Kim KA, et al. J Lipid Atheroscler. 2023 Jan;12(1):37-46. https://doi.org/10.12997/jla.2023.12.1.37

Background: Little is known about the characteristics and long‐term clinical outcomes of patients with heart failure with improved ejection fraction (HFimpEF) after acute myocardial infarction. Methods and Results: From a multicenter, consecutive cohort of patients with acute myocardial infarction undergoing percutaneous coronary intervention, patients with an initial echocardiogram with left ventricular ejection fraction ≤40% and at least 1 follow‐up echocardiogram after 14 days and within 2 years of the initial event were considered for analyses. HFimpEF was defined as an initial left ventricular ejection fraction ≤40% and serial left ventricular ejection fraction >40% with an increase of ≥10% from baseline at follow‐up. Independent factors predicting HFimpEF were identified, and clinical outcomes of patients with HFimpEF were compared with those without improvement. From an initial cohort of 10 719 patients with acute myocardial infarction, 191 patients with HFimpEF and 256 patients with non‐HFimpEF who had initial and follow‐up echocardiographic data were analyzed. The median follow‐up duration was 4.5 (interquartile range, 2.9–5.0) years. The factors predicting HFimpEF were lower peak creatine kinase myocardial band, smaller left ventricular dimensions, lower ratio between early mitral inflow velocity and mitral annular early diastolic velocity ′, and the use of β blockers or renin–angiotensin system blockers at discharge. HFimpEF was associated with a significantly decreased risk of all‐cause death compared with non‐HFimpEF (hazard ratio, 0.377 [95% CI, 0.234–0.609]; P <0.001). In 2‐year landmark analysis, these findings were consistent not only before but also after the landmark point. Similar findings were true for cardiovascular death and admission for heart failure. Conclusions: Patients with HFimpEF after acute myocardial infarction showed distinct clinical and echocardiographic characteristics and were associated with better long‐term clinical outcomes. Registration: URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02806102.

Korean Circulation Journal 대한심장학회지 순환기 Kim KA, et al. Korean Circ J. 2023 Feb;53:e22. https://doi.org/10.4070/kcj.2023.0019

Increased arterial stiffness measured by brachial‐ankle pulse wave velocity (baPWV) is a well‐known risk factor for hypertension and future cardiovascular events. The relationship between serum calcium levels and increased arterial stiffness is not well understood. Individuals undergoing baPWV measurements as part of a generalized health examination, with normal serum calcium (8.5–10.5 mg/dL) and phosphate levels and no significant renal dysfunction, were selected from the Korea Initiatives on Coronary Artery (KOICA) registry. The cross‐sectional relationship between serum calcium levels and baPWV, and the longitudinal effect of baseline serum calcium levels on baPWV progression in those with repeated baPWV measurements, were analyzed using multivariable regression models. A total of 9150 individuals with baseline baPWV and 2329 individuals (5451 PWV measurements) with follow‐up baPWV were selected for cross‐sectional and longitudinal analyses, respectively. After adjustment for confounders, higher serum calcium levels were associated with increased baseline baPWV (β‐coefficient per 1 mg/dL increase, 19.61; 95% CI 7.77–31.45; p = 0.001). Higher serum calcium was also independently associated with a greater annualized baPWV progression rate longitudinally (β‐coefficient per 1 mg/dL increase, 5.17; 95% CI, 1.82–8.67; p = 0.004). Subgroup analysis showed that the effect of serum calcium on baPWV progression had a significant interaction with baseline baPWV, systolic blood pressure, and the presence of diabetes (interaction p < 0.001). In conclusion, higher serum calcium levels within the normal range were associated with faster arterial stiffness progression measured by baPWV. Further studies are required to explore the potential for modulating calcium metabolism to slow arterial stiffness progression.

Background: The aim of this study was to compare the clinical outcomes of biodegradable polymer (BP) versus durable polymer (DP) drug eluting stents (DES) in patients with calcified coronary lesions who underwent rotational atherectomy (RA) and percutaneous coronary intervention (PCI). Methods: This study was based on a multicenter registry which enrolled patients with calcified coronary artery disease who received PCI using RA during between January 2010 and October 2019 from 9 tertiary centers in Korea. The primary outcome was 3-year all-cause mortality, and the secondary outcomes were cardiovascular death and target-lesion failure. Results: A total of 540 patients who underwent PCI using RA were enrolled with a follow-up period of median 16.1 months. From this registry, 272 patients with PCI using DP-DES and 238 patients with BP-SGDES were selected for analysis. PCI with BP-DES was associated with decreased all-cause mortality after propensity score matching (HR 0.414, CI 0.174–0.988) and multivariate Cox regression analysis (HR 0.458, HR 0.224–0.940). BP-DES was also associated with decreased cardiovascular mortality, but there was no difference in TLF between the two groups. Conclusions: BP-DES were associated with favorable outcomes compared to DP-DES in patients undergoing PCI using RA for calcified coronary lesions.

Lee SY, et al. Korean Circ J. 2025 Jul;55:e97. https://doi.org/10.4070/kcj.2024.0416