scholarly journals Long-Term Efficacy and Safety Outcomes After Unrestricted Use of Drug-Eluting Stents in Patients With Acute Coronary Syndrome

2014 ◽  
Vol 78 (7) ◽  
pp. 1628-1635 ◽  
Author(s):  
Tetsuma Kawaji ◽  
Hiroki Shiomi ◽  
Takeshi Morimoto ◽  
Toshihiro Tamura ◽  
Ryusuke Nishikawa ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Drug Eluting Stents ◽  
Efficacy And Safety ◽  
Coronary Syndrome ◽  
Term Efficacy ◽  
Safety Outcomes ◽  
Drug Eluting

Long-term efficacy and safety of newer generation ultrathin strut drug-eluting stents: a systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
B Lattuca ◽  
X Odorico ◽  
B.V Occean ◽  
L Cornillet ◽  
L Schmutz ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Target Lesion ◽  
Drug Eluting Stents ◽  
Target Vessel ◽  
Efficacy And Safety ◽  
Short Term ◽  
Term Efficacy ◽  
Drug Eluting

Abstract Background Recent trials have demonstrated that short-term efficacy and safety of ultrathin strut drug-eluting stents (DES) were non-inferior to contemporary stents but long-term benefit remains uncertain. Purpose The main objective of this meta-analysis was to evaluate efficacy and safety of ultrathin strut DES with an extended follow-up in comparison to 2nd and 3rd generations DES. Methods A double-blind review of randomized controlled trials (RCT) comparing ultrathin strut DES to contemporary DES was performed from MEDLINE and CENTRAL databases and from cardiological congresses. The primary efficacy endpoint was target vessel failure (TLF) defined as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization (TLR) and the primary safety endpoint was occurrence of stent thrombosis (ST). Short (1 year) and long term (≥2 years) effects were estimated separately. This analysis was pre-specified in PROSPERO (CRD42019142206). Results The meta-analysis included 13 RCT including 19,490 patients. In short term, we found TLF decrease with ultrathin strut DES (RR 0.85, CI [0.75–0.97], p=0.01), driven by lower TV-MI (RR 0.83, CI [0.66–1.03], p=0.1) and TLR (RR 0.77, CI [0.58–1.01], p=0.1) rates, and a non-significant downward trend in ST (RR 0.85 CI [0.64–1.14]). In long term, from the 5 trials with extended follow-up, there was no significant difference between ultrathin strut DES and thicker strut stents in rate of TLF at the longest available follow-up (RR 0.90, CI [0.76–1.06], p=0.2), despite a numerically reduction of TV-MI (RR 0.81, CI [0.61–1.08], p=0.05) and TLR (RR 0.85, CI [0.69–1.04], p=0.1) in favor of ultrathin strut stents. However, we observed a persistent numerically reduction in ST (RR 0.79, CI [0.61–1.02], p=0.01). Conclusion Ultrathin strut DES was associated with a lower target lesion failure rate at one year but not beyond 2-years follow-up. Nevertheless, the safety of the ultrathin strut stents was sustained over time with a numerically reduction of ST. Funding Acknowledgement Type of funding source: None

scholarly journals Early aspirin desensitization in unstable patients with acute coronary syndrome: Short and long-term efficacy and safety

2016 ◽  
Vol 5 (7) ◽  
pp. 41-50 ◽  
Author(s):  
Juan Gabriel Córdoba-Soriano ◽  
Miguel Corbí-Pascual ◽  
Isabel López-Neyra ◽  
Javier Navarro-Cuartero ◽  
Víctor Hidalgo-Olivares ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Efficacy And Safety ◽  
Aspirin Desensitization ◽  
Coronary Syndrome ◽  
Term Efficacy ◽  
Short And Long Term

scholarly journals Long-Term Efficacy and Safety of Everolimus-Eluting Stent Implantation in Japanese Patients with Acute Coronary Syndrome: Five-Year Real-World Data from the Tokyo-MD PCI Study

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Shunji Yoshikawa ◽  
Takashi Ashikaga ◽  
Toru Miyazaki ◽  
Ken Kurihara ◽  
Kenzo Hirao
Keyword(s):  
Acute Coronary Syndrome ◽  
Real World ◽  
Cumulative Incidence ◽  
Japanese Patients ◽  
Efficacy And Safety ◽  
Real World Data ◽  
World Data ◽  
Coronary Syndrome ◽  
Term Efficacy

