Tag: Percutaneous coronary intervention

High-Risk Percutaneous Coronary Intervention: Challenges and Considerations

Announcing a new article publication for Cardiovascular Innovations and Applications journal.

As global life expectancy increases, cardiologists increasingly face challenges of caring for an older population requiring complex coronary revascularization. A substantial portion of these patients are deemed unsuitable for surgery because of their comorbidities, coronary lesion characteristics, and hemodynamic status. In response to the therapeutic needs of this patient cohort, innovative devices and techniques have been developed to provide viable options for treatment. In assessing these patients, the heart team approach is critical, to identify anatomic, hemodynamic, and procedural characteristics that favor adjunctive MCS support. The available data support using adjunct MCS devices in patients with severely reduced LV function (EF < 35%) or in acute decompensated heart failure in the presence of complex coronary artery disease. (more…)

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Protocol for a Single-Center Randomized Controlled Trial of Percutaneous Coronary Intervention Via Distal Transradial Access Versus Transradial Access

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Although transradial access (TRA) has become the main vascular access for coronary intervention, its high radial artery occlusion rate limits its application in some patients. Studies have shown that compared with TRA, distal transradial access (dTRA) with the snuffbox area or the Hegu acupoint area as the puncture point significantly decreases the incidence of radial artery occlusion. However, no randomized controlled study has confirmed the safety and efficacy of coronary artery intervention via dTRA in China.

This single-center, prospective, randomized controlled, superiority open-label study will enroll 428 consecutive patients with coronary heart disease undergoing percutaneous coronary intervention as the study population. After preoperative evaluation, the participants will be randomly divided into a study group (dTRA) and control group (TRA) in a 1:1 ratio. The primary endpoint (radial artery occlusion at 24 hours after operation) and secondary endpoint events will be evaluated and recorded.

This study has been registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2300073902).

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2024.0015

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Minghao Liu, Huanhuan Wang and Lijian Gao et al. Protocol for a Single-Center Randomized Controlled Trial of Percutaneous Coronary Intervention Via Distal Transradial Access Versus Transradial Access. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2024.0015

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Prognostic Value of Optical Flow Ratio among Patients with Coronary Artery Disease after Percutaneous Coronary Treatment: A Hospital-Based Retrospective Cohort Investigation

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  The goal of this study was to examine the prognostic performance of optical flow ratio (OFR) among patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).

Patients with CAD undergoing optical coherence tomography (OCT)-directed PCI were recruited between January 2019 and June 2021 for a single-center, hospital-based, retrospective cohort investigation. The link between post-PCI OFR and major adverse cardiovascular events (MACE) was assessed via multivariate Cox regression analysis.

Receiver operating characteristic analysis revealed that the best post-PCI OFR threshold for MACE was 0.91, and introduction of OFR into the baseline profile and OCT results markedly enhanced MACE identification after PCI. On the basis of survival curves, patients with OFR ≤0.91 (P < 0.001) and thin-cap fibroatheroma (TCFA) (P = 0.007) exhibited higher MACE incidence, and myocardial infarction (MI) incidence was considerably greater among patients with OFR ≤0.91 (P < 0.001), compared with OFR >0.91. Multivariate Cox regression analysis suggested that OFR ≤0.91 (hazard ratio [HR]: 3.60; 95% confidence interval [CI]: 1.24–10.44; P = 0.019), and TCFA (HR: 3.63; 95% CI: 1.42–9.20; P = 0.007) were independent risk factors for MACE, and OFR ≤0.91 was independently associated with MI (HR: 14.64; 95% CI: 3.27–65.54; P < 0.001).

OFR after PCI is an independent MACE bio-indicator among patients with CAD. Adding OFR to post-PCI OCT results may potentially enhance MACE prediction.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2024.0012

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Chuliang Hong, Sicheng Chen and Tianyu Hu et al. Prognostic Value of Optical Flow Ratio among Patients with Coronary Artery Disease after Percutaneous Coronary Treatment: A Hospital-Based Retrospective Cohort Investigation. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2024.0012

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Clinical Significance of PCSK9 and Soluble P-selectin in Predicting Major Adverse Cardiovascular Events After Primary Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  This study aimed at investigating the association of proprotein convertase subtilisin/kexin type 9 (PCSK9) with soluble P-selectin (sP-selectin), and their values in predicting major adverse cardiovascular events (MACE) at 1-year follow-up in patients with acute coronary syndrome (ACS) receiving dual antiplatelet therapy after primary percutaneous coronary intervention (PCI).

