scholarly journals Comparison of neointimal healing with bioresorbable scaffolds and drug-eluting stents in patients with stable ischaemic heart disease

2021 ◽  
Vol 25 (3) ◽  
pp. 71
Author(s):  
S. S. Sapoznikov ◽  
N. A. Galeeva ◽  
I. S. Bessonov ◽  
N. A. Musikhina ◽  
T. I. Petelina ◽  
...  
Keyword(s):  
Treatment Group ◽  
Clinical Outcomes ◽  
Stable Coronary Artery Disease ◽  
Inverse Correlation ◽  
Coronary Intervention ◽  
Neointimal Formation ◽  
Bioresorbable Scaffolds ◽  
Stent Type ◽  
Significant Difference ◽  
Oct Imaging

<p><strong>Aim.</strong> To examine the process of neointimal formation after bioresorbable scaffolds (BRS) implantation using optical coherence tomography (OCT) in patients with stable coronary artery disease (SCAD) and to determine relationship between neointimal healing and biochemical parameters of inflammation.<br /><strong>Methods.</strong> Patients with SCAD (n = 20) who were indicated for percutaneous coronary intervention (PCI) were enrolled. Patients were randomised into two groups as per the stent type. The treatment group comprised 10 patients who were implanted with BRS ABSORB (Abbott Laboratories, Abbott Park, USA) during PCI. The comparison group comprised 10 patients who were implanted with DES XIENCE (Abbott Laboratories, Abbott Park, USA) during PCI. All the patients underwent OCT imaging during PCI. Subsequently, 18 patients were subjected to coronary angiography with OCT imaging in 12 mon. The primary endpoint was the 12-month neointimal healing (NIH) score. Secondary endpoints were clinical outcomes (all-cause hospitalisation, myocardial infarction, probable stent thrombosis and death), OCT parameters at the 12-month follow-up and biochemical markers dynamics.<br /><strong>Results.</strong> Initial angiographic data analysis indicated a higher rate of balloon pre-dilatation (100% vs. 30%; р = 0,003) and post-dilatation (100% vs. 20% р = 0,001) in patients of the treatment group. According to OCT, the NIH score was significantly higher in the XIENCE group [0 versus 9,14 (1,63–17,55); р = 0,008] at 12 mon. There was no significant difference in the clinical outcomes between the two groups. However, the ABSORB group had an increased CD40 level after 4–5 d of PCI. In agreement with the results of correlation analysis, there was an inverse correlation between the NIH score and CD40 level at 4–5 d after PCI (r = −0,576; р = 0,016). The cut-off value of CD40 level at 4–5 d after PCI was 47,5 ng/mL for the detection of optimal neointimal healing.<br /><strong>Conclusion.</strong> In patients with SCAD, BRS demonstrated higher rate of neointimal healing than everolimus-coated stents. There was a registered inverse correlation of the NIH score with the CD40 level at 4–5 days after PCI. CD40 level &gt; 47,5 ng/mL at 4–5 d after PCI increases the likelihood of optimal neointimal healing as per OCT data.</p><p>Received 19 February 2021. Revised 7 June 2021. Accepted 16 June 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors</strong><br />Conception and study design: I.S. Bessonov, N.A. Musikhina, T.I. Petelina<br />Data collection and analysis: S.S. Sapoznikov, I.S. Bessonov, N.А. Galeeva, A.O. Dyakova<br />Statistical analysis: S.S. Sapoznikov, E.A. Gorbatenko<br />Drafting the article: S.S. Sapoznikov, N.А. Galeeva, A.O. Dyakova<br />Critical revision of the article: I.S. Bessonov, S.S. Sapoznikov, E.A. Gorbatenko, N.A. Musikhina<br />Final approval of the version to be published: S.S. Sapoznikov, N.А. Galeeva, I.S. Bessonov, N.A. Musikhina, T.I. Petelina, A.O. Dyakova, E.A. Gorbatenko</p>

Clinical outcomes after percutaneous coronary intervention in patients with and without history of diabetes mellitus with different stent size

2020 ◽  
Author(s):  
Mohammad Javad Zibaeenezhad ◽  
Mehrab Sayadi ◽  
Seyyed Saeed Mohammadi ◽  
Soorena Khorshidi ◽  
Ehsan Hadiyan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Lesion Length ◽  
Diabetic Patients ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Stent Length ◽  
History Of

