Apolipoprotein CIII in statin-treated type 2 diabetic patients: Its implications for plaque progression and instability: The pre-specified analysis from the OPTIMAL randomized controlled trial.

Aims: Apolipoprotein CIII (ApoCIII) has a variety of proatherogenic properties. Given that hyperglycemia induces ApoCIII transcription, this apolipoprotein may promote coronary atherosclerosis in type 2 diabetic patients. We aimed to elucidate whether ApoCIII affects plaque progression and instability in statin-treated type 2 diabetic patients.

Circulating apolipoprotein B levels in statin-treated type 2 diabetic patients with coronary artery disease: Implications for coronary atheroma progression and instability.

Background: Type 2 diabetic patients exhibited an increased secretion of triglyceride-rich lipoproteins and low high-density lipoprotein cholesterol levels with a greater amount of small dense low-density lipoprotein (LDL). Given that apolipoprotein B (apoB), a proatherogenic lipoprotein, exists at both triglyceride-rich lipoproteins and LDL particles, circulating apoB may associate with diabetic coronary atherosclerosis.

Methods: The OPTIMAL study was a prospective randomized-controlled study which employed serial near-infrared spectroscopy (NIRS)/intravascular ultrasound (IVUS) imaging to evaluate the efficacy of glycemic control on coronary atherosclerosis in 94 statin-treated type 2 diabetic patients with coronary artery disease (CAD) (UMIN000036721).

Serial inflammation imaging with pericoronary adipose tissue in patients with immunoglobulin G4-related coronary periarteritis: a case report.

Background: Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated inflammatory disease that infrequently involves the coronary arteries. Given that pericoronary adipose tissue (PCAT) attenuation reflects the degree of inflammation in the coronary arteries, monitoring inflammation with PCAT may enable evaluation of disease activity in IgG4-related coronary periarteritis (CP).

Case Summary: A 58-year-old man with a history of IgG4-RD presented with ST-segment elevation myocardial infarction.

Drug-Coated Balloon Versus Newer-Generation Drug-Eluting Stent Following Directional Coronary Atherectomy for Left Main Bifurcation Lesions.

Directional Coronary Atherectomy (DCA) is a potential treatment option for left main (LM) bifurcation lesions, as it may prevent side branch occlusion and reduce the need for complex stenting. Recent studies have suggested that combining drug-coated balloon (DCB) with DCA can lead to favorable cardiovascular outcomes. However, the comparative efficacy of DCB and current drug-eluting stents (DES) following DCA for LM bifurcation lesions remains unclear.

Impact of evolocumab on plaque phenotypic changes in patients with acute coronary syndrome and elevated lipoprotein(a) levels: a HUYGENS secondary analysis.

Aims: The proprotein convertase subtilisin/kexin Type 9 inhibitor, evolocumab, promoted plaque stabilization on serial imaging in patients following an acute coronary syndrome. The impact of evolocumab in patients with varying lipoprotein(a) [Lp(a)] levels is unknown.

Methods And Results: Serial optical coherence tomography imaging was performed to evaluate changes in plaque composition in response to treatment with evolocumab 420 mg or placebo for 50 weeks.

Lipoprotein(a) Levels and the Risk of Coronary Heart Disease and Stroke: The Suita Study.

Aims: Lipoprotein(a) (Lp[a]) exhibits atherogenic and thrombogenic properties. We investigated the association between Lp(a) levels and the risk of coronary heart disease (CHD) and stroke.

Methods: We used data from 5138 people ≥ 30 years old registered in the Suita Study, a Japanese population-based prospective cohort study.

Nationwide Trends in Idiopathic Pericarditis Management and Outcomes in Japan - A Nationwide JROAD-DPC Analysis.

Background: Idiopathic pericarditis generally has a favorable prognosis, but contemporary data on treatment patterns and outcomes remain limited.

