Malapposed Struts with Cre8, Biomatrix, and Xience Stents Assessed with OCT Immediately after Implantation and at 6-Month Follow-Up: Can the Different Biomechanical Characteristics of the Three Stents Impact on Struts Malapposition?

Background. Although the clinical effects of stent malapposition remain controversial, several analyses of stent registries consistently have found that malapposed struts were frequently identified in patients who experienced stent thrombosis. In this study, which is a subanalysis of the previously published CREBX-OCT study, we compared optical coherence tomography (OCT) analysis at the index percutaneous coronary intervention (PCI) and at six-month follow-up in 37 patients randomly assigned to receive, by a single operator, three different second-generation drug-eluting stents (Cre8, Biomatrix, and Xience) aiming to clarify if the malapposition observed at six-month follow-up was persistent or late-acquired. Moreover, we investigated if there were some differences in the behavior of the three different kinds of stents in relation to the struts malapposition. Material and Methods. We analyzed 614 and 599 cross sections and 5514 and 5377 struts at the index PCI and at six-month follow-up, respectively. The qualitative analysis of the plaque composition among the three groups did not show significant differences. Results. The lumen area did not significantly change from the index procedure to the six-month follow-up in the three groups; on the contrary, the number of malapposed struts increased significantly in the Cre8 and Biomatrix groups but not in the Xience group: 0.58 ± 1.51 and 3.29 ± 5.33 ( p < 0.023 ) in the Cre8 group, 0.55 ± 1.81 and 1.73 ± 2.28 ( p < 0.024 ) in the Biomatrix group, and 0.55 ± 1.5 and 0.25 ± 0.87 ( p < 0.166 ) in the Xience group, respectively. Conclusions. Therefore, the malapposition observed at six-month follow-up in our study population could be mainly considered as acquired and attributable to biomechanical reasons due to the structural differences among the three stents. This trial is registered with Clinical Trials.gov Identifier: NCT02850497.

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Abstract 11491: Differences in the Development of Restenosis Over Time for Various Drug-Eluting Stents

Circulation ◽

10.1161/circ.130.suppl_2.11491 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Kosei Tanaga

Keyword(s):

Coronary Intervention ◽

Drug Eluting Stents ◽

Minimal Lumen Diameter ◽

Percutaneous Coronary ◽

Late Loss ◽

Drug Eluting ◽

Coronary Lesions ◽

To Receive ◽

Over Time

Objective: This study aims to compare the efficacy of sirolimus-eluting stents (SES), paclitaxel-eluting stents (PES), zotarolimus-eluting stents (ZES), and everolimus eluting stents (EES) via sequential angiographic follow-up and to reveal the development of restenosis over time. Methods: Patients were randomized to receive SES, PES, ZES, or EES, and follow-up angiography was performed at 6, 12 and 24months after percutaneous coronary intervention. Results: The baseline clinical characteristics of the patients and the coronary lesions are shown in (Table 1). In all groups, mean minimal lumen diameter decreased slightly during the 2-year period after the procedure (Figure 1). Compared with the SES group, the PES and the ZES groups showed greater late loss (LL) within 1 year. However, the SES group showed significantly greater LL compared with the other drug-eluting stents (DES) between 1 and 2 years (Figure 2). Conclusion: Serial angiographic analysis revealed differences in the rate of restenosis development over time for various DES. As DES are comprised of many components (metallic platform, alloy, drug and polymer), the progression of LL can be complex and affected by different factors.

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Abstract 111: Assessing Statin Therapy and Lipid Profile Goals 6 Months After Percutaneous Coronary Intervention at a Veterans Hospital

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.6.suppl_1.a111 ◽

2013 ◽

Vol 6 (suppl_1) ◽

Author(s):

Dmitry Blumenkrants ◽

Saifullah M Siddiqui ◽

Karthik Challa ◽

Amit Ladani ◽

Adhir Shroff

Keyword(s):

Percutaneous Coronary Intervention ◽

Statin Therapy ◽

Coronary Intervention ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Percutaneous Coronary ◽

Core Measure ◽

Study Population ◽

Artery Disease

Background: Patients undergoing percutaneous coronary intervention (PCI) represent a high-risk cohort for cardiovascular events. Lipid lowering therapy is an established core measure of secondary prevention in coronary artery disease management. The NCEP-ATPIII advises a minimum LDL level < 100 mg/dL in patients with coronary heart disease (CHD). However, further research suggests that an LDL < 70 is more desirable in this population to further reduce adverse CHD endpoints. Methods: We conducted a retrospective, observational study on all patients undergoing PCI at an urban Veterans Hospital from September 2004 to December 2011. Statin use and lipid profiles at 6 months post-PCI were compared to pre-PCI values. Results: A total of 1052 unique patients had PCI during the study period. Approximately 70% of patients were on statins at baseline, which improved to 88% at 6 months post-PCI (p < 0.0001). LDL levels improved significantly when compared to pre-PCI levels, from a mean of 97.2 to 85.1 (p < 0.0001). With regards to NCEP-ATPIII guidelines, the proportion of the study population that met minimum LDL goals (<100) post-PCI increased from 59% to 76% (p < 0.0001). The percentage of patients meeting ideal goals for LDL (<70) increased from 23% to 33% (p < 0.0001). Conclusion: In patients who have undergone PCI, there was significant improvement in LDL levels. At six months, there was an increase in usage of statin therapy. Furthermore there was a statistically significant increase in adherence to NCEP-ATIII guidelines at both the minimum and ideal LDL levels on follow-up after PCI.

