Network motifs in central positions are considered to not only have more in-coming and out-going connections but are also localized in an area where more paths reach the networks. These central motifs have been extensively investigated to determine their consistent functions or associations with specific function categories. However, their functional potentials in the maintenance of cross-talk between different functional communities are unclear. In this paper, we constructed an integrated human signaling network from the Pathway Interaction Database. We identified 39 essential cancer-related motifs in central roles, which we called cancer-related marketing centrality motifs, using combined centrality indices on the system level. Our results demonstrated that these cancer-related marketing centrality motifs were pivotal units in the signaling network, and could mediate cross-talk between 61 biological pathways (25 could be mediated by one motif on average), most of which were cancer-related pathways. Further analysis showed that molecules of most marketing centrality motifs were in the same or adjacent subcellular localizations, such as the motif containing PI3K, PDK1 and AKT1 in the plasma membrane, to mediate signal transduction between 32 cancer-related pathways. Finally, we analyzed the pivotal roles of cancer genes in these marketing centrality motifs in the pathogenesis of cancers, and found that non-cancer genes were potential cancer-related genes.

Background: Calcified lesions are one of the most challenging cases for PCI, where optimal angiographic results and satisfying outcomes are hard to achieve. Methods: We evaluated the baseline clinical, procedures characteristics and outcomes of patients with severe coronary artery calcification (CAC) who underwent coronary intravascular lithotripsy (IVL) and rotational atherectomy (RA). Results: Respectively 152 and 238 patients who underwent IVL and RA are enrolled from January 2023 to November 2023. Regarding demographic characteristics, the gender proportion, medical history of PCI and smoke history among groups reach statistical significance. Left anterior descending and right coronary artery were the main vessels treated in both groups. The 2.5 and 3.0 mm IVL balloons and 1.5 mm burr were the most commonly used. 99.3% cases were successfully implanted drug-eluting stents after IVL balloon pre-treatment, which was higher than in the group treated with RA. During hospitalization, there were no serious adverse events in the IVL group, but there were two adverse events in the RA group. Procedural complications were higher in the RA group than the IVL group (5.5% vs. 0.7%, P = 0.027). Conclusions: IVL appears to be safe and effective for the treatment of severe CAC lesions compared to RA.

Coronary artery bypass graft (CABG) accelerates the prevalence of native coronary chronic total occlusion (CTO), and this kind of CTO shows extensive challenging and complex atherosclerotic pathology. As a result, the procedural success rate of percutaneous coronary intervention (PCI) is inferior to another kind of lesions. The present meta‐analysis aims to compare the lesion characteristics and procedural complications of CTO‐PCI in patients with or without prior CABG. A total of 8 studies, comprising of 13439 patients, published from inception to August 2021 were included in this meta‐analysis. Results were pooled using random effects model and are presented as odds ratio (OR) with 95% confidence intervals (95% CIs). From the 13439 patients enrolled, 3349 (24.9%) patients had previous CABG and 10090 (75.1%) formed the control group in our analysis. For the clinical characteristic, compared to the non‐CABG patients, prior CABG patients were older (OR, 3.98; 95% CI, 3.19–4.78; p < .001; I² = 72%), had more male (OR, 1.30; 95% CI, 1.14–1.49; p < .001; I² = 6%), diabetes mellitus (OR, 1.54; 95% CI, 1.36–1.73; p < .001; I² = 37%), dyslipidemia (OR, 1.89; 95% CI, 1.33–2.69; p < .001; I² = 81%), hypertension (OR, 1.88; 95% CI, 1.46–2.41; p < .001; I² = 71%), previous myocardial infarction (OR, 1.94; 95% CI, 1.48–2.56; p < .001; I² = 85%), and previous PCI (OR, 1.74; 95% CI, 1.52–1.98; p < .001; I² = 22%). Non‐CABG patents had more current smoker (OR, .45; 95% CI, 0.27–0.74; p < .001; I² = 91%). BMI (OR, −0.01; 95% CI, −0.07–0.06; p = .85; I² = 36%) were similar in both groups. For lesions location, the right coronary artery (RCA) was predominant target vessel in both groups (50.5% vs 48.7%; p＝.49), although, the left circumflex (LCX) was more frequently CTO in the prior CABG group (27.3% vs 18.9%; p＜.01), while left anterior descending artery (LAD) in non‐CABG ones (16.0% vs 29.1%; p＜0.01). For lesions characteristics, prior CABG patients had more blunt stump (OR, 1.71; 95% CI, 1.46–2.00; p < .001; I² = 40%), proximal cap ambiguity (OR, 1.45; 95% CI, 1.28–1.64; p < .001; I² = 0.0%), severe calcifications (OR, 2.91; 95% CI, 2.19–3.86; p < .001; I² = 83%), more bending (OR, 3.07; 95% CI, 2.61–3.62; p < .001; I² = 0%), lesion length > 20 mm (OR, 1.59; 95% CI, 1.10–2.29; p = .01; I² = 83%), inadequate distal landing zone (OR, 1.95; 95% CI, 1.75–2.18; p＜.001; I² = 0.0%), distal cap at bifurcation (OR, 1.65; 95% CI, 1.46–1.88; p < .001; I² = 0.0%), and higher J‐CTO score (SMD, 0.52; 95% CI, 0.42–0.63; p < .001; I² = 65%). But side branch at proximal entry (OR, 0.88; 95% CI, 0.72–1.07; p = .21; I² = 45%), in‐stent CTO (OR, 0.99; 95% CI, 0.86–1.14; p = .88; I² = 0.0%), lack of interventional collaterals (OR, 0.80; 95% CI, 0.55–1.15; p = .23; I² = 78%), and previously failed attempt (OR, 0.73; 95% CI, 0.48–1.11; p = .14; I² = 89%) were similar in both groups. For complication, prior CABG patients had more perforation with need for intervention (OR, 1.91; 95% CI, 1.36–2.69; p < 0.001; I² = 34%), contrast‐induced nephropathy (OR, 3.40; 95% CI, 1.31–8.78; p = .01; I² = 0.0%). Non‐CABG patents had more tamponade (OR, 0.25; 95% CI, 0.09–0.72; p = .01; I² = 0.0%), and the major bleeding complication (OR, 1.18; 95% CI, 0.57–2.44; p = .65; I² = 0%) were no significant difference in both groups. In conclusion, Patients with prior CABG undergoing CTO‐PCI have more complex lesion characteristics, though procedural complication rates were comparable.

