<div class="OutlineElement Ltr SCXW147628018 BCX0"></div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="858881804" paraeid="{3e251f5f-e37f-442d-a51e-bf159eb1fb98}{210}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Specific anatomical site stenoses,<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">such as</span><span class="NormalTextRun SCXW147628018 BCX0"> the left main and right coronary artery</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>(RCA)</span><span class="NormalTextRun SCXW147628018 BCX0">, put patients at higher risk<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">for sudden cardiac death (SCD) versus patients w</span><span class="NormalTextRun SCXW147628018 BCX0">ith other types of<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">coronary<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">anatomy, a new study shows.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="964150303" paraeid="{7e793527-7c72-4221-a695-a61868a122b8}{205}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Jani Rankinen, MD, PhD, of the Heart Hospital and Tampere University Faculty of Medicine in Tampere, Finland, and colleagues, reported the c</span><span class="NormalTextRun SCXW147628018 BCX0">orresponding data in a manuscript published online and in the May issue of<span> </span></span></span><em><span class="NormalTextRun SCXW147628018 BCX0">JACC: Cardiovascular Interventions</span></em><span class="NormalTextRun SCXW147628018 BCX0">.</span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1937448211" paraeid="{649846c4-d9b9-478d-805f-8f2c20716ef9}{243}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Patients with coronary artery disease (CAD) are at risk for SCD. Coronary stenosis in specific anatomical sites may influence the risk of ischemic events and arrythmias</span><span class="NormalTextRun SCXW147628018 BCX0">. Investigators in this study examined the relationship between anatomical locations of stenoses and SCD events.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="21936576" paraeid="{70ae35ab-2283-471e-986f-4c9385b2b2dc}{55}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Data were collected from a registry of patients<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">(n=12,695)<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">with suspected or known CAD who underwent elective coronary angiography (n=9,800</span><span class="NormalTextRun SCXW147628018 BCX0">; mean age=68.1 years; 67.1% male</span><span class="NormalTextRun SCXW147628018 BCX0">) at the Tampere Heart Hospital betwe</span><span class="NormalTextRun SCXW147628018 BCX0">en 2007 and 2018. Patients’ stenosis anatomy was noted, and follow-up took place through the end of December 2022.</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>The median follow-up time was 8.1 years.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1723178274" paraeid="{7fa318e2-449e-46c4-87e1-4d72b1810acd}{162}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">The investigators</span><span> </span><span class="NormalTextRun SCXW147628018 BCX0">defined SCD<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">as true fatal SCD, SCD with successful resuscitation or adequate implantable cardioverter-defibrillator therapy for ventricular arrhythmia resulting in hemodynamic<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">collapse.</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>The</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>primary endpoint in this study was SCD.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1564075621" paraeid="{e1c48bb9-4ffa-4ef8-be29-fed1ab7d7bdf}{54}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">A total of 1,048 SCDs were recorded.</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>Upon analysis,</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>stenosis of the RCA was associated with the greatest risk of SCD (hazard ratio [HR]=1.53, 95% confidence interval [CI]=1.31-1.80; p<0.001). Left circum</span><span class="NormalTextRun SCXW147628018 BCX0">flex coronary artery stenosis was the second highest to predict risk of SCD (HR=1.34, 95% CI=1.15-1.57; p<0.001).</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1093141848" paraeid="{b9539783-6716-487b-be0c-671f075b4c72}{30}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">L</span><span class="NormalTextRun SCXW147628018 BCX0">eft anterior descending coronary artery<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">stenosis<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">was also associated with SCD in patients who had acute coronary syndromes (ACS) (HR=1.37, 95% CI=1.09-1.72</span><span class="NormalTextRun SCXW147628018 BCX0">; p=0.007), the researchers noted.