scholarly journals The efficacy of bare metal stent implantation for patients with acute myocardial infarction in the drug-eluting stent era

2008 ◽  
Vol 51 (3) ◽  
pp. 189-195 ◽  
Author(s):  
Hajime Fujimoto ◽  
Susumu Tao ◽  
Jun Masuda ◽  
Haruo Mitani ◽  
Sachiko Ito ◽  
...  
Author(s):  
Vijay P. Bakhtar ◽  
Niyati V. Bakhtar ◽  
Sameer P. Chaudhari

Background: The present study was conducted with the aim of determining whether drug-elutingstents are superior to uncoated stents in the setting of primaryPCI in terms of occurrence of serious adverse cardiac events.Methods: In this prospective, single blind, randomized study, 20 to 80 years old patients with acute myocardial infarction with ST-segment elevation with >30 minutes of chest pain and at least 1 mm of ST-segment elevation in at least two standard leads or a new LBBB or 2 mm of ST-segment elevation in at least two contiguous leads were included. Patients were randomly assigned to receive either drug eluting stent (DES) (Everolimus Eluting stent, Endevour-Medtronics) or bare metal stent (BMS, Cordis-Dx sonic) in a 1:1 ratio. During follow ups at 30 days and 12 months, all serious adverse cardiac events like death from cardiac or non-cardiac cause, recurrent MI, revascularization of target vessel, coronary artery bypass grafting (CABG) or other intervention to target or non-target vessel etc. were recorded and compared between groups.Results: No significant differences were found between the two treatmentgroups for occurrence of adverse events during first 30 days after the intervention. At one year follow-up, trends were observed in favorof the DES group, none of the differences weresignificant.Conclusions: No significant benefit was observed with the use of Everolimus-eluting stents in primaryPCI for acute myocardial infarction with ST-segment elevation,in comparison with baremetal stents.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Masami Nishino ◽  
Takahiro Yoshimura ◽  
Yasuharu Lee ◽  
Daisuke Nakamura ◽  
Shinpei Nakatani ◽  
...  

Drug-eluting stent (DES) achieved significant reduced restenosis, however the safety of efficacy of DES in acute myocardial infarction (AMI) are still controversial. In this study, we compared angioscopic parameters between DES and bare metal stent (BMS) in patients with AMI. Eighty-seven consecutive patients who received DES or BMS for AMI were enrolled. At 6-month after AMI, coronary angiography was performed in all patients. We performed coronay angioscope (CAS) if the patients did not show significant in-stent restenosis (>50% stenosis). Using CAS, we evaluated the maximum and minimum grade of neointimal coverage within one stent using the following CAS score: 0: stent struts were exposed similary to right implantaiton, 1: stent were covered by very thin neointima, 2: struts were embedded but visible and 3: struts were fully embedded and invisible. We adopted minimium grade as the magnitude of neointimal coverage and calculated heterogeneity score as the following formula: (maximum grade) − (minimum grade). We compared CAS parameters including magnitude and heterogeneity score of neointimal coverage, visible thrombi and plaque color (white or yellow) aroud stent, and serum parameters including low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, hemoglobin A1c and high sensitive C-reactive protein (hs-CRP). Restnosis rate of DES (n=56) was significantly lower than that of BMS (n=31): 9% vs. 29%, p=0.03. In patients without restenosis, DES group revealed lower magnitude and higher heterogeneity score as compared to BMS group while there were no significant differences of the other parameters between the two groups (table ). Not only lower magnitude but also more heterogeneous propery of neointimal coverage were shown in DES as compared to in BMS at 6-month after AMI. These findings may be correlated with future cardiac evetns while restenosis rate is lower in DES than in BMS.


2009 ◽  
Vol 30 (15) ◽  
pp. 1828-1830 ◽  
Author(s):  
A. V. Finn ◽  
G. Nakazawa ◽  
F. Kolodgie ◽  
R. Virmani

2019 ◽  
Vol 29 (8) ◽  
pp. 1057-1065 ◽  
Author(s):  
Yoshihiko Kurita ◽  
Kenji Baba ◽  
Maiko Kondo ◽  
Takahiro Eitoku ◽  
Shingo Kasahara ◽  
...  

AbstractBackground:Pulmonary vein stenosis (PVS) is a condition with challenging treatment and leads to severe cardiac failure and pulmonary hypertension. Despite aggressive surgical or catheter-based intervention, the prognosis of PVS is unsatisfactory. This study aimed to assess the prognosis and to establish appropriate treatment strategies.Methods:We retrospectively reviewed endovascular treatments for PVS (2001–2017) from the clinical database at the Okayama University Hospital.Results:A total of 24 patients underwent PVS associated with total anomalous pulmonary venous connection and 7 patients underwent isolated congenital PVS. In total, 53 stenotic pulmonary veins were subjected to endovascular treatments; 40 of them were stented by hybrid (29) and percutaneous procedures (11) (bare-metal stent, n = 34; drug-eluting stent, n = 9). Stent size of hybrid stenting was larger than percutaneous stenting. Median follow-up duration from the onset of PVS was 24 months (4–134 months). Survival rate was 71 and 49% at 1 and 5 years, respectively. There was no statistically significant difference between stent placement and survival; however, patients who underwent bare-metal stent implantation had statistically better survival than those who underwent drug-eluting stent implantation or balloon angioplasty. Early onset of stenosis, timing of stenting, and small vessel diameter of pulmonary vein before stenting were considered as risk factors for in-stent restenosis. Freedom from re-intervention was 50 and 26% at 1 and 2 years.Conclusions:To improve survival and stent patency, implantation of large stent is important. However, re-intervention after stenting is also significant to obtain good outcome.


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