Free-to-play open-world RPG NTE recently launched its Containment Test, a closed beta that showcases the upgrades developer Hotta Studio has made since the game’s last technical test. There are improvements across the board, including better visuals, new mechanics, racing content, reworked combat, and more.
NTE takes place in Hethereau, a sprawling metropolis that’s really more like two cities in one. On the surface, it’s a pristine urban center filled with people going about their daily lives. But the underworld is constantly warped by reality-defying anomalies, and you’re an unlicensed Anomaly Hunter tasked with investigating these strange occurrences and putting a stop to them.
Hethereau itself has always been one of the game’s focal points, a city built in Unreal Engine 5 to allow seamless travel across its massive size. But the latest updates have taken things to another level, giving the city a comprehensive visual overhaul. There’s richer detail, updated aesthetics, and improvements to lighting and environmental effects.
Light and shadows now show more contrast, which is especially apparent as you progress through the natural day/night cycle. You also can experience dynamic weather conditions — from fog to rain to snow — as you travel across the city, and snow effects in particular have been enhanced. Thanks to physically based rendering, snowflakes now look translucent and lifelike.
Characters have also gotten a graphical makeover. The materials of their clothes and strands of their hair are now much more detailed, making each character pop even more in the anime-inspired art style.
You’ll form a party of four characters during your anomaly-hunting missions, and each character has their own skills called Esper Abilities. You control one character at a time, but can switch between the four in your party on the fly to chain their Esper Abilities together and form combos that synergize well together.
That experience has also been refined in the latest update, with actions, skills, and the overall feel of combat reworked for smoother gameplay. There are also new mechanics, like parry attacks and critical dodge counterattacks, that have been introduced to add more variety to combat.
No matter which characters are in your party, you can make use of their Esper Abilities inside and outside of combat. Some help with traversal of the city, like allowing you to run up the sides of buildings and parkour to get around quickly. But that’s not the only way to travel through Hethereau. There are also ziplines that can help you find hidden corners of the city, and with the help of the character Mint from the Bureau of Anomaly Control, you can “requisition” cars.
Buying and modding cars has always been part of NTE. There are lots of customization options — including colors, tires, bumpers, and engines — and you can mix and match until you have your ride just how you want it. There are dozens of different custom cars, and you can drive in first-person or third-person.
Requisitioning cars is new in the latest update and can bring some consequences with it if you’re reckless. With Mint’s help, you can commandeer vehicles at any time across the city, which can help quickly get you from mission to mission if you don’t have an owned car easily at hand. However, be aware that if you damage the vehicle or disturb public safety, things can get out of hand fast. There’s a new multi-level wanted system with escalating consequences — police officers and bots will you pursue you and get increasingly aggressive the higher your wanted level rises. You can see this system in action in the video below.
However you end up with your car, you can take it online and team up with friends to take on street racing crews across different districts in multiplayer races, another new addition in the latest update. Racing also includes drifting, but be careful when it’s raining or snowing — the roads will be slippery and handling will be worse.
The Containment Test is running from now until July 16, after which Hotta Studio will take player feedback and address it in future updates. The full release of NTE will be available on PC, console, iOS, and Android, and it will be free-to-play with cross-progression across all platforms. Pre-registration is open now, and for the latest news and info, you can follow them on Twitter, Facebook, Instagram, TikTok, or Discord.
There is no better excuse to travel than to see a total solar eclipse, and the next one happens on Aug. 12, 2026. Although a total solar eclipse is an unforgettable experience, totality lasts only a few minutes. So what do you do before and after the eclipse?
Boredom won’t be a problem for the 2026 total solar eclipse, with some truly spectacular locations and popular vacation areas in or close to the path of totality. From Greenland to Spain, there are myriad unique experiences and off-the-beaten-track itineraries that offer much more than nature’s greatest spectacle.
Related: Best total solar eclipse 2026 cruises for the ultimate adventure
1. Astrophotography and an eclipse chase
The Picos de Europa within the Cantabrian Mountains of northern Spain. (Image credit: Carlos Fernandez via Getty Images)
With a total solar eclipse and the peak of the Perseid meteor shower happening the same night, Aug. 12, 2026, is poised to be a significant day for astrophotographers. The core of this tour, led by British astrophotographer Ollie Taylor, is centered around astrophotography, with expert tuition provided where needed — and beginners are welcome. Taking place from Aug. 10 to Aug. 19, 2026, the tour will view the eclipse between Madrid and Zaragoza — wherever there is a clear sky — before visiting the Cantabrian Mountains and the coast for sunset shoots, more astrophotography and, once at the northern coast, seascapes and lighthouses.
2. Totality from a geothermal pool
Iceland’s Blue Lagoon will hold an eclipse-viewing event. (Image credit: Alex Walker via Getty Images)
With an eclipse, the peak of the Perseid meteor shower and the possibility of northern lights, Aug. 12, 2026, is all about the sky in Iceland, where warm geothermal waters and volcanic landscapes could provide the ideal backdrop. Guided by Canadian astronomer and astrophotographer Stéphane Picard at Cliff Valley Astronomy, this small-group tour from Aug. 10 to 16, 2026, explores southwestern Iceland, offering the opportunity to witness the eclipse from the Blue Lagoon on the Reykjanes Peninsula, followed by the Perseids from the countryside near Vík.
Evenings feature stargazing sessions and expert-led astronomy briefings, accompanied by day trips to classic Icelandic landmarks, including Thingvellir National Park, Gullfoss waterfall, and the black-sand beaches of Reynisfjara.
3. A sunset eclipse with Bill Nye “The Science Guy”
A sunset eclipse will grace Sant Elm in Mallorca, Spain. (Image credit: imageBROKER/Harry Laub via Getty Images)
The eclipse in Spain happens close to sunset, which makes mountainous terrain risky, unless an astronomer has checked out the sight lines in advance. However, from Spain’s Balearic Islands (Ibiza, Mallorca, Menorca, Formentera and some smaller islands) in the Mediterranean Sea, there’s something else on offer: a sunset eclipse. Yes, there could be clouds on the horizon, as seen from the west coasts of these popular vacation islands, but a rare golden corona is the prize.
Breaking space news, the latest updates on rocket launches, skywatching events and more!
Relatively few tours visit these islands, but Betchart Expeditions is an exception. The company is offering an adventure from Aug. 3 to 13, 2026, with The Planetary Society’s Bill Nye (“The Science Guy”). It starts off on mainland Spain, with visits to Madrid’s historic Royal Observatory, the Castile La Mancha Science Museum in Cuenca, and the City of Arts and Science Center in Valencia, before transferring to Mallorca (also spelled Majorca) to target a total solar eclipse at sunset.
4. Whales and rare wildlife in northern Spain
A dolphin in the clear waters of the Bay of Biscay off the northern coast of Spain, near Bilbao. (Image credit: Dr John A Horsfall via Getty Images)
Starting from Plymouth in the U.K., Naturetrek’s 10-day journey from Aug. 9 to 18, 2026, offers a unique blend of astronomy and wildlife watching. After sailing across the Bay of Biscay to Santander — with opportunities to spot fin and minke whales, dolphins and shearwaters — the group will travel inland to the Cantabrian Mountains to visit Las Loras Geopark and Palentina Mountain Natural Park.