A total of 563 patients with ACS who underwent primary PCI were prospectively recruited from March 2020 to June 2021. The baseline levels of PCSK9, sP-selectin, and other platelet reactivity biomarkers were determined using enzyme-linked immunosorbent assays.

sP-selectin and ox-LDL levels significantly increased with increasing PCSK9 tertiles. High sP-selectin was associated with high PCSK9 levels, and PCSK9 was positively correlated with sP-selectin. Patients with both PCSK9 >17.4 ng/mL and sP-selectin >7.2 ng/mL had a significantly higher incidence of MACE than patients with lower levels. Multivariate analysis indicated that high sP-selectin and PCSK9 levels were independent risk factors for MACE, and the combination of PCSK9 and sP-selectin had better predictive value than each biomarker alone.

PCSK9 and sP-selectin may be potential predictive biomarkers for 1-year prognosis in patients with ACS after primary PCI.

Read More: https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0087

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yao Yao, Qining Qiu and Xiaoye Li et al. Clinical Significance of PCSK9 and Soluble P-selectin in Predicting Major Adverse Cardiovascular Events After Primary Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2023.0087

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Intracoronary Electrocardiography-guided Strategy for the Treatment of Coronary Bifurcation Lesions

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Revascularization of bifurcation lesions remains an interventional challenge. Intracoronary electrocardiograms can predict the functional significance of side branch stenosis after bifurcation stenting.

This paper evaluates the effects of an intracoronary ECG electrocardiography (icECG)-guided revascularization strategy, compared with the currently accepted standard of care, on the clinical outcomes of patients after coronary bifurcation stenting.

Patients with coronary bifurcation lesions who underwent percutaneous revascularization were enrolled in a prospective all-comers’ registry. Clinical outcomes were compared between patients who underwent icECG-guided revascularization versus the current standard of care (SOC), provisional stenting.

A total of 768 patients were included in the analysis: 349 were treated with an icECG-guided strategy, and 419 received SOC. The overall all-cause death rate was 23.2%, and the cardiovascular death rate was 15.9%. Patients with icECG guidance had significantly lower all-cause mortality (20.3% vs. 25.5% for icECG vs. SOC, log-rank P = 0.006) and cardiovascular mortality (12.6% vs. 18.6% for icECG vs. SOC, log-rank P = 0.004). The decrease in mortality was most pronounced in patients with no increase or a moderate increase in troponin post-PCI, or with higher-than-normal baseline troponin concentrations.

An icECG-guided strategy for coronary bifurcation PCI led to lower patient mortality than the provisional stenting strategy.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0055

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Dobrin Vassilev, Niya Mileva and Panayot Panayotov et al. Intracoronary Electrocardiography-guided Strategy for the Treatment of Coronary Bifurcation Lesions. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0055

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Robotic Percutaneous Coronary Intervention in Coronary Heart Disease: Applications and Recent Advances

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Traditional percutaneous coronary intervention (T-PCI) has long been an effective method for treating coronary heart disease (CHD), but the radiation hazards and orthopedic injuries among T-PCI operators are concerning. These problems have been mitigated with the emergence of robotic percutaneous coronary intervention (R-PCI), which is expected to increase intervention accuracy and safety. In this review, the current status of PCI development is summarized, including robot systems, and PCI application and evaluation. T-PCI and R-PCI are compared to identify the benefits for patients and physicians. In addition, a new R-PCI system is described, R-PCI WSER-CD01, which incorporates multi-instrument collaborative delivery and provides full-process assistance in minimally invasive vascular intervention. This system introduces three key innovations that address safety concerns, and improve the accuracy, wire compatibility, and remote operation capabilities of existing of vascular intervention robot systems. Finally, prospects for the development of R-PCI are discussed. As an emerging technology, R-PCI aligns well with the trends of precision medicine and telemedicine, and therefore warrants continued innovation.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0062

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yan-Jun Song, Zechen Liu and Weihua Song et al. Robotic Percutaneous Coronary Intervention in Coronary Heart Disease: Applications and Recent Advances. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0062

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Combination of Neutrophil Count and Gensini Score as a Prognostic Marker in Patients with Acute Coronary Syndrome and Uncontrolled Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Several biomarkers have been studied as prognostic indicators among people with diabetes and coronary artery disease (CAD). The purpose of this study was to determine the prognostic value of neutrophil counts and the Gensini score in patients with type 2 diabetes (T2DM) and Acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

A total of 694 people with ACS and T2DM who simultaneously had elevated HBA1c received PCI. Spearman rank correlation estimates were used for correlation evaluation. Multivariate Cox regression and Kaplan-Meier analysis were used to identify characteristics associated with major adverse cardiovascular and cerebrovascular events (MACCEs) and patient survival. The effects of single- and multi-factor indices on MACCEs were evaluated through receiver operating characteristic curve analysis.

