Cardiology Journal

Could a short course of rifaximin help address high on-ticagrelor platelet reactivity after ACS?

The FLORA-ACS study protocol explores the gut–platelet axis in a clinically relevant post-ACS population, combining platelet function testing with microbiome profiling. A thought-provoking research direction for interventional cardiology and personalized antiplatelet therapy.

Authors: Klaudyna Grzelakowska, Piotr Adamski, Michał Kasprzak, Piotr Michalski, Piotr Niezgoda, Małgorzata Ostrowska, Julia Umińska, Jakub Ratajczak, Kacper Strzelewicz, Tomasz Grzybowski, Katarzyna Skonieczna, Katarzyna Buszko, Jacek Kubica

🎉 Cardiology Journal — Vol. 32, No. 5 (2025) is out now!

Dear Colleagues,
We’re pleased to announce that the new issue of Cardiology Journal is now online. It highlights current trends in cardiovascular risk assessment and personalized treatment across clinical and interventional cardiology, with concise updates on evidence-based care, emerging technologies, and practical insights for everyday decision-making.

Original articles — Clinical cardiology

🔸Neutrophil-lymphocyte ratio (NLR) as an independent factor of 1-year mortality in patients with chronic heart failure with reduced ejection fraction — In 140 clinically stable HFrEF patients, higher NLR independently predicted 1-year all-cause mortality (per-point HR ≈ 1.33) on top of natriuretic peptides and comorbidities; the effect persisted after excluding severe CKD/COPD. A practical, zero-cost prognostic marker for routine follow-up.

🔸Association between renal function and arterial stiffness among women with systemic lupus erythematosus or antiphospholipid syndrome — Study exploring links between eGFR and vascular stiffness indices in SLE/APS female cohorts (clinical cardiology focus as per ToC).

🔸The effect of P2Y12 receptor inhibitors on clinical outcomes in patients with acute coronary syndrome undergoing primary percutaneous intervention and receiving abciximab — Comparative outcomes in ACS patients on abciximab, stratified by P2Y12 choice (ToC).

Review articles

🔸(Interventional cardiology) Patient-tailored stent: Are we there yet? — State-of-the-art on matching stent platforms to anatomy/clinical context; evidence-based pointers include SES for small vessels, EES/ZES for bifurcations, EES for CTO, polymer-free options in HBR, and TiNO-coated/ultrathin DES in ACS; calls for more randomized data.

🔸(Clinical cardiology) Artificial Intelligence based fractional flow reserve — Critical overview of AI-derived FFR across CCTA, angiography and intravascular imaging; discusses cath-lab integration, accuracy versus invasive FFR/CFD methods, and current limitations.

Technology note — Interventional cardiology

🔸Reconstruction of inverted compression T-stenting for coronary bifurcation lesion: Double kissing inverted compression T-stenting — Procedural concept and stepwise reconstruction for complex bifurcations (technology note in this issue).

Study protocol — Interventional cardiology

🔸A protocol of ‘A post-market national POLish registry of biological prostheses with RESilia tissue (POLRES)’ — National post-market registry for surgical valves with RESILIA tissue (scope and endpoints defined).

Research letters

🔸(Interventional cardiology) Intracoronary adrenaline for the treatment of refractory no-reflow phenomenon: A single-centre experience — 10 NR cases during primary PCI; stepwise IC adrenaline (50 µg boluses) appeared feasible with acceptable tolerance; authors advocate randomized trials.

🔸(Interventional cardiology) Coronary microvascular dysfunction in symptomatic patients without significant epicardial stenosis — Prospective, 3-centre Polish cohort: IMR-defined dysfunction present in ~65% of patients; more frequent in women and in hypertension/diabetes; CFR–IMR discordance noted.

🔸(Clinical cardiology) Post-menopause women show age dependent increased levels in GRACE, PRECISE-DAPT and NCDR mortality risk prediction scores whereas the PARIS thrombotic score is reduced — Risk-score trajectories in postmenopausal women (letter; clinical cardiology).

Images in cardiovascular medicine

🔸(Interventional) Covert perforation caused by the edge of a drug-eluting coronary stent — Demonstrates an angiographically subtle, stent-edge–related perforation and management.

🔸(Clinical) Cardiac amyloidosis in a patient with severe chest pain: A wolf in sheep’s clothing; Early-onset severe cardiomyopathy in a Danon disease patient with a novel LAMP2 mutation; Ventricular arrhythmia aggravated by pregnancy — instructive visuals with concise clinical pearls.

🔗 Full table of contents & articles: Cardiology Journal — Vol. 32, No. 5 (2025): https://journals.viamedica.pl/cardiology_journal/issue/view/6716

Dilated cardiomyopathy without CAD: does the LV outgrow its coronary tree?

In a CCTA cohort meticulously excluding any coronary atherosclerosis, patients with DCM showed larger total proximal+mid coronary volume—yet the left-ventricular mass rose even more, yielding higher LV mass-to-coronary volume and LV mass-to-coronary ostial area ratios vs controls. Segment-level differences were modest (e.g., wider mid-LAD and OM; slightly smaller distal RCA), while ostial area was similar between groups. In regression, DCM independently predicted higher LVMM/CAV and LVMM/COA, with male s*x also upping LVMM/COA (age lowered LVMM/CAV).
Why it matters: these altered LV–coronary scaling relationships may flag a perfusion mismatch phenotype in atherosclerosis-free DCM—worth considering for risk phenotyping and future outcomes work.

Authors: Jarosław Skowroński, Emilia Szudejko, Adam Banasiak, Kacper Milczanowski, Paweł Jelski, Ilona Michałowska, Cezary Kępka, Mariusz Kruk, Adam Witkowski, Jerzy Pręgowski.

📖 Open-access full text: https://journals.viamedica.pl/cardiology_journal/article/view/104850