Objective To evaluate the effect of extracorporeal membrane oxygenation (ECMO) combined with intraaortic balloon counterpulsation (IABP) on patients with acute left main coronary artery disease. Methods 3 patients suffered from acute left main coronary artery disease and timely supported by ECMO combined with or without IABP were reviewed. Results With the assistance of ECMO and/or IABP, all of the 3 patients had successfully undergone coronary angiography and coronary revascularization. The first case was performed percutaneous transluminal coronary angioplasty (PTCA) with stents placement; the second was performed coronary artery bypass grafting (CABG); the third case was performed PTCA and CABG. All patients were weaned off ECMO. 2 patients were discharged, whereas the other one died 1 month after CABG. After 6~24 months follow-up, 2 survivors had good quality of life. Conclusion Efficient ECMO support with or without IABP might offer opportunities for the following revascularization on patients with acute left main coronary artery disease.

Objective:To explore the value of coronary artery plaque progression parameters based on coronary CT angiography (CCTA) in predicting the occurrence of major adverse cardiovascular events (MACE) in patients with non-obstructive coronary artery disease.Methods:The study included clinical, imaging, and prognosis (MACE) parameters of non-obstructive coronary artery disease patients who underwent CCTA at the First Affiliated Hospital of Nanjing Medical University from September 2010 to December 2022. Patients were grouped based on the occurrence of MACE, and differences in clinical data, plaque baseline, and progression parameters between the two groups were compared. Univariate and multivariate Cox regression analyses were employed to identify factors that could effectively predict the occurrence of MACE in patients. Models were constructed using plaque baseline parameters, plaque progression parameters, and a combination of both. The concordance index-time curve, net reclassification improvement and integrated discrimination improvement were used to evaluate the risk stratification ability of the models.Results:A total of 258 patients were included, of whom 62 cases experienced MACE during the follow-up period. In comparison to the MACE(-) group, patients in the MACE(+) group exhibited longer lesion length, greater degree of stenosis, larger plaque total volume, calcified plaque volume, non-calcified plaque volume, fibrous plaque volume, total plaque burden, lipid-rich plaque burden, higher peri-coronary adipose tissue attenuation index (FAI), and annual change of diameter stenosis(ΔDS/y). There were also more cases of coronary artery disease reporting and data system upgrades and non-obstructive progression to obstructive status ( P<0.05). Multivariate Cox analysis revealed that FAI, ΔDS/y, and non-obstructive progression to obstructive status were independent predictors of MACE occurrence. Concordance index-time curve results indicated that the combined model had a better predictive efficacy for MACE in patients with non-obstructive coronary artery disease compared to models based on plaque baseline parameters and plaque progression parameters. Conclusion:The plaque progression parameters and FAI based on CCTA have the potential to predict the high-risk population for MACE in patients with non-obstructive coronary artery disease, demonstrating good risk stratification value.