The Gensini score and neutrophil count significantly differed between the MACCE and non-MACCE groups among patients receiving PCI who had concomitant ACS and T2DM with elevated HBA1c (P<0.001). The Gensini score and neutrophil count were strongly associated with MACCEs (log-rank, P<0.001). The Gensini score and neutrophil count, alone or in combination, were predictors of MACCEs, according to multivariate Cox regression analysis (adjusted hazard ratio [HR], 1.005; 95% confidence interval [CI], 1.002–1.008; P=0.002; adjusted HR, 1.512; 95% CI, 1.005–2.274; P=0.047, respectively). The Gensini score was strongly associated with neutrophil count (variance inflation factor ≥ 5). Area under the curve analysis revealed that the combination of multivariate factors predicted the occurrence of MACCEs better than any single variable.

In patients with T2DM and ACS with elevated HBA1c who underwent PCI, both the Gensini score and neutrophil count were independent predictors of outcomes. The combination of both predictors has a higher predictability.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0051

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yanyan Xu, Zhen Qin and Jiamin Gao et al. Combination of Neutrophil Count and Gensini Score as a Prognostic Marker in Patients with ACS and Uncontrolled T2DM Undergoing PCI. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0051

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Predictive Value of a Combination of the Age, Creatinine and Ejection Fraction (ACEF) Score and Fibrinogen Level in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Announcing a new article publication for Cardiovascular Innovations and Applications journal. The purpose of this study was to explore whether consideration of FIB levels might improve the predictive value of the ACEF score in patients with ACS.

A total of 290 patients with ACS were enrolled in this study. The clinical characteristics and MACE were recorded. Multivariate logistic regression analysis revealed that the FIB level (odds ratio=7.798, 95%CI, 3.44–17.676, P<0.001) and SYNTAX score (odds ratio=1.034, 95%CI, 1.001–1.069, P=0.041) were independent predictors of MACE. On the basis of the regression coefficient for FIB, the ACEF-FIB was developed. The area under the ROC of the ACEF-FIB scoring system in predicting MACE after PCI was 0.753 (95%CI 0.688–0.817, P<0.001), a value greater than those for the ACEF score, SYNTAX score and Grace score (0.627, 0.637 and 0.570, respectively).

ACEF-FIB had better discrimination ability than the other risk scores, according to ROC curve analysis, net reclassification improvement and integrated discrimination improvement.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0027

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yuhao Zhao, Zongsheng Guo and Zheng Liu et al. Predictive Value of a Combination of the Age, Creatinine and Ejection Fraction (ACEF) Score and Fibrinogen Level in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0027

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Angiography-Derived Fractional Flow Reserve in Coronary Assessment: Current Developments and Future Perspectives

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Coronary physiology assessment is an important factor in guiding myocardial revascularization. A growing body of research highlights the value of using fractional flow reserve, FFR and other pressure-based indicators for functional assessment of stable coronary stenoses. Invasive functional coronary assessment techniques have evolved from intracoronary wire-based to wire-free approaches as a result of technological advancements. In addition, several software programs on the market have been thoroughly investigated and validated against invasive FFR, and have shown good accuracy and correlation. However, use of FFR remains modest.

This article provides an overview of angiography-based FFR solutions and compares their technologies. Additionally, a systematic scoping review was performed to understand the research landscape in wire-free coronary physiology assessment, to complement the narratives of existing FFR trials on wire-free FFR. Furthermore, future developments and strategies that could expand the use of wire-free computed coronary functional assessment in the Asia Pacific region are discussed.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0021

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Han Bing Chow, Shirley Siang Ning Tan and Wei Hong Lai et al. Angiography-Derived Fractional Flow Reserve in Coronary Assessment: Current Developments and Future Perspectives. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0021

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