On Aug. 12, totality will be experienced from a carefully selected site near Peña Ulaña, with 1 minute, 42 seconds of totality visible just before sunset, followed by post-eclipse stargazing under dark mountain skies during the peak of the Perseid meteor shower. The trip will then reach the dramatic limestone peaks of the Picos de Europa, home to Alpine choughs, griffon vultures, and elusive wall creepers.
5. Iceland’s remote Westfjords
Látrabjarg in the Westfjords, Iceland. (Image credit: Smartshots International via Getty Images)
With Greenland the preserve of cruise ships for this eclipse, the first people on land to experience totality will be in Iceland’s lonely Westfjords region. Organized by Betchart Expeditions and led by astronomer Joe Llama of the Lowell Observatory, a special expedition to Iceland from Aug. 8 to 16, 2026, will observe totality near Ísafjörður, weather permitting, with preparations and photography set up on-site. On each side, there will be an in-depth look at Iceland’s volcanic geology and mid-Atlantic tectonic setting, with the itinerary also including Lake Mývatn’s lava fields and the rift between the Eurasian and North American plates.
6. Totality from the plains of Spain
The cathedral in Burgos, Spain, is close to the centerline of the path of totality. (Image credit: Gonzalo Azumendi via Getty Images)
It’s one of the least-visited areas of Spain — at least for international travelers — but the north central plains of Spain are the highest and driest of the entire eclipse track. This short trip from New Scientist Discovery Tours, from Aug. 10 to 14, 2026, is based entirely in Burgos, a medieval city that’s home to Burgos Cathedral and the Museum of Human Evolution. Expect talks from astronomers John Mason and Martin Griffiths, as well as private eclipse viewing from a secluded site west of Burgos, near the centerline of the path of totality. The eclipse will be followed by a celebratory dinner before the peak of the Perseid meteor shower.
7. A journey through the Basque Country
Parador de Lerma in Lerma, Spain. (Image credit: Rachel Carbonell via Getty Images)
Straddling the border between France and Spain in the western Pyrenees, the Basque Country is the focus of this Aug. 9-13, 2026, journey with Wilderness Travel through culture, gastronomy and astronomy. The tour begins in Bilbao, with visits to the iconic Guggenheim Museum and a cruise on the Nervión River, followed by a drive south to Burgos (which is not in the Basque Country but rather the autonomous community of Castile-Leon) for a tour of the city’s Gothic cathedral.
Totality will be experienced at the 17th-century Parador de Lerma, directly on the centerline, with astronomy talks and guided viewing from veteran astronomer and eclipse chaser Alex Filippenko, a professor of astronomy at the University of California, Berkeley. A plethora of hiking add-ons are possible, including across the French-Spanish border along the Camino de Santiago, visits to prehistoric dolmens, and time to explore San Sebastián.
8. Valencia and an inland eclipse
Valencia, Spain. (Image credit: Anton Petrus via Getty Images)
This affordable week-long tour, from Aug. 7 to 13, 2026, with eclipse tour specialist Astro Trails begins with four nights in coastal Valencia before a train journey to Madrid and a trip to the medieval town of Sigüenza to witness totality for 1 minute, 38 seconds from the ramparts of the 12th-century Sigüenza Castle.
9. Hiking and astronomy in the Picos de Europa
The landscape near Sotres in Picos de Europa National Park. (Image credit: Ashley Cooper via Getty Images)
If daily walks to explore glacial valleys, high plateaus, shepherd trails and limestone gorges — with a few cheese and cured-meat tastings along the way — sounds like your thing, consider this eight-day hiking and astronomy-focused tour from Explore based in the heart of the Picos de Europa. Participants stay at the family-run Casa Cipriano, known for its hearty local cuisine and mountain hospitality, in the remote village of Sotres. The highlight is a guided hike to Pico de la Tabla for a high-altitude view of the total solar eclipse on Aug. 12, with nearly two minutes of totality as the sun sets over the rugged peaks. Astronomer Rebecca Fernández will be on hand for eclipse interpretation and night-sky viewing with a telescope.
10. Madrid, Toledo and Valladolid
Madrid is not in the path of totality but would make a good base. (Image credit: basiczto via Getty Images)
Just south of the eclipse track, Madrid — with its international connectivity — is a great base for independent travelers. This Special Interest Tour is based for four nights in Madrid (including a walking tour, a flamenco show and an Ibérico ham-carving workshop), takes day trips to Toledo and Ávila, and spends two nights in Abadía Retuerta Le Domaine vineyard close to Valladolid. This region has an excellent chance of clear skies for a totality of 1 minute, 35 seconds. The group will be accompanied by astronomer Bob Berman, who will give lectures and serve as a guide to the night sky.
(Bloomberg) — US stock futures retreated Friday as American trade partners pushed for concessions ahead of a July 9 deadline to finalize trade deals with the Trump administration.
Contracts for the US benchmark fell 0.6% after the gauge ended the trading week at a fresh all-time high. US President Donald Trump dialed up trade tensions after Thursday’s close, warning partners he may start setting levies of as much as 70% unilaterally as soon as today.
With less than a week to go before the deadline, European Union carmakers and capitals were pushing for an agreement that would allow for tariff relief in return for increasing US investments, Bloomberg News reported. Meanwhile, a draft US-Swiss trade accord contained assurances about tariffs on pharma exports, according to people familiar with the matter.
Europe’s Stoxx 600 closed 0.5% lower, recovering from a steeper intraday decline. Gold rose 0.3% as investors sought havens. The dollar dipped. US stock and Treasury markets were closed for the July 4 holiday.
Equity markets have rallied sharply since April’s tariff-driven volatility, partly fueled by the ongoing strength of the US economy. Still, some investor caution lingers as the trade war continues to cloud the outlook for inflation and corporate profitability.
“There’s a little bit of doubt creeping in, especially after the bump up this week,” said Neil Wilson, investor strategist at Saxo UK. “Today’s a good day to take a little bit of risk off. But I don’t think there’s a fundamental shift, it’s all on the margins at the moment.”
What Markets Live Strategists Say:
“It would take a shocking set of trade outcomes to overwhelm the slew of good news we’ve recently had. All the more so, given that the bullishness of institutional investors has been tempered by constant threats, leaving them relatively underexposed to a market at record highs.”
— Mark Cudmore, Markets Live Executive Editor
The S&P 500’s surge has put it on the verge of triggering a sell signal, according to Michael Hartnett of Bank of America Corp.
The strategist advised that investors consider trimming their holdings once the index climbs beyond 6,300, a level just 0.3% above where it closed on Thursday. He also reiterated that bubble risks are mounting into the summer, especially following the House’s approval of a $3.4 trillion fiscal package featuring tax cuts.
