The management of cardiovascular diseases in rural areas is plagued by the limited access of rural residents to medical facilities and specialists. The development of telecardiology using information and communication technology may overcome such limitation. To shed light on the global trend of telecardiology, we summarized the available literature on rural telecardiology. Using PubMed databases, we conducted a literature review of articles published from January 2010 to December 2020. The contents and focus of each paper were then classified. Our search yielded nineteen original papers from various countries: nine in Asia, seven in Europe, two in North America, and one in Africa. The papers were divided into classified fields as follows: seven in tele-consultation, four in the telemedical system, four in the monitoring system, two in prehospital triage, and two in tele-training. Six of the seven tele-consultation papers reported the consultation from rural doctors to urban specialists. More reports of tele-consultations might be a characteristic of telecardiology specific to rural practice. Further work is necessary to clarify the improvement of cardiovascular outcomes for rural residents.

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Background: Although there are many reports of temperature being associated with the onset of acute coronary syndrome (ACS), few studies have examined differences in ACS due to climatic differences between Japan and Thailand. The aim of this joint Japan–Thailand study was to compare patients with myocardial infarction in Japanese and Thai hospitals in different climates.Methods and Results: We estimated the climate data in 2021 for the Wakayama Prefecture and Chonburi Province, two medium-sized cities in Japan and Thailand, respectively, and ACS patients who were treated at the Wakayama Medical University (WMU) and Burapha University Hospital (BUH), the two main hospitals in these provinces (ACS patient numbers: WMU, n=177; BUH, n=93), respectively. In the Chonburi Province, although the average temperature was above 25℃, the number of ACS cases in BUH varied up to threefold between months (minimum: July, 4 cases; maximum: October, 14 cases). In Japan and Thailand, there was a mild to moderate negative correlation between temperature-atmospheric pressure at the onset of ACS, but different patterns for temperature-humidity (temperature-atmospheric pressure, temperature-humidity, and atmospheric pressure-humidity: correlation index; r=−0.561, 0.196, and −0.296 in WMU vs. r=−0.356, −0.606, and −0.502 in BUH).Conclusions: The present study suggests that other climatic conditions and factors, not just temperature, might be involved in the mechanism of ACS.

Background: It remains debated whether just ostial stenting (JOS) or crossover stenting (COS) is optimal for isolated ostial lesions of the left anterior descending (LAD) artery, and available comparative data on intravascular imaging (IVI)-guided percutaneous coronary intervention (PCI) remains limited. We aim to compare clinical outcomes between the strategies and identify determinants of strategy selection. Methods and results: This retrospective study included 172 patients with isolated ostial LAD lesions who underwent IVI-guided PCI with either JOS ( n = 112) or COS ( n = 60) between 2018 and 2025. The primary endpoint was two-year major adverse cardiac events (MACEs), defined as all-cause mortality, myocardial infarction, and any revascularization. MACE rates did not differ significantly in both strategies (23% vs.17%; adjusted hazard ratio: 0.74; 95% confidence interval [CI]: 0.37–1.49; P = 0.40). LAD diameter on angiography (odds ratio [OR] 2.04, 95% CI 1.03–4.05, P = 0.040) and LAD proximal reference area measured by IVI (OR 1.26, 95% CI 1.02–1.55, P = 0.033) were independently associated with selecting JOS over COS. Optimal minimum stent areas (MSA) were achieved in most cases in both groups (89% vs. 98%, P = 0.032). Conclusions: Under IVI-guided PCI, clinical outcomes showed no significant difference between JOS and COS, and LAD anatomy determined the strategy. These findings support individualized, anatomy-driven technique selection and IVI-guided procedural optimization for ostial LAD lesions.