Randomized comparison of endothelial progenitor cells capture stent versus cobalt-chromium stent for treatment of ST-elevation myocardial infarction. Six-month clinical, angiographic, and IVUS follow-up

2010 ◽  
Vol 76 (5) ◽  
pp. 627-631 ◽  
Author(s):  
Marian Bystroň ◽  
Pavel Červinka ◽  
Radim Špaček ◽  
Martin Kvašňák ◽  
Jozef Jakabčin ◽  
...  
2011 ◽  
Vol 64 (12) ◽  
pp. 1123-1129 ◽  
Author(s):  
Manuel F. Jiménez-Navarro ◽  
Francisco Jesús González ◽  
Juan Caballero-Borrego ◽  
Juan Antonio Marchal ◽  
Noela Rodríguez-Losada ◽  
...  

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D De Almeida Fernandes ◽  
V Leal ◽  
B Oliveiros ◽  
S Silva ◽  
L Goncalves ◽  
...  

Abstract Background Endothelial progenitor cells (EPCs) are bone marrow-derived cells that play a crucial role in vascular repair after an acute myocardial infarction (AMI). Recent studies suggest that circulating EPCs levels may be useful as a surrogate biomarker for cardiovascular (CV) events. Nevertheless, the lack of a consensual definition and phenotypic characterization of EPCs hampers its use in clinical practice. CD34+KDR+, CD45dimCD34+KDR+ and CD34+CD133+KDR+ are among the most used antigenic phenotypes to define circulating EPCs but the best phenotype to predict CV outcomes remains to be determined. Purpose To determine the EPCs' surface phenotype that best predicts long-term CV death after an AMI, and to evaluate its optimal cut-off point. Methods One-hundred AMI patients were prospectively enrolled in the study. Circulating EPCs were quantified through high-performance flow cytometer within the first 24 hours of admission using different surface markers combinations allowing to simultaneously compare three EPCs definitions: 1) CD34+KDR+, 2) CD45dimCD34+KDR+, 3) CD34+CD133+KDR+. Mean follow-up time was 8.0±2.2 years. Results The mean age of our population was 59.7±11.0, the majority of patients were male (90%), 65% had ST-elevation myocardial infarction (STEMI) and 35% non-ST segment elevation myocardial infarction (NSTEMI). Diabetes mellitus was present in 38% and hypertension in 67% of the studied sample. During the long-term follow-up, 34 patients had re-admissions due to cardiovascular causes, 11 of them for AMI. Thirty-one patients had major adverse cardiovascular events (MACE) and 19 died. Using ROC curves, the CD34+KDR+ phenotype showed the biggest area under the curve regarding prediction of CV mortality (0.722; p=0.010; confidence interval 95% (CI95%): 0.554 to 0.890). Patients with lower levels of EPCs according to this definition (≤0.022%) are 7 times more likely to die from CV causes at any time (hazard ratio = 7.55; p=0.008; CI95% 1.69 to 33.83). Conclusion The CD34+KDR+ phenotype appears to be the best definition of circulating EPCs for predicting long-term CV mortality after AMI. Further studies with larger samples are needed to clarify the optimal cut-off point for determining patients at risk and its role in everyday Cardiology. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Bolsa de Estudo João Porto da Sociedade Portuguesa de Cardiologia CD34+KDR+ as a predictor of CV death


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Oishi ◽  
T Shinke ◽  
H Tanaka ◽  
K Ogura ◽  
K Arai ◽  
...  

Abstract Background Recent clinical study suggests newer-generation drug-eluting stents (DES) that combine ultrathin strut and nano-coating with biodegradable polymers sirolimus-eluting stent (BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) over current generation DES. However, safety profiles in very early phase have not been systematically addressed. Objective and method We exploratory investigate early vascular response following BP-SES implantation in patients with STEMI to reveal mechanism of the favorable clinical outcomes in recent studies using frequency domain-optical coherence tomography (FD-OCT). Consecutive twenty patients with STEMI who underwent FD-OCT immediately after primary PCI and were eligible for follow-up FD-OCT at 2 weeks after implantation were enrolled between June 2018 and November 2019. Results Twenty patients (age 62.7±11.3 years, male 85.0%) were enrolled with frequencies of hypertension (45.0%), diabetes mellitus (35.0%), dyslipidemia (55.0%) and smoking (80.0%). Aspiration catheter were used in all patients, and 1.13±0.34 stents were used. Only one patient (5.0%) received chronic antiplatelet therapy with aspirin prior to the onset of STEMI. All patients started to receive prasugrel as thienopyridine from this event and continued dual antiplatelet therapy for 2 weeks. The percentage of uncovered struts significantly decreased from post-procedure to 2W follow-up (69±18% post-procedure versus 30±11% at 2W follow up, p<0.0001). Malapposed struts also decreased (5.6±5.7% post-procedure versus0.9±1.2% at 2W follow up, p<0.0001).The average protrusion area of athero-thrombotic burden numerically decreased (0.37±0.19 at post-procedure versus 0.34±0.14 mm2 at 2W follow up, p=0.19) and its volume showed similar tendency (10.60±6.40 at post-procedure versus 9.36±5.14 mm3 at 2W follow up, p=0.19). Conclusion(s) This study firstly elucidated very early vascular responses following ultrathin strut BP-SES implantation in STEMI patients, showing early progression of strut coverage and resolution of athero-thrombotic materials. This technology may have a potential to overcome the current generation DESs in this clinical setting. Thrombus, uncovered and malapposed struts Funding Acknowledgement Type of funding source: None


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