Nanoshield-Assisted Viral Gene Therapy with Induction of Non-Apoptotic Cell Death and Durable Antitumor Immunity.

Non-apoptotic cell death have emerged as promising strategies to overcome apoptotic resistance in cancer therapy. We suggest a hybrid gene delivery platform integrating adeno-associated virus (AAV)-mediated expression of receptor-interacting kinase 3(RIPK3) with manganese dioxide-polyethyleneimine (MnO-PEI) to induce necroptosis and immunogenic cell death (ICD), thereby remodeling the tumor microenvironment and enhancing antitumor immunity. This platform combines high transduction efficiency with the tumor-accumulation ability and immunostimulatory potential of non-viral carriers.

Non-culprit Lesion Location and FFR-guided Revascularization in Acute Myocardial Infarction With Multivessel Disease: FRAME-AMI Substudy.

Background And Objectives: The prognosis of unrevascularized non-culprit lesions (NCLs) and the benefits of non-culprit percutaneous coronary intervention (PCI) may depend on their functional significance and location in patients with acute myocardial infarction (AMI) and multivessel coronary disease (MVD). We investigated the differential outcomes of fractional flow reserve (FFR) versus angiography-guided PCI for NCL between the left anterior descending artery (LAD) and non-LAD arteries.

Methods: This was a prespecified post hoc analysis of the FRAME-AMI trial.

Duration of dual antiplatelet therapy in patients undergoing percutaneous coronary intervention for bifurcation lesions: Insights from the ULTRA-BIFURCAT registry.

Background: The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains debated, particularly for bifurcation lesions, which are associated with increased thrombotic risk. Shorter DAPT regimens may reduce bleeding but could compromise ischemic protection.

Methods: This study analyzed data from the ULTRA and BIFURCAT registries, including patients treated with PCI for bifurcation lesions.

Late stent strut apposition and coverage after drug-eluting stent implantation by optical coherence tomography in patients with acute myocardial infarction.

Background: Although drug-eluting stents (DES) are effective, stent thrombosis (ST) remains a major concern in patients with acute myocardial infarction (AMI) who undergo DES implantation. We aimed to evaluate the incidence of late stent malapposition (SM) and uncovered struts 12 months after implantation of a bioabsorbable polymer everolimus-eluting stent (BP-EES) or a durable polymer zotarolimus-eluting stent (DP-ZES) in patients with AMI using optical coherence tomography (OCT).

Methods: Sixty-nine patients with AMI were randomly assigned 2:1 to the BP-EES (46 patients) or DP-ZES (23 patients) groups.

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.

Comparison of Thick Biolimus A9-Eluting Stent and Thin Zotarolimus-Eluting Stent in Multi-Vessel Percutaneous Coronary Intervention.

Background And Objectives: There are limited randomized studies on patients undergoing multi-vessel percutaneous coronary intervention (PCI) comparing the outcomes between stent thickness and polymer types. To compare the clinical outcomes of thick biodegradable polymer-based biolimus A9-eluting stents (BESs) and thin durable polymer-based zotarolimus-eluting stents (ZESs) in patients undergoing multi-vessel PCI.

Methods: A total of 936 patients who underwent multi-vessel coronary artery stenting were randomly assigned to the BES (n=472) or ZES (n=464) groups.

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.

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.

Drug-Coated Balloon-Based Treatment of Left Main True Bifurcation Lesion.

Background: There is a paucity of data regarding drug-coated balloon (DCB) treatment in the context of left main (LM) true bifurcation lesions.

Aims: The aim of this study was to evaluate the safety and efficacy of DCB-based treatment for unprotected LM true bifurcation lesions.

Methods: A total of 39 patients with LM true bifurcation lesion (Medina: 1,1,1/0,1,1/1,0,1) who were successfully treated with DCB alone or in combination with drug-eluting stent (DES) were retrospectively enrolled into the DCB-based group.

Staged versus immediate complete revascularization for non-culprit arteries in acute myocardial infarction: a post-hoc analysis of FRAME-AMI.

Background And Objectives: The optimal timing for complete revascularization (CR) in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) remain uncertain.

Methods: This post-hoc analysis of the FRAME-AMI trial included AMI patients with MVD ( = 549). They were classified into immediate ( = 329) and staged CR ( = 220) groups.

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.

Clinical Value of Single-Projection Angiography-Derived FFR in Noninfarct-Related Artery.

Background: The Murray law-based quantitative flow ratio (μFR) is an emerging technique that requires only 1 projection of coronary angiography with similar accuracy to quantitative flow ratio (QFR). However, it has not been validated for the evaluation of noninfarct-related artery (non-IRA) in acute myocardial infarction (AMI) settings. Therefore, our study aimed to evaluate the diagnostic accuracy of μFR and the safety of deferring non-IRA lesions with μFR >0.

Transradial Versus Transfemoral Access for Bifurcation Percutaneous Coronary Intervention Using Second-Generation Drug-Eluting Stent.