“Overbought markets can stay overbought as greed is harder to conquer than fear,” Hartnett wrote in a note.
UK gilts resumed their slide after a selloff on Wednesday that was driven by fiscal concerns. The yield on 10-year UK government debt advanced two basis points to 4.56%, compared with 4.45% at the close on Tuesday. The pound was flat.
In signs of diplomatic and trade tensions escalating between China and the EU, Beijing said it intends to cancel part of a two-day summit with EU leaders planned for later this month. China also imposed anti-dumping duties on European brandy for five years, while exempting major cognac makers that meet a price commitment.
In commodities, oil dropped in the lead-up to an OPEC+ meeting that’s set to deliver another oversized production hike, threatening to swell a glut forecast for later this year.
Corporate Highlights:
President Donald Trump’s administration plans to restrict shipments of AI chips from the likes of Nvidia Corp. to Malaysia and Thailand, part of an effort to crack down on suspected semiconductor smuggling into China.
India’s regulator has temporarily barred Jane Street Group LLC from accessing the local securities market, dealing a severe hit to the US firm that allegedly made $4.3 billion in trading gains in the South Asian nation in less than two years.
French train maker Alstom SA has won a €2 billion ($2.4 billion) order from New York’s Metropolitan Transportation Authority, which is in the process of modernizing its fleet.
Frasers Group Plc warned Hugo Boss AG it will vote against any dividends, as the British retailer owned by billionaire Mike Ashley exerts its influence after years of building a stake in the German fashion house.
Airlines across Europe have canceled hundreds of flights on the second day of an air traffic controllers’ strike in France that’s causing chaos just as the busiest travel season of the year gets underway.
Banco Sabadell SA has called two shareholders meetings as it seeks to approve an extraordinary dividend after agreeing to sell it’s UK unit — part of its broader attempt to block a takeover by larger rival BBVA SA.
Country Garden Holdings Co.’s sales slid again in June, with the developer faring worse than peers, as a lack of policy support dampened demand.
Some of the main moves in markets:
Stocks
S&P 500 futures fell 0.6% as of 2:08 p.m. New York time
Futures on the Dow Jones Industrial Average fell 0.6%
The MSCI World Index was little changed
The MSCI Asia Pacific Index fell 0.3%
The MSCI Emerging Markets Index fell 0.5%
Ibovespa rose 0.4% to a record high
S&P/BMV IPC was little changed
Currencies
The Bloomberg Dollar Spot Index fell 0.1%
The euro rose 0.2% to $1.1775
The British pound was little changed at $1.3649
The Japanese yen rose 0.3% to 144.50 per dollar
The offshore yuan was little changed at 7.1658 per dollar
The Mexican peso was little changed at 18.6343
Cryptocurrencies
Bitcoin slipped 1.9%, more than any closing loss since June 22
Ether slipped 4.1%, more than any closing loss since June 22
Bonds
The yield on 10-year Treasuries was little changed at 4.35%
Germany’s 10-year yield was little changed at 2.61%
Britain’s 10-year yield advanced one basis point to 4.55%
Commodities
West Texas Intermediate crude fell 0.7%, more than any closing loss since June 24
Spot gold rose 0.3% to $3,337.39 an ounce
This story was produced with the assistance of Bloomberg Automation.
Our expert team reviews products in dedicated test rooms, to help you make the best choice for your budget. Find out more about how we test.
Home cinema speaker systems are our preferred method of achieving immersive cinematic sound. We’re willing to admit, though, that they are, frankly speaking, a bit of a hassle to set up and live with.
We wouldn’t blame anyone for not wanting to traipse cables around their living room, or have floorstanding speakers take up precious space – so what’s the alternative?
The wireless soundbar surround-sound system, of course! This genre of easy-to-use sound systems has been steadily growing in popularity, with more and more manufacturers adding wireless surround speakers and a subwoofer to their Dolby Atmos soundbars.
When it comes to nailing the concept, we have to give Samsung some kudos, as last year’s HW-Q990D was an absolute doozy. This all-in-one surround sound solution skyrocketed its way into the Product of the Year slot, as it delivered grade-A audio performance in an easy-to-use, fuss-free package.
So, when the Korean tech goliath announced the newest version of this neat concept, we were immediately intrigued. Enter the HW-Q990F, a soundbar package that, on the surface, doesn’t look a whole lot different from its predecessor.
In fact, the spotlight seems to be placed mostly on an adorable new subwoofer, but don’t be fooled by its cute cubic chassis, as it packs an almighty punch that takes this already superb soundbar system into a whole new league.
Price
(Image credit: What Hi-Fi?)
The Samsung HW-Q990F is officially priced at £1699 / $1999 / AU$1999. That’s the same price as its predecessor in the UK and Australia, though the US has been subjected to a $400 price increase.
That being said, we’re already seeing discounts that bring it down to $1600. That’s still $200 more than its predecessor’s launch price in the States, but it’s a start.
Therein lies a wider issue; the HW-Q990D is still available at a wide selection of retailers, and it can be snapped up for around half the price of the new model.
The good news is that the 2024 model has seen some truly aggressive discounts throughout its lifespan, so we expect to see some equally good deals eventually come to the HW-Q990F.
Largely speaking, Samsung is its own biggest competitor in this sector, as LG’s equivalent package scored an underwhelming three stars in our review, so we can’t really recommend it as an alternative.
There is the Sonos Arc Ultra Immersive Set, which combines the power of the Sonos Arc Ultra (five stars) with a pair of Era 300 speakers (Award-winners), but you’re looking at £2969 / $2969 / AU$4596 for that package – and even more if you also want to add a sub.
Build
(Image credit: What Hi-Fi?)
If there is one area where we’d like to see Samsung change things up with this concept, it’s the design. Most of the elements of the Q990F package look very similar to the Q990D, which in turn looked very similar to the Q990C.
Samsung HW-Q990F tech specs
(Image credit: What Hi-Fi?)
Connectivity HDMI out (eARC), 2 x HDMI 2.1 in, optical, wi-fi, Bluetooth 5.0, AirPlay 2
Format support Dolby Atmos, Dolby TrueHD, Dolby Digital Plus, DTS:X
The bar itself is an angular hexagonal shape measuring 7 x 123 x 14cm (hwd), with a lined pattern running the length of the top panel. You’ll find a selection of buttons on top to change source, mute the onboard microphones and adjust the volume, with a simplistic dot matrix display on the front displaying corresponding information.
Samsung bundles a simplistic remote with functions to change the input, sound mode and EQ for the system, as well as adjusting the subwoofer level and enabling or disabling the SpaceFit Sound feature.
The surround speakers are also the same boxy, angular design as found with the 2024 model, including the handy cable guide on the bottom edge. They also carry identical dimensions to the 2024 versions, measuring 20 x 13 x 14cm.
Where this version truly differs from its predecessor is with the included subwoofer. Samsung has swapped from a tall, narrow cuboid sub to a much more compact, rounded-cube subwoofer. Side by side, the old subwoofer absolutely dwarfs the new model, with its dimensions of 25 x 25 x 25cm (hwd).