Background. The long-term safety of first-generation drug-eluting stent (DES) in acute coronary syndrome (ACS) was controversial. Purpose. The purpose of this study was to establish 5-year real-world data regarding the long-term efficacy and safety of second-generation DES in Japanese patients with ACS. Methods. The Tokyo-MD PCI study is a multicenter, observational cohort study enrolling consecutive patients who underwent everolimus-eluting stent (EES) implantation. The 5-year clinical events were compared between the ACS group (n = 644) and the stable coronary artery disease (SCAD) group (n = 1255). The primary efficacy endpoint was ischemia-driven target lesion revascularization (TLR), and the primary safety endpoint was the composite of all-cause death or myocardial infarction (MI). Results. The median follow-up duration was 5.4 years. The cumulative incidence of ischemia-driven TLR was similar between ACS and SCAD (1 year: 3.0% versus 2.7%; P=0.682, 1–5 years: 2.7% versus 2.9%; P=0.864). The cumulative incidence of all-cause death or MI within 1 year was significantly higher in ACS than in SCAD (7.4% versus 3.8%; P<0.001); however, ACS did not increase the risk of all-cause death or MI after adjusting confounders (adjusted hazard ratio, 1.260; 95% confidence interval, 0.774–2.053; P=0.352). From 1 to 5 years, the cumulative incidence of all-cause death or MI was not significantly different between ACS and SCAD (11.6% versus 11.4%; P=0.706). The cumulative incidence of very late stent thrombosis was low and similar between ACS and SCAD (0.2% versus 0.2%; P=0.942). Conclusion. This real-world registry suggested that EES has comparable long-term efficacy and safety in patients with ACS and SCAD.

scholarly journals The comparison of the chronic-phase vascular healing between bioabsorbable and durable polymer drug eluting stent by using optical coherence tomography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Yamakami ◽  
S Kimura ◽  
K Hara ◽  
M Ohmori ◽  
R Tateishi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Acute Coronary Syndrome ◽  
Clinical Presentation ◽  
Neointimal Hyperplasia ◽  
Chronic Phase ◽  
Drug Eluting Stents ◽  
Coronary Syndrome ◽  
Durable Polymer ◽  
Drug Eluting

Abstract Background Bioabsorbable polymer drug eluting stents (BP-DESs) were designed to reduce a vascular inflammatory reaction compared to durable polymer drug eluting stents (DP-DESs). However, few studies have compared vascular responses to BP-DESs and DP-DESs. Methods We enrolled 88 consecutive patients with single culprit coronary artery lesions (31 lesions with acute coronary syndrome) undergoing a single stent-implantation. BP-DESs and DP-DESs were implanted in 50 (57%) and 38 patients (43%), respectively. All lesions underwent optical coherence tomography examination at chronic phase and intrastent OCT findings at the follow-up were evaluated in every 1-mm cross-sections (CSs). Results A total of 1887 CSs (BP-DES: 1096, DP-DES: 791) were analyzed. The median period of follow-up OCT was 293 (250–374) days. There were no differences in the patient, lesion, and initial clinical presentation of acute coronary syndrome (ACS). BP-DESs had significantly higher percent neointimal hyperplasia area, defined as neointimal hyperplasia area divided by stent area x 100 (18.4±9.0% vs. 16.1±9.9%, p&lt;0.001), fewer malapposed struts (1.7% vs. 3.9%, p=0.005), fewer uncovered struts (3.6% vs. 5.8%, p=0.02) but higher frequency of superficial low intensity neointima (LIN) (7.7% vs. 3.4%, p&lt;0.001). Multivariate logistic analysis showed that BP-DES (OR: 2.5, 95% CI: 1.49–4.08, p&lt;0.001) and the initial clinical presentation of ACS (OR: 2.31, 95% CI: 1.47–3.62, p&lt;0.001) are independent predictive factors for LIN. Conclusion BP-DESs showed homogenous neointimal growth and complete stent coverage quantitatively. Meanwhile, the significant relationships of BP-DES with LIN may suggest that the neointimal quality remains immature in BP-DESs in this period. Funding Acknowledgement Type of funding source: None

scholarly journals Long-Term Efficacy and Safety of Paclitaxel-Eluting Balloon for the Treatment of Drug-Eluting Stent Restenosis

2015 ◽  
Vol 8 (7) ◽  
pp. 877-884 ◽  
Author(s):  
Sebastian Kufner ◽  
Salvatore Cassese ◽  
Marco Valeskini ◽  
Franz-Josef Neumann ◽  
Stefanie Schulz-Schüpke ◽  
...  
Keyword(s):  
Drug Eluting Stent ◽  
Efficacy And Safety ◽  
Term Efficacy ◽  
Stent Restenosis ◽  
Drug Eluting
Sign in / Sign up

Export Citation Format

Share Document