Background: The benefits of transradial access (TRA) over transfemoral access (TFA) for bifurcation percutaneous coronary intervention (PCI) are uncertain because of the limited availability of device selection. This study aimed to compare the procedural differences and the in-hospital and long-term outcomes of TRA and TFA for bifurcation PCI using second-generation drug-eluting stents (DESs).

Methods: Based on data from the Coronary Bifurcation Stenting Registry III, a retrospective registry of 2,648 patients undergoing bifurcation PCI with second-generation DES from 21 centers in South Korea, patients were categorized into the TRA group (n = 1,507) or the TFA group (n = 1,141).

Cost-Effectiveness of Fractional Flow Reserve-Guided Treatment for Acute Myocardial Infarction and Multivessel Disease: A Prespecified Analysis of the FRAME-AMI Randomized Clinical Trial.

Importance: Complete revascularization by non-infarct-related artery (IRA) percutaneous coronary intervention (PCI) in patients with acute myocardial infarction is standard practice to improve patient prognosis. However, it is unclear whether a fractional flow reserve (FFR)-guided or angiography-guided treatment strategy for non-IRA PCI would be more cost-effective.

Objective: To evaluate the cost-effectiveness of FFR-guided compared with angiography-guided PCI in patients with acute myocardial infarction and multivessel disease.

Guiding Intervention for Complex Coronary Lesions by Optical Coherence Tomography or Intravascular Ultrasound.

Background: Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) have shown comparable outcomes in guiding percutaneous coronary intervention (PCI). However, their comparative effectiveness in complex coronary artery lesions remains unclear.

Objectives: This study compared the effectiveness and safety of OCT-guided vs IVUS-guided PCI for complex coronary artery lesions.

QFR Assessment and Prognosis After Nonculprit PCI in Patients With Acute Myocardial Infarction.

Background: Complete revascularization using either angiography-guided or fractional flow reserve (FFR)-guided strategy can improve clinical outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, there is concern that angiography-guided percutaneous coronary intervention (PCI) may result in un-necessary PCI of the non-infarct-related artery (non-IRA), and its long-term prognosis is still unclear.

Objectives: This study sought to evaluate clinical outcomes after non-IRA PCI according to the quantitative flow ratio (QFR).

Surveillance of adenosine stress myocardial contrast echocardiography following percutaneous coronary intervention.

Background: The ability of adenosine stress myocardial contrast echocardiography (AS-MCE) to reveal decreased coronary blood flow or perfusion defects (PDs) has not been explored for clinical implications after coronary revascularization. This study sought to identify the prognostic value of PDs in asymptomatic patients following percutaneous coronary intervention (PCI).

Methods: We retrospectively analyzed 342 asymptomatic patients (67 years of mean age, 72% male) who underwent PCI with stents at least 9 months before AS-MCE between May 2019 and December 2020.

Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: The OCTIVUS Randomized Clinical Trial.

Background: Intravascular imaging-guided percutaneous coronary intervention (PCI) with intravascular ultrasound (IVUS) or optical coherence tomography (OCT) showed superior clinical outcomes compared with angiography-guided PCI. However, the comparative effectiveness of OCT-guided and IVUS-guided PCI regarding clinical outcomes is unknown.

Methods: In this prospective, multicenter, open-label, pragmatic trial, we randomly assigned 2008 patients with significant coronary artery lesions undergoing PCI in a 1:1 ratio to undergo either an OCT-guided or IVUS-guided PCI.

Comparison of Outcomes Between 1- and 2-Stent Techniques for Medina Classification 0.0.1 Coronary Bifurcation Lesions.

Background: Although Medina 0.0.1 bifurcation lesions are often treated by percutaneous coronary intervention (PCI) in real-world practice, the optimal revascularization strategy for this lesion is uncertain.

Fractional flow reserve versus angiography-guided strategy in acute myocardial infarction with multivessel disease: a randomized trial.

Aims: In patients with acute myocardial infarction (MI) and multivessel coronary artery disease, percutaneous coronary intervention (PCI) of non-infarct-related artery reduces death or MI. However, whether selective PCI guided by fractional flow reserve (FFR) is superior to routine PCI guided by angiography alone is unclear. The current trial sought to compare FFR-guided PCI with angiography-guided PCI for non-infarct-related artery lesions among patients with acute MI and multivessel disease.

Effect of Atorvastatin on Serial Changes in Coronary Physiology and Plaque Parameters.

Background: The effects of statin on coronary physiology have not been well evaluated.

Objectives: The authors performed this prospective study to investigate changes in coronary flow indexes and plaque parameters, and their associations with atorvastatin therapy in patients with coronary artery disease (CAD).

Methods: Ninety-five patients with intermediate CAD who received atorvastatin therapy underwent comprehensive physiological assessments with fractional flow reserve (FFR), coronary flow reserve, index of microcirculatory resistance, and intravascular ultrasound at the index procedure, and underwent the same evaluations at 12-month follow-up.