Features
(Image credit: What Hi-Fi?)
We can’t really find fault with the HW-Q990F’s feature set. It’s an 11.1.4 system with 23 drivers across the bar, surrounds and sub. That’s 15 drivers in the main soundbar, three drivers in each of the surround-sound units, and dual 20cm force-cancelling drivers in the subwoofer, which features a claimed 300W power output.
The soundbar and surrounds feature upward-firing drivers for Dolby Atmos height effects (DTS:X is also supported). Samsung recommends placing the rear surround speakers at a 135-150-degree angle behind the listening position, though the system will compensate if you opt to place them in a different position.
Interestingly, the Smart Things app, which can be used to control a variety of functions on the soundbar, has an option to reconfigure the system with the surround speakers at the front to work in tandem with the soundbar. We strongly recommend placing them in the intended rear position for the best surround-sound experience, though.
Speaking of the Smart Things app, we deem it to be a solid, and in many cases, the preferred method of interacting with the bar. The included remote has plenty of useful buttons, including a dedicated rocker to increase or decrease the subwoofer level, but the simplistic dot matrix display on the front of the soundbar is often hard to interpret.
The wireless surrounds and subwoofer connect to the bar seamlessly with an easy pairing process, and once they’re in position, you shouldn’t need to adjust anything. Samsung kindly provides different-length cables in the box, despite all components of the system using the same connection for power. It’s worth saving the longest leads for the surround speakers as this allows for greater flexibility during set-up.
(Image credit: What Hi-Fi?)
Samsung has, unsurprisingly, imbued the Q990F with a hearty helping of its proprietary functions and technology.
SpaceFit Sound Pro returns, which utilises the built-in microphones to constantly monitor and adjust the soundbar and subwoofer to accommodate your viewing space. It’s an optional feature, but we find it to work rather well and see no reason not to switch it on.
Q Symphony is also on board, allowing Samsung TV users to utilise the speakers in their TV alongside the soundbar system, using the power of AI to synchronise the sound. Your mileage with this feature will vary depending on the Samsung TV you pair it with, though we often find that the different drivers within the TV don’t always gel well with the rest of the system; especially considering that the Q990F features excellent tonal balance between its components (more on this later).
There are a handful of Samsung-specific sound processing modes too, many of which can also be found on Samsung TVs – who doesn’t love a bit of synergy? Active Voice Amplifier Pro, which is an AI-backed dialogue enhancement sound mode that can adapt to ambient noise levels in your viewing space, is on board.
Private Listening mode, on the other hand, disables the soundbar and subwoofer and instead relies on the surround speakers to direct sound to your specific listening position. This is an interesting alternative to the sort of Night mode that is found on many sound systems.
There is also a Moderate Bass setting, which disables the subwoofer to allow the soundbar to handle lower frequencies, and a Party mode, which synchronises the rear speakers to play music in all directions.
On top of these are a handful of other sound modes, including Standard, Surround, Game and Adaptive. The last of these will automatically adjust the sound based on the content you’re watching, whereas the Standard option will output the audio channels carried by the original signal.
This is, of course, restricted to anywhere between 2.0 to 7.1.4, meaning the system will never ultilise the full 11.1.4 channels that the system is capable of. Instead, the named sound modes above will use processing to upmix signals into the full 11.1.4 output.
Finally, we have the connectivity features of the HW-Q990F. HDMI eARC and optical ports handle audio transmission from your TV, while the additional HDMI sockets, of which there are two, serve as passthrough sockets.
Both are rated to the HDMI 2.1 standard, with support for up to 4K/120Hz signals, plus HDR10+ and Dolby Vision.
Wireless connectivity is also stellar, with Google Cast, Apple AirPlay 2, Spotify Connect, Tidal Connect, Amazon Music and Deezer, and it’s even Roon compatible.
Alongside the music services, the HW-Q990F is also compatible with a duo of voice assistants, with Amazon Alexa built in and Works with Google Assistant certification.
Sound
(Image credit: What Hi-Fi?)
It takes a moment to decipher the upgrades that the Q990F delivers over its predecessor. However, once we become attuned to the new system, we realise that Samsung has taken a spectacular soundbar package and turned it into an exemplary one.
We’ve paired the system with our reference Sony Bravia 8 OLED TV, Oppo UDP-203 4K Blu-ray player, and a handful of our reference discs, including Civil War, Dune: Part Two, Blade Runner 2049 and The Dark Knight Rises.
We set up this system in the same way we did its predecessor, opting for the Surround mode with SpaceFit Pro on.
Adaptive is also a good option for those who appreciate a punchier and more assertive sound. However, we feel that it makes certain sound effects stick out in an unnatural way. That being said, it’s a close second to Surround, and we especially like that it can, as the name suggests, adapt to different types of content.
We’ll start with the positives that translate from last year’s model. The Q990F retains its clear and crisp sound. Dialogue, such as the conversation between Officer K and Joi in the former’s apartment, sounds excellent, with natural and detailed voices that carry plenty of subtle inflection. This carries forth to sound effects, with the slashing Fremen knives in Dune sounding crisp and textured.
Furthermore, we have to commend the Q990F’s delivery of Dolby Atmos effects. The “bubble of sound” that we look for in any Dolby Atmos system is well and truly present here, and it’s not just the impressively placed height effects that we like. It’s the way that the soundbar and surrounds are so tonally well matched, while the audio processing ensures that sounds move organically between the channels, that truly seals the deal for us.
The disembodied voices that narrate the hologram adverts outside K’s apartment in Blade Runner are at an appropriate height and are placed relative to their position on screen with impressive accuracy. It’s not miles apart from the Q990D, but the Q990F’s handling of Dolby Atmos is certainly an improvement on an already very capable product.
(Image credit: What Hi-Fi?)
We try a non-Atmos movie in the form of The Dark Knight Rises, using the plane heist sequence from the beginning of the film. The HW-Q990F once again has no issue delivering a convincing surround-sound experience, and while the height effects are missing, we still hear plenty of effects being passed from the ’bar to the surrounds in the ensuing chaos.
Another familiar area that the Q990F excels in is dynamics. The pulse-pounding battle sequence in the final third of Civil War features dynamic build-ups with punchy and weighty payoffs, while immediate dynamic shifts, such as sudden gunshots, are impactful too.
Subtle improvements in areas we already approved of with its predecessor are one thing; however, the Q990F has an ace up its sleeve in the form of its new subwoofer. To cut a long story short, it is incredibly effective, and it elevates the system as a whole.
We run our bass stress test, Blade Runner 2049’s chapter two sequence, which includes the notoriously tricky Flight To The LAPD track. The crackle and occasionally unfocused low-end that we observed on the Q990D’s subwoofer is nowhere to be heard. Instead, the Q990F’s rich and powerful bass sounds are controlled and dynamic, as we gain a sense of mounting tension as K approaches the police precinct.
There is a much greater sense of tonal variation from this sub, which unearths a new layer to the bass. The Q990F’s bass feels more organic, balanced, and seamlessly integrated into the system as a result.
