scholarly journals Moderate-intensity versus high-intensity statin therapy in Korean patients with angina undergoing percutaneous coronary intervention with drug-eluting stents: A propensity-score matching analysis

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0207889 ◽  
Author(s):  
Mahn-Won Park ◽  
Gyung-Min Park ◽  
Seungbong Han ◽  
Yujin Yang ◽  
Yong-Giun Kim ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Statin Therapy ◽  
High Intensity ◽  
Coronary Intervention ◽  
Moderate Intensity ◽  
Drug Eluting Stents ◽  
Propensity Score Matching Analysis ◽  
Percutaneous Coronary ◽  
Drug Eluting

scholarly journals Intensive versus non-intensive statin pretreatment before percutaneous coronary intervention in Chinese patients: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Xian Yang ◽  
Xi Lan ◽  
Xin-Lin Zhang ◽  
Zhong-Lin Han ◽  
Si-Min Yan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Statin Therapy ◽  
High Intensity ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Statin Treatment ◽  
Chinese Patients ◽  
Moderate Intensity ◽  
Percutaneous Coronary ◽  
Intensive Statin Therapy

Abstract Background: The results of intensive statin pretreatment before percutaneous coronary intervention (PCI) is inconsistent between Chinese and Western populations and there are no corresponding meta-analyses involving hard clinical end-points in the available published literature. The aim of this study was to evaluate the efficacy and safety of high-dose statin loading before PCI in Chinese patients through a meta-analysis. Method: Relevant studies were identified by searching the electronic databases of PubMed, Embase, and Cochrane’s Library to December 2019. The outcomes included an assessment of major adverse cardiovascular event (MACE), non-fatal myocardial infarction (MI), cardiac death, target vessel revascularization (TVR), myalgia/myasthenia and abnormal alanine aminotransferase (ALT) in all enrolled patients. Results: 12 studies involving 3,183 individuals were included．The results showed statistically significant different in the incidence of MACE (RR=0.49, 95% CI: 0.30-0.80, P=0.004, I2=63%) and non-fatal MI (RR=0.54, 95% CI: 0.33-0.88, P= 0.01, I2=62%) on comparing the intensive statin and non-intensive statin treatment groups. Subgroup analysis further suggested the benefits of different treatments were inconsistent. Compared with preoperative intensive statin therapy, the incidence of MACE and non-fatal MI were significantly elevated in patients receiving placebo or no statin treatment before surgery (RR=0.47, 95% CI: 0.34-0.65, P<0.00001, I2=0%; RR=0.49, 95% CI: 0.35-0.70, P<0.0001, I2=0%). However, the incidence of MACE and non-fatal MI were not statistically significant when comparing preoperative high-intensity statin therapy with moderate-intensity statin therapy (RR=0.96, 95% CI: 0.44-2.08, P=0.91, I2=11%; RR=1.10, 95% CI: 0.86-1.39, P=0.44). The study also demonstrated that the Asian population could tolerate high-intensity atorvastatin during the perioperative period. Conclusion: Compared with placebo or no statin pretreatment, Chinese patients receiving intensive statin therapy before PCI displayed reduced incidence of MACE and non-fatal MI. However, there was no significant benefit between high-intensity and moderate-intensity statin treatment. Further, the Chinese population tolerated well preoperative intensive statin pretretment.

Percutaneous Coronary Intervention for Complex Bifurcation Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 58
Author(s):  
Yves Louvard ◽  
Morice Marie-Claude ◽  
Thomas Hovasse ◽  
Thierry Lefèvre ◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
Drug Eluting Stents ◽  
Open Angle ◽  
Balloon Inflation ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Stent Diameter

Coronary bifurcations are prone to the development of atherosclerosis. They pose technical difficulties for angioplasty treatment and are a predictor of stent thrombosis and restenosis. Treatment of coronary bifurcations is still subject to debate, especially when the side branch (SB) is large, not easily accessible and narrowed by a long lesion. There is currently no indexed treatment for this type of lesion (Medina classification), as the strategy of provisional SB stenting with drug-eluting stents (DES) has proved to be equally efficient as the dualstent technique. Complex techniques are associated with poor outcome in certain lesion types, such as T-stenting when the angle between the two distal branches is small or the crush and culotte technique in the presence of an open angle. Provisional SB stenting may be used when primary dual stenting is required, with a low risk of failure provided that the following guidelines are implemented: stenting of the main branch through the protected SB with a stent diameter adapted to the distal main branch, immediate optimisation of the proximal stent segment (Finet’s law), guidewire exchange, kissing balloon inflation with non-compliant balloons selected according to the diameter of the distal branches and T-stenting of the SB before final kissing inflation.

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