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Background Chronic total occlusion intervention remains challenging and detailed real-world data on the safety and efficacy of which are limited. This study sought to determine whether there are differences in the 1-year clinical outcomes between chronic total occlusion patients with acute coronary syndrome and stable angina following chronic total occlusion intervention. Patients and methods Data from the Korean chronic total occlusion registry were collected from May 2003 to September 2012, and a total of 3268 patients who underwent chronic total occlusion intervention were enrolled. Cardiovascular outcomes up to 12 months in the acute coronary syndrome group were compared with stable angina group. Results The acute coronary syndrome group consisted of 1657 patients, and stable angina group consisted of 1264 patients. In the acute coronary syndrome group, patients with successful chronic total occlusion intervention had a lower incidence of total death and cardiac death compared to patients with failed intervention. However, there were no significant differences in cardiovascular events in the stable angina group. The successful chronic total occlusion intervention was a significant prognostic factor for lower total death (P = 0.006, hazard ratio = 0.46) and cardiac death (P = 0.003, hazard ratio = 0.36) within acute coronary syndrome group. On the other hand, successful chronic total occlusion intervention was not a prognostic factor for cardiovascular events within stable angina group. Conclusions Successful chronic total occlusion intervention in acute coronary syndrome patients was associated with a lower incidence of cardiovascular outcome compared to patients with failed chronic total occlusion intervention.

Background Bifurcation coronary artery disease (CAD) represents 15-20% in PCI patients, however, limited data concerning the short and long term clinical outcome in AMI. Methods A total of 1402 patients underwent bifurcation lesions PCI were enrolled. Patients were divided into two groups: 1) chronic stable angina group (CSA, N = 954) and 2) acute myocardial infarction group (AMI, N = 448) (241 NSTEMI and 207 STEMI). Major adverse cardiac events (MACE), the composite of death, myocardial infarction (MI), stroke and revascularization and stent thrombosis were compared between the two groups at up to 5 years. Results At 30 days follow up, the AMI group had significantly higher incidence of total death (HR: 5.901, 95% CI : 1.879 to 18.532; p = 0.002), cardiac death (HR: 6.438, 95% CI 1.743 to 23.781; p = 0.005), MI (HR: 4.736 , 95% CI :1.646 to 13.632; p = 0.004), TLR (HR: 4.300 , 95% CI :1.295 to 14.279; p = 0.017), Stroke (HR: 5.901 , 95% CI :1.879 to 18.532; p = 0.002) and MACE (HR: 4.318, 95% CI : 1.940 to 9.611; p = 0.000) than the CSA group moreover, at 5 years follow up the AMI group had significantly higher incidence of MI , TLR , Stent Thrombosis and MACE than the CSA group.Using Multivariate logistic regression, and after adjusting for potential confounding factors, the AMI patients had higher incidence of total MACE at 30 days (HR: 3.668, 95% CI 1.572 to 8.558 ; p = 0.003) and at 5 years MACE (HR: 1.693, 95% CI 1.206 to 2.377 ; p = 0.002) Conclusion In this study, bifurcation lesion PCI in AMI setting was associated with a higher incidence of adverse clinical outcomes at 30 days and up to 5 years. Clinical Outcomes at 5 Years The incidence of Event (%) at 5 years Outcomes CSA (n = 954) AMI(n = 448) Log Rank Hazard ratio (95% Confidence interval ) P value Total death 21 (2.2) 14 (3.1) 0.285 1.443 (0.734-2838) 0.288 Cardiac death 10 (1.0) 10 (2.2) 0.078 2.160 (0.899-5.190) 0.085 Myocardial infarction 22 (2.3) 23 (5.1) 0.004 2.302 (1.283-4.130) 0.005 Revascularization 65 (6.8) 50 (11.2) 0.003 1.749 (1.210-2.529) 0.003 Target lesion 36 (3.7) 45 (6.4) 0.000 2.854 (1.831-4.448) 0.000 Target vessel 42 (4.4) 47 (10.5) 0.000 2.548 (1.680-3.863) 0.000 Non-target vessel 26 (2.7) 8 (1.8) 0.320 0.671 (0.304-1.482) 0.324 Stroke 131 (13.7) 66 (14.7) 0.555 1.093 (0.813-1.469) 0.556 Stent thrombosis 8 (0.8) 11 (2.5) 0.013 2.997 (1.205-7.451) 0.018 Total MACE 87 (9.1) 60 (13.4) 0.006 1.579 (1.135-2.196) 0.007

Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic vascular disease. However, there are limited data regarding the impact of Lp(a) levels on the incidence and severity of endothelium-dependent coronary vasomotor response.A total of 2416 patients without significant coronary artery lesion (50% stenosis) by coronary angiography and underwent acetylcholine (ACh) provocation test were enrolled and categorized according to their serum Lp(a) level into four quartile groups: less than 6.70, 6.70-13.30, 13.30-26.27, and more than 26.27 mg/dl. The aim of this study is to estimate the incidence and severity of endothelium-dependent positive ACh provocation test in each group; moreover, to access the incidence of major adverse cardiovascular events, the composite of total death, myocardial infarction, and de novo percutaneous coronary intervention were compared between the four groups up to 5 years.The group with higher Lp(a) had a higher incidence of coronary heart disease, myocardial infarction, and peripheral arterial disease history. However, there was no difference among the four groups as regards the incidence of positive ACh provocation test, spasm severity, spasm extent, and location. However, at up to 5 years of clinical follow-up, the higher-Lp(a) group showed higher total death, de novo percutaneous coronary intervention, recurrent angina, and total major adverse cardiovascular events compared with the lower-Lp(a) groups.In our study, there was no relationship between the elevated Lp(a) level and the vasospastic response to the intracoronary ACh provocation test; however, higher Lp(a) levels were associated with poor clinical outcomes up to 5 years.

Drug-eluting stents (DESs) have improved the outcomes of acute myocardial infarction patients (AMI) patients, however, the risk of late stent thrombosis with DES due to delayed healing of vessel wall is still considerable. The aim of this study was to compare the safety and efficacy of biodegradable

Renin-angiotensin system (RAS) inhibitors are widely used for not only hypertension patients but also cardiovascular disease (CVD) patients, including those with heart failure. However, there were limited data regarding the comparison of long-term effectiveness of two different RAS inhibitors in

Percutaneous coronary intervention (PCI) for multivessel disease has been widely used as a revascularization option for elderly patients with development of contemporary drug-eluting stents (DES). However, there are limited data regarding long-term clinical outcomes following successful PCI in

Drug-eluting stents (DES) have improved the outcomes of acute myocardial infarction patients (AMI) patients; however, the risk of late stent thrombosis with DES due to delayed healing of the vessel wall is still considerable. The aim of this study was to compare the safety and efficacy of

Left main (LM) coronary artery disease (CAD) represents 3-5% in patients undergoing coronary angiography. LM percutaneous coronary intervention (PCI) remains challenging, especially in the acute coronary syndrome (ACS) setting. However, there are limited data concerning long-term clinical outcomes

Reduced left ventricular ejection fraction (LVEF) remains a strong predictor of adverse outcomes after percutanous coronary intervention (PCI). However, there are limited data about the impact of low LVEF on long-term outcomes after percutaneous transluminal angioplasty (PTA) for lower-extremity

Post-stenting balloon dilation is associated with improvement of stent deploymanet and better angiographic results in percutaneous coronary intervention (PCI). However, it had not been evaluated competently in setting of acute coronary syndrom (ACS) undergoing PCI. There are limited data regarding

Percutaneous coronary intervention (PCI) for ostial coronary lesions associated with inappropriate angiographic results, challenging adjustment of stent position and higher risk of cardiovascular complications. A total 3747 patients underwent PCI were included. Patients were divided into two groups