Methods And Results: Using a nationwide Japanese database, we analyzed 8,020 pericarditis patients hospitalized between April 2016 and March 2021, and identified 3,963 (49%) patients with idiopathic pericarditis after excluding those with infectious, autoimmune or other causes. During the study period, the median age increased from 62 to 68 years (P<0.

Impact of the en face view for coronary cannulation after transcatheter aortic valve replacement.

With the increasing number of transcatheter aortic valve replacements (TAVR) performed annually, coronary cannulation in post-TAVR patients has gained importance. The aim of this study was to investigate the effectiveness of the en face view for post-TAVR coronary cannulation. Between March 2015 and March 2024, we evaluated coronary cannulation based on the period when the en face view was initiated post-TAVR in December 2021.

Surgical repair for postinfarction left ventricular free-wall rupture: 25-year single-centre experience†.

Objectives: Postinfarction left ventricular free-wall rupture (LVFWR) is a rare, unpredictable and often fatal complication of acute myocardial infarction. We reviewed our surgical experience with postinfarction LVFWR over 25 years to identify risk factors for in-hospital mortality.

Methods: Seventy-two consecutive patients with LVFWR who underwent surgical repair between 1994 and 2023 were retrospectively analysed.

Achieved levels of apolipoprotein B and plaque composition after acute coronary syndromes: Insights from HUYGENS.

Background And Aims: Addition of the PCSK9 inhibitor, evolocumab, to statin therapy promoted coronary plaque stabilization after an acute coronary syndrome. While apolipoprotein B (ApoB) has been proposed as a goal for lipid-lowering therapy in the prevention of cardiovascular disease, its association with plaque stability has not been studied.

Methods: The High-Resolution Assessment of Coronary Plaques in a Global Evolocumab Randomized Study (HUYGENS) used serial optical coherence tomography to assess coronary plaque phenotypes in patients with non-ST elevation myocardial infarction treated with evolocumab plus statin or placebo plus statin for 52 weeks.

Characterization of lipidic plaque features in association with LDL-C<70 mg/dL and lipoprotein(a) <50 mg/dL.

Background: The ongoing residual cardiovascular risks despite lowering low-density lipoprotein cholesterol (LDL-C) levels suggest the need to identify additional drivers associated with atherosclerosis. Circulating lipoprotein(a) [Lp(a)] promotes formation of foam cells via its proatherogenic properties. However, whether a lower Lp(a) level in combination with favorable LDL-C control could induce a more stable form of disease remains unknown.

Reduced Pulmonary Artery Compliance in a Conscious State Predicts Cardiac Event After Transcatheter Edge-to-Edge Repair in Patients With Ventricular Secondary Mitral Regurgitation.

Background: Right ventricular (RV) dysfunction negatively affects mitral valve transcatheter edge-to-edge repair (M-TEER) outcomes in patients with ventricular secondary mitral regurgitation (vSMR). However, RV dysfunction occurs in the late phase of heart failure, when it may not respond to interventions. The pulsatile component of RV afterload, pulmonary artery (PA) compliance, is a sensitive parameter that decreases before RV dysfunction occurs.

Clinical implications of calcification severity adjacent to calcified nodule: Its association with first and recurrent risks of target lesion revascularization after percutaneous coronary intervention.

Background And Aims: Calcified nodule (CN) is a plaque phenotype characterized by protruding calcification, associated with repeat revascularization after percutaneous coronary intervention (PCI). The severity of calcification increases the risk of future target lesion revascularization (TLR). This study was conducted to determine whether calcification severity in the adjacent zone is associated with TLR.

Association between left ventricular reverse remodelling and the B-type natriuretic peptide-cGMP cascade after anterior acute myocardial infarction.

Background: The role of cyclic guanosine 3',5'-monophosphate (cGMP) after acute myocardial infarction (AMI) is not well understood despite its significance as a second messenger of natriuretic peptides (NPs) in cardiovascular disease. We investigated the association between the NP-cGMP cascade and left ventricular reverse remodelling (LVRR) in anterior AMI.