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Dynamic kinking of right coronary artery after the button Bentall procedure

BMJ Case Reports ◽

10.1136/bcr-2020-239128 ◽

2021 ◽

Vol 14 (1) ◽

pp. e239128

Author(s):

Tomoki Fukui ◽

Nobuyuki Ogasawara ◽

Shinji Hasegawa

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Multidetector Ct ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Sinus Of Valsalva Aneurysm ◽

Bentall Procedure ◽

Percutaneous Coronary ◽

Drug Eluting

Postoperative coronary artery complications after Bentall procedures are well recognised but are rare and potentially fatal. There have been only five cases documenting percutaneous coronary intervention (PCI) for right coronary artery (RCA) involvements after button Bentall procedures. We describe a case of postoperative silent myocardial ischaemia in a 72-year-old man who underwent the button Bentall procedure for a right sinus of Valsalva aneurysm. On postoperative day 15, an RCA complication was incidentally detected by follow-up multidetector CT. Coronary angiography showed proximal RCA kinking, which was not an anastomosis but a native coronary artery. The patient underwent a successful PCI with drug-eluting stent implantation. We reviewed six cases consisting of this case and five previous cases treated with PCI. These cases enhance the recognition of potential RCA complications after the button Bentall procedure.

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Abstract 16049: A Comparison of Short- and Medium-Term Outcomes Between Men and Women Undergoing Percutaneous Coronary Intervention in a Chinese Population During the Contemporary Era of Drug-Eluting Stents

Circulation ◽

10.1161/circ.130.suppl_2.16049 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Peiyuan He ◽

Yuejin Yang ◽

Shubin Qiao ◽

Bo Xu ◽

Yongjian Wu ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Major Bleeding ◽

Chinese Population ◽

Coronary Intervention ◽

Drug Eluting Stents ◽

Access Site ◽

Men And Women ◽

Percutaneous Coronary ◽

Drug Eluting

Background: Very few studies have compared the percutaneous coronary intervention (PCI) outcomes between men and women among Asian population in the era of drug-eluting stents (DES). We aimed to evaluate the sex-specific disparities in a Chinese population. Methods: From June 1, 2006 to April 30, 2011, a total of 21,964 coronary artery disease patients who have undergone PCI with stents implantation were included from one single Chinese heart center. Among them, 17209 were males, and 4755 were females. The primary endpoint was defined as major cardiovascular events (MACE) during hospitalization and at 1 year follow-up, which included cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). The secondary endpoint was defined as each component of MACE. Major bleeding after the procedure was recognized as the safety endpoint. Results: The rates of MACE during hospitalization and at 1 year follow-up were similar between men and women (in-hospital: 1.5% vs. 1.6%, P=0.730, at 1 year follow-up: 4.0% vs. 4.1%, P=0.589). The adjusted rates of the primary endpoint was still similar (in-hospital odds ratio [OR], 0.94; 95% confidence interval [CI], 0.66–1.33, at 1 year follow-up hazard ratio [HR], 1.00; 95% CI, 0.96-1.04). No significant differences were detected in each component of MACE (P all > 0.05). But major bleeding after PCI occurred more in women than in men (1.2% vs. 0.7%, P=0.002), mainly driven by the access site-related major bleeding (0.8% vs. 0.4%, P=0.002). The access site complications were also more frequent in women (2.5% vs. 1.6%, P <0.001). Conclusions: In the Chinese population with frequent use of DES, women present similar in-hospital and 1 year major outcomes compared with men. But women have higher risk of major bleeding and access site complications.

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Improved clinical outcome with biodegradable polymer drug-eluting stents compared to durable polymer drug-eluting stents for primary percutaneous coronary intervention

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-138243 ◽

2020 ◽

pp. postgradmedj-2020-138243

Author(s):

Ratna Andriyati ◽

Doni Firman ◽

Yovi Kurniawati ◽

Amir Aziz Alkatiri ◽

Raymond Pranata ◽

...

Keyword(s):

Myocardial Infarction ◽

Second Generation ◽

Coronary Intervention ◽

Drug Eluting Stents ◽

Recurrent Myocardial Infarction ◽

Repeat Revascularisation ◽

Durable Polymer ◽

Percutaneous Coronary ◽

Drug Eluting

BackgroundStudies comparing the clinical outcomes of second-generation biodegradable polymer drug-eluting stents (BP-DES) and second-generation durable polymer drug-eluting stents (DP-DES) in patients with ST-segment elevation myocardial infarction (STEMI) with follow-up duration of more than 1 year are still limited.ObjectiveThis study aimed to compare the 2-year clinical outcome of BP-DES with second-generation DP-DES in patients undergoing primary percutaneous coronary intervention (PPCI).MethodsThis is a retrospective cohort study in patients with STEMI, the primary endpoint was major adverse cardiac events (MACE) defined as recurrent myocardial infarction, total repeat revascularisation and cardiac death. The secondary endpoint was stent thrombosis (ST) defined as definite, probable or possible.ResultsA total of 400 patients were analysed (197 BP-DES groups and 203 DP-DES groups). BP-DES were independently associated with lower incidence of MACE (adjusted HR 0.67, 95% CI 0.21 to 0.91, p=0.005) and ST (adjusted HR 0.62, 95% CI 0.19 to 0.73, p<0.016) within 2 years of follow-up. Subgroup analysis of MACE individual components showed that BP-DES were associated with lower cardiac deaths (HR 0.35; 95% CI 0.18 to 0.94; p<0.001) compared to DP-DES, but not recurrent myocardial infarction and total repeat revascularisation.ConclusionsBP-DES were associated with better clinical outcomes compared to second-generation DP-DES in patients with STEMI undergoing PPCI.

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