Background: With advancements in chronic total coronary occlusion (CTO) recanalization techniques and concepts, the success rate of recanalization has been steadily increasing. However, the current data are too limited to draw any reliable conclusions about the efficacy and safety of drug-coated balloons (DCBs) in CTO percutaneous coronary intervention (PCI). Herein, we conducted a meta-analysis to confirm the efficacy of DCB in CTO PCI. Methods: We systematically searched PubMed, Web of Science and Embase from inception to July 25, 2023. The primary outcome was major advent cardiovascular events (MACE), including cardiac death, nonfatal myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR). The follow-up angiographic endpoints were late lumen enlargement (LLE), reocclusion and restenosis. Results: Five studies with a total of 511 patients were included in the meta-analysis. Across studies, patients were predominantly male (72.9-85.7%) and over fifty years old. The summary estimate rate of MACE was 13.0% (95% CI 10.1%-15.9%, I² = 0%, p = 0.428). The summary estimate rates of cardiac death and MI were 2.2% (95% CI 0.7%-3.7%, I² = 0%, p = 0.873) and 1.2% (95% CI -0.2-2.6%, I² = 13.7%, p = 0.314), respectively. Finally, the pooled incidences of TLR and TVR were 10.1% (95% CI 5.7%-14.5%, I² = 51.7%, p = 0.082) and 7.1% (95% CI 3.0%-11.2%, I² = 57.6%, p = 0.070), respectively. Finally, the summary estimate rates of LLE, reocclusion and restenosis were 59.4% (95% CI 53.5–65.3%, I² = 0%, p = 0.742), 3.3% (95% CI 1.1–5.4%, I² = 0%, p = 0.865) and 17.5% (95% CI 12.9–22.0%, I² = 0%, p = 0.623), respectively. Conclusion: Accordingly, DCB has the potential to be used as a treatment for CTO in suitable patients.

Background: There is limited research on the long-term prognosis of percutaneous coronary intervention (PCI) in coronary chronic total occlusion (CTO) patients who have previously undergone coronary artery bypass grafting (CABG). Additionally, the prognostic value of a novel systemic immune inflammation index (SII) in this specific patient population remains unclear. Methods: To adjust for differences in baseline features and minimize bias, 335 pairs of patients with or without prior CABG undergone PCI were obtained after probability score matching (PSM) in a single-center cohort. The clinical characteristics were collected, and the primary outcomes were major cardiovascular events (MACE), which included all-cause death, nonfatal MI and unplanned revascularization, were recorded during the follow-up period after discharge. The group with prior CABG were divided according to the median level of SII: Lower SII group (SII ≤ 570.10, N = 167) and higher SII group (SII ≥ 570.10, N = 168). Results: The SII values were significantly higher in the prior CABG group than in the without prior CABG group [570.10 (444.60, 814.12) vs 519.65 (446.86, 565.84), P < 0.001, respectively]. The survival Kaplan–Meier analysis showed that patients with prior CABG was significantly associated with a higher risk of MACE than patients without prior CABG (P = 0.016) in the long-term follow-up. As SII levels increased, the cumulative risk of MACE became significantly higher in the patients with prior CABG (P = 0.023) stratified by the median value of SII. The Cox proportional hazards regression model analysis indicated that the level of SII (hazard ratio = 2.035, 95% CI, 1.103– 3.753, P = 0.023) emerged as independent predictors of MACE. The restricted cubic spline (RCS) analysis illustrated that the HR for MACE increased with increasing SII. Conclusion: SII is a reliable predictor of long-term cardiovascular events after PCI in CTO patients with prior CABG, suggesting that SII may be helpful in identifying high-risk patients who need more aggressive treatment and follow‐up strategies.