Methods: 67 patients with their first anterior AMI (median age, 64 years; male, 76%) underwent prospective evaluation of plasma concentrations of the molecular forms of A-type and B-type natriuretic peptide (BNP) and cGMP from immediately after primary percutaneous coronary intervention (PPCI) to 10 months post-AMI.

Predictive models of in-hospital deterioration of Society of Cardiovascular Angiography and Intervention shock stage in patients with acute myocardial infarction initially presenting with stable hemodynamic condition.

Background: The Society of Cardiovascular Angiography and Intervention (SCAI) has defined 5 stages of cardiogenic shock (CS). In patients with acute myocardial infarction (AMI) who initially present in stable hemodynamic condition (SCAI CS stage: A or B), CS stages could deteriorate despite therapeutic management. However, deterioration of SCAI CS stages after AMI remains to be fully characterized.

Covered stent implantation for calcified nodule to physically hinder its protrusion causing restenosis: a case report.

Background: Calcified nodule (CN) is a phenotypic feature of calcified plaques which causes acute coronary syndrome (ACS). Recent studies reported that culprit lesions harboring CN has been shown to increase a risk of repeat revascularization after percutaneous coronary intervention (PCI) with the implantation of newer-generation drug-eluting stent (DES) or debulking device. Mechanistically, a re-protrusion of CN into the lumen has been considered as an important cause associated with repeat revascularization after PCI.

Optical coherence tomography assessment of the impact of colchicine on non-culprit coronary plaque composition after myocardial infarction.

Aims: Low-dose colchicine reduces the risk of cardiovascular events after myocardial infarction (MI). The purpose of this study was to assess the effect of colchicine post-MI on coronary plaque morphology in non-culprit segments by optical coherence tomography (OCT).

Methods And Results: COCOMO-ACS was a double-blind, placebo-controlled trial that randomized 64 patients (median age 61.

Change in Pd/Pa: Clinical Implications for Predicting Future Cardiac Events at Deferred Coronary Lesions.

Background: Cardiovascular events still occur at intermediate stenosis with fractional flow reserve (FFR) ≥0.81, underscoring the additional measure to evaluate this residual risk. A reduction in distal coronary artery pressure/aortic pressure (Pd/Pa) from baseline to hyperemia (ie, change in Pd/Pa) reflects lipidic burden within vessel walls.

Giant cell myocarditis attributable to myositis: therapeutic management under the guidance of serial endomyocardial biopsy-a case report.

Background: Giant cell myocarditis is a fatal disease that could be rapidly progressive if not properly managed. However, the role of immunosuppressive therapy, especially in refractory cases, remains unclear.

Case Summary: A 76-year-old man presented with back pain with elevated cardiac enzymes.

Asymptomatic Intracranial Artery Stenosis/Occlusion in Heterozygous Familial Hypercholesterolemia: Its Frequency and Implications for Cerebrovascular and Cardiovascular Events.

Background: The atherogenic characteristics of heterozygous familial hypercholesterolemia (HeFH) increase the risk of premature atherosclerotic cardiovascular disease including not only coronary artery disease but ischemic stroke. Asymptomatic intracranial artery stenosis/occlusion (IASO) is a major cause of ischemic stroke, but it has not yet been fully characterized in patients with HeFH.

Methods And Results: This study analyzed 147 clinically diagnosed subjects with HeFH who underwent magnetic resonance imaging/magnetic resonance angiography imaging for evaluation of IASO (≥50% diameter stenosis).

Longitudinal Observation of Micromotion upon Loading of Implant-Abutment Connection.

While technological advances have made implants a good treatment option with a good long-term prognosis, peri-implantitis, which results in alveolar bone resorption around implants, has been observed in some cases. Micromotion at the implant abutment connection can cause peri-implantitis. However, the temporal progression of micromotion upon loading remains unclear.