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Aims Publicized adverse events after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised concern among patients with coronary atherosclerosis disease (CAD). We sought to study the association between SARS-CoV-2 vaccines and long-term clinical outcomes including ischaemic and bleeding events among patients with CAD. Methods and results Inpatients diagnosed with CAD by coronary angiography, without a history of SARS-CoV-2 infection and vaccination, were included between 1 January and 30 April 2021, and underwent follow-up until 31 January 2022. Two doses of inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac, BBIBPCorV, or WIBP-CorV) were available after discharge, and the group was stratified by vaccination. The primary composite outcomes were cardiovascular death, non-fatal myocardial infarction, stent thrombosis, unplanned revascularization, ischaemic stroke, venous thrombo-embolism, or peripheral arterial thrombosis. The bleeding outcomes were Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. Cox regression models with vaccination status as a time-dependent covariate were used to calculate the hazard ratio (HR) for the outcomes. A propensity score matching method was used to reduce confounding biases. This prospective cohort study included 2078 individuals with CAD, 1021 (49.1%) were vaccinated. During a median follow-up of 9.1 months, 45 (4.3%) primary composite outcomes occurred in the unvaccinated group, and 33 (3.2%) in the vaccinated group. In Cox regression, the adjusted HR was 1.13 [95% confidence interval (CI) 0.65–1.93]. The adjusted HR for the bleeding outcomes associated with vaccination was 0.81 [95% CI 0.35–1.19]. After matching, the adjusted HR for the primary composite outcomes associated with vaccination was 1.06 [95% CI 0.57–1.99] and for the bleeding outcomes was 0.91 [95% CI 0.35–2.38]. Similar results were found in the seven prespecified subgroups. No grade 3 adverse reactions after vaccination were recorded. Conclusion Our results indicated no evidence of an increased ischaemic or bleeding risk after vaccination with inactivated SARS-CoV-2 vaccine among Chinese patients with CAD, with limited statistical power. [ABSTRACT FROM AUTHOR]

Aims The available literature on morbidity risk of cardiovascular diseases associated with ambient ozone pollution is still limited. This study examined the potential acute effects of exposure to ambient ozone pollution on hospital admissions of cardiovascular events in China. Methods and results A two-stage multi-city time-series study approach was used to explore the associations of exposure to ambient ozone with daily hospital admissions (n = 6 444 441) for cardiovascular events in 70 Chinese cities of prefecture-level or above during 2015–17. A 10 μg/m3 increment in 2-day average daily 8 h maximum ozone concentrations was associated with admission risk increases of 0.46% [95% confidence interval (CI): 0.28%, 0.64%] in coronary heart disease, 0.45% (95% CI: 0.13%, 0.77%) in angina pectoris, 0.75% (95% CI: 0.38%, 1.13%) in acute myocardial infarction (AMI), 0.70% (95% CI: 0.41%, 1.00%) in acute coronary syndrome, 0.50% (95% CI: 0.24%, 0.77%) in heart failure, 0.40% (95% CI: 0.23%, 0.58%) in stroke and 0.41% (95% CI: 0.22%, 0.60%) in ischemic stroke, respectively. The excess admission risks for these cardiovascular events associated with high ozone pollution days (with 2-day average 8-h maximum concentrations ≥100 µg/m3 vs. < 70 µg/m3) ranged from 3.38% (95% CI: 1.73%, 5.06%) for stroke to 6.52% (95% CI: 2.92%, 10.24%) for AMI. Conclusion Ambient ozone was associated with increased hospital admission risk for cardiovascular events. Greater admission risks for cardiovascular events were observed under high ozone pollution days. These results provide evidence for the harmful cardiovascular effects of ambient ozone and call for special attention on the control of high ozone pollution. [ABSTRACT FROM AUTHOR]

Within this context, Xu I et al i .[9] provide new data from the FAVOR III China trial, which sought to determine whether the peri-procedural use of quantitative flow ratio (QFR) to guide lesion selection for percutaneous coronary intervention (PCI) might improve clinical outcomes, compared with angiography-guidance alone. Accordingly, a greater proportion of lesions with QFR <= 0.80 was treated in the QFR-guided group than in the angiography-guided group [1990 (96.7%) of 2058 lesions vs. 1843 (91.1%) of 2023 lesions]. Keywords: Fractional flow reserve; Quantitative flow ratio; Non-invasive physiological assessment; Percutaneous coronary intervention; Major adverse cardiovascular events EN Fractional flow reserve Quantitative flow ratio Non-invasive physiological assessment Percutaneous coronary intervention Major adverse cardiovascular events e78 e80 3 09/01/22 20220701 NES 220701 Pressure wire-based physiological assessment with fractional flow reserve (FFR) and the instantaneous wave-free ratio (iFR) more accurately identifies flow-limiting lesions than angiographic assessment alone. [Extracted from the article]

Key data elements for clinical management and outcomes of patients with coronary artery disease: definitions from Coronary Artery Disease and Creative Antithrombotic Clinical Research Collaboration (CardiaCare). Fast-growing AI and digital health technologies will inevitably bring revolutionary development in the field of cardiovascular disease, especially in the progress of cardiovascular clinical research, which will be worth promoting and adopting. Artificial intelligence (AI) and digital health technologies have become of increasing interest in cardiovascular medicine due to their unique ability to improve the quality of patient care and leverage growing data to facilitate personalized and precision medicine.[1],[2] The potential of AI in cardiovascular medicine is tremendous; however, the practical application of these technologies has not been fully integrated into the current clinical workflow. [Extracted from the article]