lesion location are unclear. This study aimed to identify whether clinical outcomes of true bifurcation lesions differed between left main coronary artery (LM) and non-LM bifurcations and to determine the optimal treatment strategy for subtypes of bifurcation lesions in the current-generation drug-eluting stent era.

Methods: The ULTRA-BIFURCAT (Combined Insights From the Unified COBIS III, RAIN, and ULTRA Registries) was created by merging 3 bifurcation-dedicated registries from Korea and Italy.

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.

Differences in coronary microcirculation measurements during regadenoson vs. adenosine - induced hyperemia.

Background: Little is known about the similarity of microcirculation assessment outcomes performed with regadenoson and adenosine. The aim of the current study was to compare coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) assessment using adenosine and regadenoson, and to evaluate predictors regarding the size of differences.

Methods: 44 patients were enrolled and diagnosed between 2021 and 2023.

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.

Impact of intravascular ultrasound for coronary bifurcations treated with last generations stents: insights from the BIFURCAT-ULTRA registry.

Background: Bifurcation lesions are associated with higher rates of major adverse cardiovascular events (MACE).

Aim: To investigate the impact of imaging-guided PCI in a real-world population with coronary bifurcation lesions.

Methods: From the ULTRA-BIFURCAT registry, we compared IVUS vs.

Non-invasive physiological assessment of intermediate coronary stenoses from plain angiography through artificial intelligence: the STARFLOW system.

Background: Despite evidence supporting use of fractional flow reserve (FFR) and instantaneous waves-free ratio (iFR) to improve outcome of patients undergoing coronary angiography (CA) and percutaneous coronary intervention, such techniques are still underused in clinical practice due to economic and logistic issues.

Objectives: We aimed to develop an artificial intelligence (AI)-based application to compute FFR and iFR from plain CA.

Methods And Results: Consecutive patients performing FFR or iFR or both were enrolled.

Long-term outcomes of DCB and DES for the treatment of in-stent restenosis in relation to the vessel size.

Background: Percutaneous coronary intervention (PCI) with drug-coated balloons (DCB) or drug-eluting stents (DES) are well-established treatments for in-stent restenosis, however little is known about the impact of vessel size on the outcomes. The study aimed to evaluate the efficacy and safety profile of DCB versus DES in DES in-stent restenosis depending on the vessel size.

Methods: Consecutive patients with DES in-stent restenosis who underwent PCI between January 2010 and February 2018 entered the registry with a long-term follow-up.

Risk factors of cardiac arrest during a percutaneous coronary intervention performed with rotational atherectomy - analysis based on a Large National Registry.

Background: Rotational atherectomy (RA) is traditionally administered for patients with heavily calcified lesions and is thereby characterized by a high risk of the performed intervention. However, the prevalence characteristics of cardiac arrest are poorly studied in this group of patients. We aimed to evaluate the frequency and risk factors of cardiac arrest during percutaneous coronary interventions (PCI) performed with RA and preceding coronary angiography (CA).

Sirolimus-coated balloon versus drug-eluting stent for complex coronary lesions. A propensity matched comparison.

Introduction: Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in complex coronary artery disease (CAD) has been established as the standard of care, but stent-related events are not uncommon. Sirolimus-Coated Balloon (SCB)-based angioplasty is an emerging technology, although it needs to be thoroughly evaluated compared with DES in the complex PCI setting. This study aimed to investigate the safety and efficacy of SCB-based angioplasty compared with new-generation DES in complex PCI.

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 gender disparities in new-onset heart failure after acute coronary syndrome.

Aims: A paucity of studies addressed sex-related differences in clinical outcomes in the long term following acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI). In these patients, it remains uncertain whether heart failure (HF) might exert a differential impact on the prognosis in the long term.

Methods: We queried a large-scale database of ACS patients undergoing PCI.