Dune: Part Two’s Harkonnen Arena sequence has a range of bass-heavy alien chanting and a bone-rattling score, and we are immediately immersed thanks to the Q990F’s encompassing sound and rich, textured bass.
Switching to music, we put the bar into the Standard sound mode for some two-channel testing.
Aurora’s Churchyard and Wolf Alice’s Bloom, Baby Bloom (via Tidal Connect) are both presented with a clear-cut sense of timing and rhythmic drive, more so than the previous model. Vocals sound clear and emotive, while instruments have depth and texture.
Our music testing ultimately affirms the positive attributes that we discovered with our movie testing.
Verdict
(Image credit: What Hi-Fi?)
This is how to take a product that was already highly regarded and make it even better. Samsung’s upgrades didn’t appear to be that striking on paper, but the HW-Q990F’s enhancements need to be heard to be believed.
Once again, this system should be on the radar for anyone who wants a full Dolby Atmos experience without having to buy an AVR or finding the space to place countless speakers around your room.
The compact new cube subwoofer is easily the star of the show, offering a richer, more focused sound with greater tonal variation. Who knew shrinking down a core component of your system could deliver such huge performance gains?
SCORES
MORE:
Read our review of the Samsung HW-Q990D
Also consider the Sonos Arc Ultra
Read our Sony Theatre Bar 9 review
Best soundbars options for every need, recommended by our experts
(From Lorenzo et al. (2022)) RGB composite image of Sextans A made with Hα (red) and V bands (green) from Massey et al. (2007), and GALEX FUV (blue). The LITTLE THINGS neutral hydrogen map (Hunter et al. 2012) is overlaid in white. OB stars catalogued in Lorenzo et al. (2022) are color-coded according to their spectral type and with different symbols based on their luminosity class. The LUMOS field-of-view is overlaid. In 100h, HWO could obtained FUV and NUV spectra of most of the stars shown in this image with S/N > 20. — astro-ph.GA
The cycle of metals between the gas and the dust phases in the neutral interstellar medium (ISM) is an integral part of the baryon cycle in galaxies.
The resulting variations in the abundance and properties of interstellar dust have important implications for how accurately we can trace the chemical enrichment of the universe over cosmic time.
Multi-object UV spectroscopy with HWO can provide the large samples of abundance and dust depletion measurements needed to understand how the abundance and properties of interstellar dust vary within and between galaxies, thereby observationally addressing important questions about chemical enrichment and galaxy evolution.
Medium-resolution (R~50,000) spectroscopy in the full UV range (950-3150 A) toward massive stars in Local Volume galaxies (D < 10 Mpc) will enable gas- and dust-phase abundance measurements of key elements, such as Fe, Si, Mg, S, Zn. These measurements will provide an estimate of how the dust abundance varies with environment, in particular metallicity and gas density.
However, measuring the carbon and oxygen contents of dust requires very high resolution (R > 100,000) and high signal-to-noise (S/N > 100) owing to the non-saturated UV transitions for those elements being extremely weak. Since carbon and oxygen in the neutral ISM contribute the largest metal mass reservoir for dust, it is critical that the HWO design include a grating similar to the HST STIS H gratings providing very high resolution, as well as FUV and NUV detectors capable of reaching very high S/N.
Julia Roman-Duval, Yumi Choi, Mederic Boquien
Comments: 12 pages; 6 figures; will be published in ASP conference proceedings of the HWO2025 conference Subjects: Astrophysics of Galaxies (astro-ph.GA) Cite as: arXiv:2507.00201 [astro-ph.GA] (or arXiv:2507.00201v1 [astro-ph.GA] for this version) https://doi.org/10.48550/arXiv.2507.00201 Focus to learn more Submission history From: Julia Roman-Duval [v1] Mon, 30 Jun 2025 19:10:27 UTC (663 KB) https://arxiv.org/abs/2507.00201 Astrobiology
Explorers Club Fellow, ex-NASA Space Station Payload manager/space biologist, Away Teams, Journalist, Lapsed climber, Synaesthete, Na’Vi-Jedi-Freman-Buddhist-mix, ASL, Devon Island and Everest Base Camp veteran, (he/him) 🖖🏻
On a brisk autumnal day in late October, the French women’s national football team kicked off the new Olympic cycle against Jamaica.
The result was a resounding success.
A 3-0 convincing win over the Reggae Girlz showed a fierce intent, and for the newly appointed Laurent Bonadei, it was the perfect start.
Clara Mateo, selected in the number 10 shirt for Bonadei’s first XI, notably looked at ease in the role, running the front line with authority.
When the opportunity came, she opened the scoring with a low drive in the 22nd minute, clenching her fist in conquest before turning to celebrate with teammate Delphine Cascarino.
It was a moment of great pride for the striker. Just a few weeks after not being selected for the Olympic Games Paris 2024, she found herself cheered by a standing ovation. The goal proved to be an apt reward, not only for the occasion, but also for the hungry Mateo, who didn’t stop working on her international dream even after the disappointment.
“It’s true that I had a very good start to the season,” she told Olympics.com in an exclusive interview.
“I was very happy to be back with the French team. When you’re a top-level athlete, you always want to represent your country. To be able to play and score right from the start of the match, I was obviously very happy. And it also showed the work I’d done to bounce back.”
As the rest of the season unfurled, the 27-year-old was similarly productive.
She finished as the top scorer in the French league with 18 goals to her name and was voted the best player by her peers.
“It’s been a successful season. It’s also a season that rewards the work I’ve put in over the last few years,” she continued. “On an individual level, I was there in terms of statistics, and I was consistent and efficient throughout the season. And then to win a trophy with my club was a real source of pride and emotion.”
But how did she rebuild into the form of her life after missing out on the Games?
Olympics.com caught up with the Nantes native at Clairefontaine, just a few days before Les Bleues take on defending champions England at UEFA Women’s EURO 2025, to find out.
Being a member of, or showing support for, Palestine Action will be a criminal offence from Saturday after a last-minute legal challenge to suspend the group’s proscription under anti-terrorism laws failed.
Huda Ammori of Palestine Action. Photograph: Abdullah Bailey
A ban on Palestine Action, which uses direct action to mainly target Israeli weapons factories in the UK and their supply chain, was voted through by parliament this week but lawyers acting for its co-founder Huda Ammori had sought to prevent it taking effect.
After a hearing at the high court on Friday, however, Mr Justice Chamberlain declined to grant her application for interim relief.
It means Palestine Action will become the first direct action protest group to be banned under the Terrorism Act, placing it in the same category as Islamic State, al-Qaida and the far-right group National Action.
UN experts, civil liberties groups, cultural figures and hundreds of lawyers have condemned the ban as draconian and said it sets a dangerous precedent by conflating protest with terrorism.
Another hearing is scheduled for 21 July when Palestine Action will apply for permission for a judicial review to quash the order. In the meantime, and unless the judicial review is successful, membership of, or inviting support for, the group will carry a maximum sentence of 14 years in prison.
