Background: The decision-making factors and long-term clinical outcomes between PCI and CABG in left main (LM) disease are still not well defined in the real world. Methods: We evaluated consecutive patients (n = 230) with LM disease either treated by PCI (n = 118) or CABG (n = 112). The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, spontaneous myocardial infarction (MI), stroke, and target vessel revascularization (TVR) for 7 years. Results: In the multivariate-adjusted analysis, the presence of intermediate EuroSCORE II and high SYNTAX scores predisposed to CABG. Isolated LM disease was associated with receiving PCI. The PCI group had a similar rate of MACE (HRadj 0.97, 95% CI [0.48–1.94], p = 0.92) and a lower tendency of hard MACE (HRadj 0.49, 95% CI [0.22–1.07], p = 0.07) compared to the CABG group, mainly due to the balance between a higher rate of TVR (HRadj 9.71, p = 0.02) and a lower rate of stroke (HRadj 0.22, p = 0.09) with the PCI group than in the CABG group. Conclusions: The decision making of treatment strategy was made based on clinical and angiographic factors. The selected patients who received PCI showed similar MACE and trend of a lower rate of composite hard endpoints despite multivariate adjustment.

BACKGROUND Kawasaki disease (KD) is an acute self-limiting febrile vasculitis that occurs during childhood and can cause coronary artery aneurysm (CAA). CAAs are associated with a high rate of adverse cardiovascular events. CASE SUMMARY A Korean 35-year-old man with a 30-year history of KD presented to the emergency room with chest pain. Emergent coronary angiography was performed as ST-segment elevation in the inferior leads was observed on the electrocardiogram. An aneurysm of the left circumflex (LCX) coronary artery was found with massive thrombi within. A drug-eluting 4.5 mm 23 mm-sized stent was inserted into the occluded area without complications. The maximal diameter of the LCX was 6.0 mm with a Z score of 4.7, suggestive of a small aneurysm considering his age, sex, and body surface area. We further present a case series of 19 patients with KD, including the current patient, presenting with acute coronary syndrome (ACS). Notably, none of the cases showed Z scores; only five patients (26%) had been regularly followed up by a physician, and only one patient (5.3%) was being treated with antithrombotic therapy before ACS occurred. CONCLUSION For KD presenting with ACS, regular follow up and medical therapy may be crucial for improved outcomes.

Blood type is reportedly correlated with the occurrence of cardiovascular diseases, presumably because of its effect on thrombogenicity. However, the relationship between blood type and thrombotic complications in atrial fibrillation (AF) remains unclear. This retrospective study analyzed the blood types of 1170 AF patients (mean age, 70 years; 58% men) who were followed up for up to 4 years. Patients with greater than mild mitral stenosis or prosthetic valves were excluded. The cohort included 305 (26%) type O, 413 (35%) type A, 333 (28%) type B, and 119 (10%) type AB patients. The primary endpoint of major adverse cerebrovascular events (MACE) occurred in 52 (4.4%) patients. When longitudinal outcomes were plotted, AB blood type patients had worse prognosis than non-AB blood type patients (p = 0.039), particularly type O blood patients (p = 0.049). Multivariate Cox regression analysis revealed that AB blood type was associated with higher MACE rates (adjusted hazard ratio, 2.01; 95% confidence interval, 1.01–4.00; p = 0.048) than non-AB blood types independent of anticoagulation therapy duration or CHA2DS2-VASc score. These indicate that AF patients with AB blood type are at an increased risk of MACE compared to those with non-AB blood type independent of the duration of anticoagulation or the CHA2DS2-VASc score.

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: Biomass has been used for energy sources from the prehistoric age. Biomass are converted into solid, liquid or gaseous fuels and are used for heating, electricity generation or for transportation recently. Solid biofuels such as bio-chips or bio-pellet are used for heating or electricity generation. Liquid biofuels such as biodiesel and bioethanol from sugars or lignocellulosics are well known renewable transportation fuels. biogas produced from organic waste are also used for heating, generation and vehicles. Biomass resources for the production of above mentioned biofuels are classified under following 4 categories, such as forest biomass, agricultural residue biomass, livestock manure and municipal organic wastes. The energy potential of those biomass resources existing in Korea are estimated. The energy potential for dry biomass (forest, agricultural, municipal waste) were estimated from their heating value contained, whereas energy potential of wet biomass (livestock manure, food waste, waste sludge) is calculated from the biological methane potential of them on annual basis. Biomass resources potential of those 4 categories in Korea are estimated to be as follows. Forest biomass 355.602 million TOE, agricultural biomass 4.019 million TOE, livestock manure biomass 1.455 million TOE, and municipal organic waste 1.074 million TOE are available for biofuels production annually.