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="2026575163" paraeid="{c8119af6-fc3d-4d99-b1dc-f0f2a5fc1574}{219}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Different revascularization strategies influences patients’ risk of SCD, too: in patients who underwent percutaneous coronary intervention (PCI), RCA stenosis presented the greatest risk, patients without stenosis had grea</span><span class="NormalTextRun SCXW147628018 BCX0">ter risks after coronary artery bypass grafting (CABG) and in patients who were managed noninvasively, left main stenosis was the highest risk for SCD (HR=1.53, 95%</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>CI=1.03-2.27; p=0.036).</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1509228476" paraeid="{39b569f1-1377-4686-8a17-3dadc2b1b6be}{75}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">In an accompanying editorial, Amartya Kundu, MD, of the University of Kentucky, Lexington, and Partha Sardar, MD, of the Columbia University Irving Medical Center, New York, wrote about the impacts of this study and highlighted that “n</span><span class="NormalTextRun SCXW147628018 BCX0">ot all stenoses are created equal” in CAD.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="880210492" paraeid="{2b71ff85-8d40-4097-b651-0c9685d2684d}{47}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">The investigators in this study highlighted a few limitations: patients who were diagnosed noninvasively were not included in the analysis, the results are limited to mostly Caucasians in Finland with centralized healthcare</span><span class="NormalTextRun SCXW147628018 BCX0">, medical therapies were not accounted for and the potential biases that come along with a retrospective study design.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="509741492" paraeid="{2101626f-a226-4199-97b9-a8d63da797bb}{37}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Overall, this study<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">demonstrated</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>how the risk for SCD varies based on the site of coronary artery stenosis. Left main stenosis and RCA stenosis presented the greatest risk for SCD in this patient population.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="2082152319" paraeid="{22513094-c4b1-4259-9ff9-ec0edf239b35}{110}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">This study was supported by Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital, the Tampere University Hospital support association,<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">Business Finland research funding, the Finnish Foundation for Cardiovascular Research, the Tampere Tuberculosis</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1937883101" paraeid="{22513094-c4b1-4259-9ff9-ec0edf239b35}{28}"><strong><span class="NormalTextRun SCXW147628018 BCX0">Sources:</span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="1093945976" paraeid="{22513094-c4b1-4259-9ff9-ec0edf239b35}{76}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Rankinen J,<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW147628018 BCX0">Hernseniemi</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>J, Uimonen M, et al. Coronary stenosis location, revascularization<span> </span></span><span class="NormalTextRun SCXW147628018 BCX0">strategy</span><span class="NormalTextRun SCXW147628018 BCX0"><span> </span>and sudden cardiac death in chronic and acute coronary syndromes.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0"><em>JACC</em> <em>Cardiovasc </em></span><em><span class="NormalTextRun SpellingErrorV2Themed SCXW147628018 BCX0">Interv</span></em><span class="NormalTextRun SCXW147628018 BCX0">.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">2026;</span><span class="NormalTextRun SCXW147628018 BCX0">19(10):1244-1254.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="468422020" paraeid="{1a14c5ba-96e2-45d7-944b-43405d90151f}{197}"><span class="NormalTextRun SCXW147628018 BCX0">Kundu A, Sardar P. Not all stenoses are created equal: Revisiting coronary anatomy and risk of sudden cardiac death.<span> </span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><em><span class="NormalTextRun SCXW147628018 BCX0">JACC Cardiovasc </span><span class="NormalTextRun SpellingErrorV2Themed SCXW147628018 BCX0">Interv</span></em><span class="NormalTextRun SCXW147628018 BCX0">.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">2026;19(10)</span><span class="NormalTextRun SCXW147628018 BCX0">.</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW147628018 BCX0"> <p class="Paragraph SCXW147628018 BCX0" lang="EN-US" paraid="586677299" paraeid="{54f1457a-9961-4b61-b483-9b23ccbf6ec0}{123}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW147628018 BCX0"><span class="NormalTextRun SCXW147628018 BCX0">Image Credit: </span><span class="NormalTextRun SpellingErrorV2Themed SCXW147628018 BCX0">pikselstock</span><span class="NormalTextRun SCXW147628018 BCX0"> </span><span class="NormalTextRun SCXW147628018 BCX0">– stock.adobe.com</span></span><span class="EOP SCXW147628018 BCX0" data-ccp-props="{}"> </span></strong></p> </div>