Lipoprotein(a) [Lp(a)] is a unique lipoprotein particle structurally similar to low-density lipoprotein (LDL), consisting of apolipoprotein B-100 covalently linked to apolipoprotein(a) via a disulfide bond.1 Its plasma concentration varies widely among individuals and is primarily determined by genetic factors through an autosomal co-dominant inheritance pattern.2 Lp(a) exhibits both atherogenic and thrombogenic properties due to its structural resemblance to plasminogen and LDL.3 It contributes to lipid deposition, impaired fibrinolysis, inflammation, and smooth muscle cell proliferation,3 thus playing a significant role in the development of atherosclerosis and thrombosis. Elevated Lp(a) levels have been associated with increased cardiovascular risk and recurrent ischemic events in patients with coronary artery disease (CAD) who have undergone percutaneous coronary intervention (PCI).4–6
Drug-eluting stents (DES), particularly newer-generation devices with thinner struts and more biocompatible polymers, have substantially reduced in-stent restenosis (ISR) and thrombosis rates compared to first-generation stents.7 However, stent edge restenosis (SER)—restenosis occurring at the proximal or distal margins of the stent—remains a relevant limitation.8 SER is often attributed to mechanical and procedural factors, including vascular injury during balloon dilation, residual plaque at the stent edge, mismatches between stent and vessel size, and mechanical stresses at the stent-artery interface.9–11 Additional contributors include hinge motion, plaque burden, and lipid arc presence.11,12 Despite these known mechanical factors, the potential biological contributors to SER, particularly the role of elevated Lp(a), have not been well defined. Given Lp(a)’s proatherogenic and prothrombotic properties, it is biologically plausible that elevated Lp(a) may influence the development of SER. Intravascular ultrasound (IVUS), a high-resolution imaging modality, plays a central role in assessing lesion morphology and plaque characteristics and is therefore instrumental in evaluating the underlying mechanisms of SER. Accordingly, this study aimed to investigate the association between elevated Lp(a) levels and the incidence of SER in patients with CAD undergoing PCI, using IVUS to provide detailed lesion characterization. In particular, the study sought to assess whether elevated Lp(a) levels were associated with specific tissue features of restenosis, such as neoatherosclerosis and neointimal hyperplasia(NIH), to better understand potential biological mechanisms underlying SER.
Materials and Methods
Study Population
This single-center, retrospective observational research initially encompassed 211 consecutive CAD patients receiving IVUS-guided treatment for SER lesions from January 1, 2017 to December 31, 2021. Exclusion criteria encompassed bare metal stent (BMS)-related SER (n=12), absence of serum Lp (a) measurement (n=25), suboptimal IVUS image quality (n=6), serious pulmonary, hepatic, or renal insufficiency (n=8), malignant tumor or autoimmune disease (n=2)(Figure 1). The final cohort was stratified into two cohorts based on serum Lp(a) levels: elevated Lp (a) group (≥50 mg/dL, n=75) and non-elevated Lp (a) group (<50 mg/dL, n=136).13 The study protocol adhered to the Declaration of Helsinki (2013 revision) and received approval from the Research and Ethics Committee of Xiangtan Central Hospital. Written informed consent from all participants or their legal representatives was obtained after they had been fully informed about the objectives of the study (X201863231-3).
Figure 1 Study flow.
Abbreviations: SER, stent edge restenosis; PCI, percutaneous coronary intervention; IVUS, intravascular ultrasound; BMS, bare metal stent; Lp(a), lipoprotein(a).
Clinical Baseline, Procedures and Angiographic Characteristic Data
A dedicated database captured comprehensive information on patient demographics, comorbidities, and laboratory findings. The choice of interventional strategies, encompassing drug-coated balloon (DCB) angioplasty, second-generation DES implantation, auxiliary device usage, and pharmacotherapy, was determined by operators based on current guidelines and local best practices.14,15 Medication regimens at discharge were documented on dual antiplatelet therapy with 100 mg aspirin daily and a P2Y12 inhibitor (clopidogrel 75 mg daily or ticagrelor 90 mg twice daily), selected according to guideline recommendations and individual bleeding risk assessments. Additional secondary prevention medications, including statins, nitrates, β-blockers, as well as angiotensin-converting enzyme inhibitors, were prescribed in alignment with prevailing guidelines.
Quantitative coronary angiography (QCA) was conducted using QAngio XA software (Medis Medical Imaging Systems, Leiden, the Netherlands). Coronary lesion morphology evaluation followed previously established methodologies.16 Two experienced angiographers, working independently and blinded to the study details, performed all quantitative measurements using off-line computerized analysis. Lesion images were acquired in at least two orthogonal projections following the administration of 0.5 mg intracoronary nitroglycerin.The major angiographic parameters assessed included minimum lumen diameter (MLD), lesion length, diameter of reference vessel, and percentage diameter stenosis. To minimize procedural variability, all interventions were performed by experienced interventional cardiologists following current PCI guidelines. Decisions on lesion preparation, stent sizing, and landing zone selection were made under IVUS guidance and QCA support. Although lesion preparation techniques (eg, pre-dilation or scoring balloon use) were not uniformly documented, stent deployment adhered to best practices and IVUS-optimized expansion targets.
Lp(a) Measurement
Serum Lp(a) levels were quantified using an immune-turbidimetry assay, with ≥50 mg/dL established as a risk-enhancing threshold in accordance with recent guidelines.13 For patients with multiple preprocedural Lp(a) measurements, the value closest to the procedure date was selected for analysis.
IVUS Image Acquisition and Assessment
IVUS imaging of SER arteries was performed using a 40-MHz OptiCross™ catheter (Boston Scientific, Marlborough, MA, USA). Following intracoronary nitroglycerin administration (0.1–0.2 mg), automated pullback (0.5 mm/s) was initiated. The IVUS catheter was advanced >10 mm beyond the stent distally and proximally. IVUS image analysis utilized QIvus® software (Medis, Leiden, the Netherlands). SER was defined as >50% diameter stenosis within 5mm proximal or distal to the stent edge.17 Reference segments, representing the most normal-appearing cross-sections in 5 mm of the SER, were identified for comparative analysis (Figure 2). The minimum lumen area (MLA) and minimum stent area (MSA) sites were determined based on smallest lumen/greatest plaque and smallest stent area, respectively. Two independent, blinded cardiologists performed SER identification and quantitative analyses, with high intra-observer as well as inter-observer agreement (κ = 0.92 and 0.90, respectively). NIH area (stent area minus lumen area) and percentage (NIH/stent area) were calculated from stent and lumen areas. Stent expansion was defined as MSA divided via the largest reference lumen,18 with under-expansion classified as MSA <4 mm2 or expansion <50%.19 To further address potential procedural bias, IVUS analysis included parameters related to stent expansion and plaque morphology. The classification of neoatherosclerosis and other SER subtypes was based on consensus definitions and validated by two independent observers. While procedural nuances such as exact lesion preparation were not systematically recorded, the combination of anatomical imaging, blinded review, and high inter-observer agreement (κ = 0.90–0.92) supports the reliability of lesion classification.
