Search

Introduction: The DESyne novolimus‐eluting coronary stent (NES) is a new‐generation drug‐eluting stent (DES) that is widely used, but clinical data are rarely reported for this stent. We compared the safety and effectiveness of the DESyne NES and the Orsiro bioresorbable polymer sirolimus‐eluting stent (SES) in patients undergoing percutaneous coronary intervention (PCI). Methods: This was a retrospective, single‐center, observational study. Between July 2017 and December 2022, patients who presented with chronic or acute coronary syndrome undergoing PCI with DESyne NES or Orsiro SES were consecutively enrolled in the present study. The primary endpoint, major adverse cardiovascular event (MACE), was a composite of cardiovascular death, target‐vessel myocardial infarction, or clinically driven target‐lesion revascularization. Results: A total of 776 patients (age 68.8 ± 12.2; 75.9% male) undergoing PCI were included. Overall, 231 patients with 313 lesions received NES and 545 patients with 846 lesions received SES. During a follow‐up duration of 784 ± 522 days, the primary endpoint occurred in 10 patients (4.3%) in the NES group and in 36 patients (6.6%) in the SES group. After multivariate adjustment, the risk of MACE did not significantly differ between groups (NES vs. SES, hazard ratio 0.74, 95% CI, 0.35–1.55, p = 0.425). The event rate of individual components of the primary endpoint was comparable between the two groups. Conclusions: Favorable and similar clinical outcomes were observed in patients undergoing PCI with either NES or SES in a medium‐term follow‐up duration. Future studies with adequately powered clinical endpoints are required for further evaluation. [ABSTRACT FROM AUTHOR]

Background: Ruling out obstructive coronary artery disease (CAD) using coronary computed tomography angiography (CCTA) is time‐consuming and challenging. This study developed a deep learning (DL) model to assist in detecting obstructive CAD on CCTA to streamline workflows. Methods: In total, 2929 DICOM files and 7945 labels were extracted from curved planar reformatted CCTA images. A modified Inception V3 model was adopted. To validate the artificial intelligence (AI) model, two cardiologists labelled and adjudicated the classification of coronary stenosis on CCTA. The model was trained to differentiate the coronary artery into binary stenosis classifications <50% and ≥50% stenosis. Using the quantitative coronary angiography (QCA) consensus results as a reference standard, the performance of the AI model and CCTA radiology readers was compared by calculating Cohen's kappa coefficients at patient and vessel levels. The net reclassification index was used to evaluate the net benefit of the DL model. Results: The diagnostic accuracy of the AI model was 92.3% and 88.4% at the patient and vessel levels, respectively. Compared with CCTA radiology readers, the AI model had a better agreement for binary stenosis classification at both patient and vessel levels (Cohen kappa coefficient:.79 vs..39 and.77 vs..40, p <.0001). The AI model also exhibited significantly improved model discrimination and reclassification (Net reclassification index =.350; Z = 4.194; p <.001). Conclusions: The developed AI model identified obstructive CAD, and the model results correlated well with QCA results. Incorporating the model into the reporting system of CCTA may improve workflows. [ABSTRACT FROM AUTHOR]

We investigate the solvability of a general class of mixed Hessian type equations on compact Kähler manifolds. Based on an observation in Guan and Zhang [Pure Appl. Math. Q. 17 (2021), pp. 865–907], the mixed Hessian equations can be rewritten as elliptic and concave equations which satisfy the general framework in Székelyhidi [J. Differential Geom. 109 (2018), pp. 337–378] and Phong and Tô [Ann. Sci. Éc. Norm. Supér. (4) 54 (2021), pp. 793–829] except one condition. We notice that the absence of this condition can be overcome by using the particular structure of the mixed Hessian equations. As an application, the solvability of the deformed Hermitian Yang-Mills equations in dimension three was also studied. [ABSTRACT FROM AUTHOR]

Background: Obesity is associated with metabolic syndrome which increases further risk of coronary artery disease and adverse cardiovascular events. Impact of body mass index (BMI) on long‐term outcome in patients with coronary chronic total occlusion (CTO) is less clear. Method and results: From January 2005 to November 2020, a total of 1301 patients with coronary angiographic confirmed CTO were enrolled in our study. Patients were divided into two groups: low BMI group: 18–24.99 kg/m2 and high BMI group ≥25 kg/m2. Clinical outcomes were 3‐year all‐cause mortality, 3‐year cardiovascular mortality and 3‐year non‐fatal myocardial infarct. During the 3‐year follow‐up period, all‐cause mortality was significantly higher in patients with low BMI group compared to those in high BMI groups (14% vs. 6%, p =.0001). Kaplan–Meier analysis showed patients with high BMI groups had significant better survival compared with those in low BMI group (p =.0001). In multivariate analysis, higher BMI was independently associated with decreased risk of 3‐year all‐cause mortality (Hazard ratio [HR]: 0.534; 95% confidence interval [CI]: 0.349–0.819, p =.004) after controlling for age, renal function, prior history of stroke, coronary artery bypass graft, co‐morbidities with peripheral arterial disease, heart failure and revascularization status for CTO. In propensity‐matched multivariate analysis, high BMI remained a significant predictor of 3‐year all‐cause mortality (HR, 0.525; 95% CI, 0.346–0.795, p =.002). Conclusion: Higher BMI was associated with better long‐term outcome in patients with coronary CTO. [ABSTRACT FROM AUTHOR]

Patients with left main coronary artery disease (LMCAD) with a high SYNTAX score (SS) were excluded from randomized studies that comparing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). We sought to compare PCI and CABG in the real-world practice and investigate the impact of SS I, SS II, and SS II 2020 on clinical outcomes. In total, 292 Patients with LMCAD (173 PCI, 119 CABG) treated between 2017 and 2021 were enrolled. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause death, stroke, or myocardial infarction (MI). The mean SS I was high in both groups (PCI vs. CABG: 31.64 ± 11.45 vs. 32.62 ± 11.75, p = 0.660). The primary outcome occurred in 28 patients (16.2%) in the PCI group and in 19 patients (16.0%) in the CABG group without significant difference [adjusted hazard ratio, 95% CI = 0.98 (0.51-1.90), p = 0.97] over the follow-up period (26.9 ± 17.7 months). No significant difference was observed in all-cause mortality (11.6% vs. 11.8%, p = 0.93) or stroke rates (3.5% vs. 5.0%, p = 0.51) between groups. However, PCI was associated with higher MI (4.6% vs. 0.8%, p < 0.05) and revascularization rates (26% vs. 5.9%, p < 0.001). Prognostic value of the SS I, SS II and SS II 2020 on the primary outcome was not relevant in the PCI group. Among patients with LMCAD, PCI and CABG did not significantly differ in the composite endpoint of all-cause death, stroke, and MI. These results support the potential expansion of PCI indications in LMCAD management for whom are ineligible for CABG with complex coronary artery disease., (© 2024. The Author(s).)