{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:16:39Z","timestamp":1775106999763,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complex left main (LM) bifurcation lesions are among the most challenging forms of coronary artery disease, with suboptimal long\u2010term outcomes after percutaneous coronary intervention (PCI), partly due to post\u2010stenting hemodynamic disturbances not detected by conventional imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We developed and validated a CFD\u2010based risk score predicting 3\u2010year adverse cardiovascular (CV) outcomes after complex LM bifurcation PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational cohort study, 211 patients undergoing successful drug\u2010eluting stent implantation for LM bifurcation disease were included. Patient\u2010specific 3D models were reconstructed using coronary angiography and intravascular ultrasound to perform transient CFD simulations. Five advanced shear\u2010related metrics were extracted: low shear stress area (LSS), oscillatory shear index (OSI), endothelial shear stress angle deviation (ESSAD), helicity index, and mean wall shear stress (WSS). A composite CFD risk score (range 0\u20135) was created by assigning one point for each abnormal parameter. The primary endpoint was a composite of CV death, target lesion revascularization (TLR), and target vessel revascularization (TVR) at 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over 3 years, 11.3% of patients experienced the primary outcome. All CFD parameters significantly differed between event and non\u2010event groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A Simulation\u2010based Coronary Outcomes Risk Evaluation in Complex Left Main (SCORE\u2010CLM)\u2009\u2265\u20093 showed strong predictive performance (sensitivity 81%; specificity 85%; negative predictive value 98%) and remained an independent predictor in multivariable analysis. These findings were confirmed in an internal validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SCORE\u2010CLM is a novel CFD\u2010derived risk index that accurately predicts 3\u2010year CV outcomes in patients undergoing PCI for complex LM bifurcation lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70478","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T06:07:40Z","timestamp":1768802860000},"page":"1340-1349","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Computational Fluid Dynamics\u2010Based Risk Score Predicting 3\u2010Year Cardiovascular Outcomes After Complex Left Main Bifurcation PCI: The SCORE\u2010CLM"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4559-1292","authenticated-orcid":false,"given":"Marco","family":"Zuin","sequence":"first","affiliation":[{"name":"Department of Translational Medicine University of Ferrara Ferrara Italy"},{"name":"Department of Cardio\u2010Thoraco\u2010Vascular Sciences and Public Health University of Padova Padua Italy"},{"name":"Division of Cardiology, Interventional Cardiology Unit Padova South Hospitals Padova Monselice Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Marchese","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Interventional Cardiology Unit Padova South Hospitals Padova Monselice Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ervis","family":"Hiso","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Interventional Cardiology Unit Padova South Hospitals Padova Monselice Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Bertolini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Interventional Cardiology Unit Padova South Hospitals Padova Monselice Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Rigatelli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Interventional Cardiology Unit Padova South Hospitals Padova Monselice Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610227"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1157\/13084649"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.31254"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-01065"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.21.2035"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2006.12.007"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.059"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.021824"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1216796"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308044"},{"key":"e_1_2_9_13_1","first-page":"9","article-title":"Vascular Wall Shear Stress: Basic Principles and Methods","volume":"46","author":"Papaioannou T. 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