Figure 2 In the example, the coronary angiogram at the time of SER (A) is shown accompanied by a white dotted line indicating the old stents. (B–E) in the coronary angiograms correspond to the IVUS image (B–E). (B′–E′) are the same images with annotation compared with (B–E). IVUS images shown excessive neointimal hyperplasia with good stent expansion; blue dotted lines in the IVUS images indicate old stent struts; the blue asterisks indicate excessive neointimal hyperplasia.
SER was categorized into five primary patterns: 1) NIH, 2) Neo-atherosclerosis, 3) uncovered lesion, 4) stent under-expansion, and 5) protruding calcified nodule (CN). Neo-atherosclerosis was characterized by atherosclerotic changes at the MLA site within the stent, manifesting as calcified NIH (echogenic tissue with acoustic shadowing), attenuated NIH (ultrasound shadowing without superficial calcium), or ruptured NIH (cavitation within NIH).20 A neo-atherosclerotic calcified nodule was distinguished from a non-neoatherosclerotic protruding calcified nodule, which presented as an irregular, convex calcium deposit within the old stent, lacking adjacent NIH.21 In cases of multiple potential causes, the primary factor contributing to in-stent restenosis was determined based on its predominant impact on stenosis severity.
Clinical Follow-up and Outcomes
The study’s primary endpoint focused on device-oriented clinical endpoints (DoCE), encompassing cardiac mortality, myocardial infarction (MI) related to the target vessel or stent thrombosis, and target lesion revascularization (TLR). These clinical outcomes were defined in compliance with the Academic Research Consortium guidelines.22 The investigation prioritized the incidence of DoCE as its main objective, while the secondary goal examined the occurrence of individual DoCE components. Patient monitoring involved periodic assessments at six-month intervals, conducted either through in-person clinical visits or telephone consultations. The follow-up period extended up to two years, with all study participants completing a minimum of one year of observation.
Statistical Analysis
Continuous variables were presented as mean ± standard deviation or median (interquartile range), and categorical variables in terms of frequencies and percentages for data presentation. Analysis of continuous outcome data was done by comparing data employing the Student’s t-test or Mann–Whitney U-test, based on the data distribution. Fisher’s exact test was used to evaluate categorical outcome data when the total number of observations was 9 or fewer; chi-square analysis was used if the total number of observations was greater than 9. Cox regression analysis, both univariate and multi-variable, were conducted to ascertain independent determinants of SER, providing odds ratio (OR) with 95% confidence interval (95% CI). Those variables demonstrating P less than 0.10 in univariate analysis were then joined into a multi-variable marginal Cox proportional hazards model. Kaplan-Meier survival assessment was utilized to estimate event rates, and hazard ratios (HR) was calculated from Cox regression analysis. For patients for whom multiple DoCEs were applicable, the first was employed for analytical purposes. All analyses were carried out at a statistical significance of P < 0.05. The statistical program SPSS 24.0 was used to handle and evaluate the data (SPSS Inc., Chicago, IL, US).
Results
Baseline Clinical Characteristics and Angiography Characteristics
The research encompassed 211 patients (136 males, 75 females; mean age 64.28±10.78 years) presenting with SER and 211 corresponding target lesions. Upon analysis, no noteworthy disparities in baseline clinical or angiographic features were detected between subjects with elevated and non-elevated Lp(a) levels (Tables 1 and 2).
Table 1 Baseline Clinical Characteristics
Table 2 Angiography Characteristics
IVUS Analysis of SER Lesions
The IVUS findings of SER were not different between the elevated Lp(a) cohort and the non-elevated Lp (a) cohort (Table 3). Between the two cohorts, there was a noticeable difference in the distribution pattern of SER stenotic tissue shape. The elevated Lp(a) cohort exhibited fewer instances of NIH compared to the non-elevated Lp(a) cohort (24.0% vs 33.8%, P<0.001)(Figure 3). Conversely, Neo-atherosclerosis was more prevalent in the elevated Lp(a) cohort than in the non-elevated Lp (a) cohort (56.0% vs 44.1%, P<0.001) (Figure 3).
As depicted within Table 4, both univariate (OR: 3.612, 95% CI: 2.226–5.477; P<0.001) and multivariate (OR: 3.391, 95% CI: 2.030–5.273; P<0.001) assessments show that elevated Lp(a) was independently correlated with the development of SER.
Table 4 Univariate and Multivariate Logistic Regression Analysis to Determine the Independent Factors Affecting the Presence of SER
Clinical Outcomes
Table 5 and Figure 4 illustrate the comparative clinical outcomes between participants with elevated and non-elevated Lp(a) levels. Over a 2-year observational follow-up period, the elevated Lp(a) cohort consistently demonstrated higher incidences of DoCE and TLR compared to the non-elevated Lp(a) cohort (16.0% vs 7.4%, P<0.001; 13.3% vs 5.1%, P= 0.011, respectively).
Table 5 Clinical Outcomes During Follow-up
Figure 4 Kaplan-Meier survival curves of DoCE for 2 years.
This study’s principal observations can be summarized as follows: 1.Among patients with SER, Neo-atherosclerosis was much more prevalent within the elevated Lp(a) cohort. 2.NIH was less frequent in the elevated Lp(a) cohort. 3.Elevated Lp(a) levels exhibited an independent correlation with SER. 4.The cumulative 2-year incidence of both DoCE and TLR was consistently elevated within the elevated Lp(a) cohort.
Impact of Lp(a) on SER
This real-world investigation reveals a notable disparity in the distribution of SER stenotic tissue structure between the two cohorts. The elevated Lp(a) cohort exhibited fewer instances of NIH but a higher prevalence of neo-atherosclerosis compared to their counterparts with non-elevated Lp(a) levels. Lp(a) promotes atherosclerosis by transporting cholesterol while adhering to macrophages, facilitating foam cell formation, which contributes to atherosclerotic plaque development.23 In addition, Lp(a) competes for specific binding sites with plasminogen and enhances the activity of plasminogen activator inhibitor, both processes promoting thrombogenesis.24 The post-stent implantation inflammatory response is badly affected by Lp(a). Through its actions on white blood cells and the immune cascades at sites of injured vessel walls, it stimulates proinflammatory cytokine and matrix metalloproteinase secretion. It triggers a localized inflammatory response and then promotes vascular smooth muscle proliferation and migration towards atherosclerotic lesions.25 A second potential proatherogenic mechanism of Lp(a) is its inverse association with vascular reactivity. Lp(a) directly binds to the extracellular matrix, is internalized via macrophages, and is associated with lipid accumulation and Neo-atherosclerosis and in-stent restenosis.26 As a consequence, increased plasma Lp(a) levels result in endothelial dysfunction,27 a major impetus for SER development.28
Predictors of SER
The development, severity, as well as pattern of SER are due to multiple factors, such as mechanical (stent under-expansion, uneven drug distribution, and stent fracture), biological (drug resistance and hypersensitivity), or operator-related technical factors (barotraumas beyond the stented section, stent gaps, and remaining uncovered atherosclerotic plaques).29 Our study corroborates that elevated Lp(a) levels independently correlate with an elevated SER risk, supporting Lp(a)’s potential impact on restenotic lesions. However, previous IVUS and optical coherence tomography (OCT) studies have highlighted several key risk factors for SER: mechanical injury, hinge motion, stent under-expansion, smaller lumen size, residual plaque at the stent edge PCI, and a larger step-up index (ie, the ratio of stent border to reference minimum lumen area).11,30,31 A retrospective OCT study of 319 patients immediately after everolimus-eluting stent implantation revealed lipidic plaque (OR: 5.99; 95% CI: 2.89–12.81; P<0.001) and minimum lumen area (OR: 0.64; 95% CI: 0.42–0.96; P=0.029) as independent predictors of SER.11 For post-PCI patients, intensive management directed toward conventional risk factors (elevated LDL level, lesion morphology, hypertension, and diabetes) is usually performed.32 Our cohort’s lack of correlation between these conventional risk variables and SER could be due to the fact that their potential influence may not be a major driver of SER and that the control of these risk factors through intense treatment interventions following baseline PCI has been effective. In contrast, secondary prevention with Lp(a)-targeted therapies is approved but only in development and not yet standardized, giving us the advantage to study the persistent effect of elevated Lp(a) levels on stent durability.
