Bo Kyung Yoon, Tae Gyu Oh, Seonghyeon Bu, Kyung Jin Seo, Se Hwan Kwon, Ji Yoon Lee, Yeumin Kim, Jae-woo Kim, Hyo-Suk Ahn, and Sungsoon Fang. Mol. Cells 2022;45:738-48. https://doi.org/10.14348/molcells.2022.0031

Coronary artery disease (CAD) and peripheral artery disease (PAD) are associated with increased blood viscosity, which contributes to vascular inflammation and impaired microcirculation. Blood viscosity plays a crucial role in disease progression, influencing endothelial function and tissue perfusion. Sarpogrelate hydrochloride, a serotonin receptor antagonist, has antiplatelet and vasodilatory properties that may improve microvascular function and blood rheology. This randomized, parallel-group, open-label, single-center, phase IV clinical trial enrolled 68 patients with both CAD and PAD. The participants were randomized in a 1:1 ratio to receive either aspirin monotherapy (100 mg) or aspirin (100 mg) plus sarpogrelate (300 mg) for 12 weeks. The primary outcome was the change in blood viscosity from baseline to week 12, assessed using the scanning capillary technique. Secondary outcomes included erythrocyte deformability, flow-mediated dilation (FMD), and tissue oxygen delivery index (tODI), which collectively provide insights into microvascular function and oxygen transport efficiency. Elevated blood viscosity is a key factor in cardiovascular disease progression, yet conventional antiplatelet therapy has shown limited effects on hemorheology. Sarpogrelate, by targeting serotonin-mediated pathways, may enhance microcirculatory function and optimize vascular health. These effects could lead to better oxygen delivery and overall vascular health, thereby optimizing cardiovascular outcomes. By integrating hemorheological and vascular markers, this study aims to provide evidence on the potential benefits of combination therapy. Findings could inform optimized antiplatelet strategies to improve vascular health and reduce cardiovascular risk in patients with CAD and PAD.

Many reports on the development of myocarditis following coronavirus disease 2019 (COVID-19) vaccination (PCVM) have emerged. However, only a few case studies have investigated endomyocardial biopsy (EMB) results. This study describes the clinicopathologic features of PCVM. We surveyed all hospitalized patients in a single university hospital in Korea and identified six cases of PCVM. All six patients underwent EMB, five of whom were men aged 15–85 years. All patients developed cardiac dysfunction. Among these patients, two had mild disease without sequelae, whereas the other four had dilated cardiomyopathy with depressed cardiac function. All six cases demonstrated lymphohistiocytic myocarditis. Two of our cases fulfilled the criterion of CD3+ T lymphocytes > 7 cells/mm² (Case nos. 3 and 6), while the remaining four cases did not fulfill the Dallas criteria. In conclusion, most PCVM cases showed mild degree inflammation histopathologically, and some cases could not fulfill the Dallas criteria and were classified as borderline myocarditis.

We report a case of excessive QT prolongation and subsequent torsades de pointes (TdP) following the administration of ticagrelor in a 58-year-old male patient. The patient had no suspected cause of QT prolongation. After cessation of ticagrelor, QT interval was normalized and no further TdP was observed.

Coronary artery disease is one of the leading causes of death worldwide and represents a major health burden in Korea. Chronic coronary syndrome (CCS) encompasses the long-term and heterogeneous clinical manifestations of ischemic heart disease, ranging from obstructive epicardial disease to non-obstructive and microvascular disease. This pathophysiological heterogeneity necessitates individualized diagnostic and therapeutic strategies to prevent progression from CCS to acute coronary syndrome. Since the publication of recent CCS guidelines, new evidence has emerged regarding optimal diagnostic strategies, physiological and intravascular imaging-based assessments, and medical therapy. In addition, contemporary CCS management increasingly emphasizes multidisciplinary integration, including cardiovascular prevention, non-invasive imaging-guided decision-making, and patient-centered revascularization strategies. However, the implementation of these principles in real-world Korean clinical practice remains unclear, highlighting the need for localized, evidence-based guidance for Korean patients with CCS. This expert consensus provides a comprehensive, stepwise framework for the diagnosis, treatment, and long-term management of CCS by integrating the latest international evidence with Korean clinical data and practice patterns.

The use of venoarterial extracorporeal membrane oxygenation (VA‐ECMO) is increasing worldwide. Patients with cardiogenic shock were the first indication for VA‐ECMO according to the Extracorporeal Life Support Organization (ELSO) guidelines. However, recent studies have shown that VA‐ECMO is not beneficial in patients with cardiogenic shock. This report describes the case of three patients who presented with infarct‐related cardiac arrest without cardiogenic shock and received VA‐ECMO to support coronary intervention. These patients tolerated the treatment and showed a good prognosis at discharge. These cases describe the potential role of VA‐ECMO as a supportive intervention in patients with infarct‐related cardiac arrest without cardiogenic shock.