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Background: Hyperglycemia has been associated with an adverse prognosis in patients with premature coronary artery disease (CAD). However, whether the intermediate hyperglycemia status affects the risk of mortality in premature CAD patients treated with percutaneous coronary intervention (PCI), remains unclear. Methods: We retrospectively included 14,585 premature CAD patients undergoing PCI from 2007 to 2020. Patients were divided into normal glycemia (

Background: Patients with secondary mitral regurgitation (sMR) often present with greater mortality and comorbidity, which may be predicted by some risk factors. This study was designed to investigate the prognostic meaning of the echocardiographically detected wall motion score index (WMSI) in coronary artery disease (CAD) patients with moderate or severe baseline sMR who underwent percutaneous coronary intervention (PCI) therapy. Methods: The present study was a multi-center and prospective cohort of consecutive CAD patients with baseline moderate or severe sMR who underwent PCI. All underwent echocardiography at baseline and at follow-up after PCI to assess sMR and WMSI. The primary endpoint was the persistence of moderate or severe sMR after the second echocardiographic measurement. Logistic and Cox proportional hazards models were constructed for the primary (persistent moderate or severe sMR) and secondary (worsening heart failure [HF]; all-cause mortality; cardiovascular-specific mortality; and major adverse cardiovascular events [MACE]) endpoints. Results: Among 920 participants, 483 had WMSI values of ≥1.47, and 437 were less. Of all the participants, 366 (39.8%) continued to have moderate or severe sMR after the second echocardiogram measurement. After full adjustment for confounders, elevated WMSI after PCI was independently associated with the primary endpoint during 3–12 month follow-up. Similarly, elevated WMSI was associated with increased risk of worsening HF, all-cause mortality, cardiovascular-specific mortality, and MACE. Conclusions: Persistent moderate or severe sMR is common (approximately 40%) in PCI patients. Elevated WMSI in CAD patients after PCI is a predictor of persistent moderate or severe sMR and has independent negative prognostic value. Patients with CAD and sMR should be monitored for WMSI to identify those at higher risk of mortality and comorbidity.

Background: Left ventricular end-diastolic diameter (LVEDD) is a common parameter in echocardiography. Increased LVEDD is associated with left ventricular (LV) dysfunction. However, the association between LVEDD and all-cause mortality in patients with coronary artery disease (CAD) is uncertain. Methods: This study enrolled 33,147 patients with CAD who had undergone transthoracic echocardiography between January 2007 and December 2018 from the Cardiorenal Improvement study (NCT04407936). The patients were stratified into four groups based on the quartile of LVEDD (Quartile 1: LVEDD ≤43 mm, Quartile 2: 43 mm < LVEDD ≤46 mm, Quartile 3: 46 mm < LVEDD ≤51 mm, Quartile 4: LVEDD >51 mm) and were categorized into two groups (Quartile 1–3 versus Quartile 4). Survival curves were generated with the Kaplan-Meier analysis, and the differences between groups were assessed by log-rank test. Restricted cubic splines and cox proportional hazards models were used to investigate the association with LVEDD and all-cause mortality. Results: A total of 33,147 patients (average age: 63.0 ± 10.6 years; 24.0% female) were included in the final analysis. In the average follow-up period of 5.2 years, a total of 4288 patients died. The mortality of the larger LVEDD group (Quartile 4) was significantly higher than the lower LVEDD groups (Quartile 1–3) (18.05% vs 11.15%, p < 0.001). After adjusting for confounding factors, patients with the larger LVEDD (Quartile 4) had a 1.19-fold risk for all-cause mortality (95% CI: 1.09–1.30) compared with the lower quartile (Quartile 1–3). Conclusions: Enlarged LVEDD is an independent predictor of all-cause mortality in patients with CAD. LVEDD measurements may be helpful for risk stratification and providing therapeutic targets for the management of CAD patients.