Clinical Outcome
Our study revealed consistently higher cumulative 2-year incidences of DoCE and TLR in the elevated Lp(a) cohort in contrast to the non-elevated Lp(a) cohort. The association seen in SER patients with elevated Lp(a) and adverse clinical outcomes following repeat PCI indicated these findings as a potential causal effect even in the DES era. Landmark assessment showed that the differences in SER in patients with elevated and non-elevated Lp(a) were greatest following the index post-baseline PCI and therefore consistent with Lp(a)’s 2-year clinical effects on SER. In fact, a previous OCT study has shown that 185° of lipid arc and a minimal lumen area of 4.10 mm² at the stent edge predict SER and future adverse clinical events.11
Limited data exist on the association involving Lp(a) levels and stent thrombosis risk following PCI with DES. Due to structural homology between apolipoprotein(a) and plasminogen, Lp(a) may compete with and inhibit tissue plasminogen’s thrombolytic activity.33 Park et al reported an association involving higher Lp(a) levels as well as stent thrombosis following PCI with DES,34 suggesting a more thrombogenic state within patients having high Lp(a) levels. However, our study found no statistically significant difference in cumulative 2-year stent thrombosis incidence involving the two cohorts, possibly due to insufficient sample size. Larger sample size studies are needed to draw definitive conclusions about Lp(a)’s role in stent thrombosis development.
Despite high and similar statin use in both cohorts (85.3% in elevated Lp(a) cohort versus 89.7% in non-elevated Lp(a) group, P=0.601), significant differences in 2-year DoCE outcomes were observed, suggesting that Lp(a) is not modified by statin therapy.35 Following treatment with a proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i), which decreased Lp(a) levels from 71.5 to 47.4 mg/dL, a patient with elevated Lp(a) levels showed no ISR recurrence, according to a case report by Akiyama et al. It is noteworthy that before to starting PCSK9i, this patient had a history of recurrent ISR (6 times) while receiving appropriate traditional antihyperlipidemia medication. Further studies are warranted to investigate potential therapies for preventing SER within patients having high Lp(a) levels undergoing PCI with DES.
Lp(a) is discussed as a promising risk factor and therapeutic target for SER prevention, and research in this area is encouraged. In patients undergoing PCI, elevated Lp(a) levels should be managed meticulously with a corresponding decrease in Lp(a) level. Of particular relevance in this era of emerging Lp(a)-targeted therapies,36 this approach is important.The clinical importance of Lp(a) in the prevention of SER is amplified because SER is routinely treated by revascularization, which may be complex PCI or surgical intervention and could affect patient prognosis.29 In addition, though, beyond treatment trials, more prospective studies are necessary to better explore the role of Lp(a) in SER.
Limitations
This study has several limitations. First, the single-center, non-randomized, retrospective design and limited sample size may introduce selection and information bias. Additionally, some patients were excluded due to missing IVUS assessments or Lp(a) measurements, which may have affected representativeness. Second, the types of DES previously implanted at SER sites included both first- and second-generation devices, potentially influencing plaque morphology and confounding the analysis. Third, although patients received guideline-directed medical therapy, detailed information on prior pharmacological interventions—particularly statin and P2Y12 inhibitor use—was not fully available, which may have contributed to observed differences in restenotic tissue characteristics between cohorts. Fourth, while clinical follow-up was performed for up to two years, extended long-term data beyond this period, including major adverse cardiovascular events (MACE) or late revascularization rates, were not collected. This may have limited the ability to fully assess the long-term prognostic implications of elevated Lp(a). In addition, dynamic changes in Lp(a) levels and longitudinal data on stent type during follow-up were not available, which may have further influenced outcomes. Fifth, while IVUS provided detailed structural information, it has intrinsic limitations in accurately characterizing tissue composition, as its imaging features may not fully correspond with histopathological findings. Future studies incorporating multimodal imaging—such as OCT, NIRS, or hybrid imaging platforms—are warranted to improve tissue characterization and validation.
Conclusion
This study demonstrates that elevated Lp(a) is independently associated with the occurrence of neoatherosclerosis and adverse two-year outcomes in patients with SER after PCI. These findings reinforce the biological plausibility of Lp(a) as a risk factor, given its pro-inflammatory and pro-thrombotic properties that may promote plaque progression and vascular remodeling. The results highlight the potential of Lp(a) not only as a predictor of SER but also as a future therapeutic target or risk stratification tool in post-PCI patient management. While the findings are supported by robust imaging and clinical analysis, the single-center, retrospective design and limited follow-up duration represent inherent limitations. Future prospective, multicenter studies with extended follow-up are warranted to validate these observations and assess the impact of Lp(a)-targeted interventions.
Data Sharing Statement
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethics Approval and Consent to Participate
The present research was carried out in accordance with the tenets mentioned in the Helsinki Declaration and was approved by the Ethical Board of Xiangtan Central Hospital (approval number:X201863231-3). Prior to the commencement of the research, our team obtained written informed consent from each patient.
Consent for Publication
Not applicable. No individual patient data will be reported.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas. Specifically, X.W. and L.W. conceived the study and critically reviewed the manuscript for important intellectual content. H.B.H. and H.H. performed the literature search and data analysis. X.W., M.X.W., L.W., Z.L., and H.H. contributed to drafting and revising the manuscript. All authors gave final approval of the version to be published, agreed on the journal to which the article has been submitted, and agree to be accountable for all aspects of the work.
Funding
This work was supported by Natural Science Foundation of Hunan Province (No.2022JJ30575) and Health Research Project of Hunan Provincial Health Commission (No. 20233486).
Disclosure
The authors declare that they have no competing interests.
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