Abstract Background There are different reports on the occurrence of post-revascularization outcomes of diabetic patients in previous studies. Lesion complexity, which is reflected in stent size, influences the occurrence of outcomes. The aim of the present study was to investigate the occurrence of clinical outcomes in patients with history of diabetes (hDM) after percutaneous coronary intervention (PCI) with emphasis on stent length and diameter. Methods In a retrospective single-center cohort approach, among patients with stable coronary artery disease who underwent PCI with first- and second-generation DES, subjects were included from 2003 until 2019. Outcomes including revascularization, myocardial infarction, and death, totally defined as major adverse cardiac events (MACE), were sought in follow-up phase. All the patients whether with and without hDM received aspirin and clopidogrel as DAPT for at least two years and one year, respectively. Results About 29% out of 1630 participants had hDM and 37.8% of patients who experienced MACE had hDM. Unlike age and time-to-event, there was significant difference in gender between hDM and non-hDM groups. However, no difference was seen in type of MACE between these two groups. Also, after adjusting confounder variables, there was no significant difference in MACE incidence between hDM and non-hDM groups with different stent length and diameter (different lesion length and diameter). Conclusions hDM did not affect MACE incidence significantly in different stent length and diameter. We think that using of DES supplemented by long term DAPT and tight control of glycemic status after PCI are the underlying reasons.

scholarly journals TCT-525 Clinical outcomes following percutaneous coronary intervention using small bioresorbable scaffolds

2015 ◽  
Vol 66 (15) ◽  
pp. B214-B215
Author(s):  
Akihito Tanaka ◽  
Azeem Latib ◽  
Neil Ruparelia ◽  
Hiroyoshi Kawamoto ◽  
Francesco Giannini ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Bioresorbable Scaffolds ◽  
Percutaneous Coronary

P971Impact of treatment strategy on 1-year outcome for Left Main trifurcation lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Tani ◽  
S Mitomo ◽  
K Tanaka ◽  
S Tahara ◽  
S Nakamura
Keyword(s):  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Restenosis Rate ◽  
Left Main ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Significant Difference ◽  
Drug Eluting

Abstract Background/Introduction Limited data exist regarding procedural strategy and clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (LM) trifurcation lesion. Purpose The aim of this study is to evaluate 1-year clinical outcomes after LM trifurcation PCI comparing different strategies in kissing balloon inflation (KBI). Methods From 1, January, 2011 to 31, March, 2017, patients who underwent LM trifurcation PCI with second generation drug-eluting stent in our center were retrospectively analyzed. They were categorized into single-stent KBT group (KBT in left anterior descending artery [LAD] and left circumflex artery [LCX], or LAD and high lateral branch [HL]) and no-KBT group. Primary endpoint is restenosis in the lesions. Results Among 1301 patients who underwent LM PCI during the study period, 163 patients (12.5%) had a trifurcation lesion. Regarding the number of stents used for the lesions, 1, 2 and 3 stents were used in 75.4%, 22.0% and 2.5%, respectively. Median follow-up period of LM trifurcation patients was 265 days (interquartile range: 81–564). In the no-KBT group (64 patients), 19 patients experienced restenosis of HL and LCX (HL: 8 patients, LCX: 0 patient, and both: 11 patients). In the KBT-group, KBT for LAD and LCX was performed in 47 patients, and of them, 19 patients experienced restenosis of LM-LAD, HL and LCX (HL: 12 patients, LCX: 6 patients and all: 1 patient). On the other hand, in 9 patients with KBT for LAD and HL, there were no restenosis cases at 1-year follow-up. There was no statistically significant difference in restenosis rate between the no-KBI and KBT group (29.6% vs. 40.4%, p=0.69). Restenosis rates in each segments Conclusion After LM trifurcation PCI, restenosis rate at 1-year follow-up was high, and no difference between no-KBT and KBT group overall. However, there was no restenosis case in patients with KBT for LAD and HL.

Abstract 3138: Impact of “Off Label” Utilization of Drug-Eluting Stents on Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Probal Roy ◽  
Ashesh N Buch ◽  
Aamir Javaid ◽  
Teruo Okabe ◽  
Vikram Raya ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Drug Eluting Stents ◽  
Cardiac Events ◽  
Off Label ◽  
Repeat Revascularization ◽  
Significant Difference ◽  
Drug Eluting ◽  
Q Wave

Background: The utilization of drug-eluting stents (DES) in “real world” practice has deviated substantially from Food and Drug Administration (FDA) approved indications. The outcomes of patients undergoing intracoronary DES implantation (versus BMS) for non-FDA approved indications has not been determined. Methods : The clinical outcomes of 546 patients undergoing DES implantation for ≥1 non-FDA approved (“Off label”) indication after device approval were assessed. This group was then compared to 546 propensity-matched patients receiving BMS prior to DES approval for the same indications. The primary endpoint was major adverse cardiac events [MACE; death-all cause, non-fatal Q-wave MI and target vessel revascularization (TVR)] at 12 months. Results: Baseline clinical and procedural characteristics were well matched. Patients in the BMS group were more likely to be treated with larger diameter and shorter stents. Though both in-hospital and 30-day all-cause mortality was greater in the DES group, there was no significant difference in cardiac death at both time points. At 30 days all other clinical outcomes were comparable. At 12 months MACE was significantly reduced in the DES group (27.8% vs. 21.4% p=0.014) driven by reductions in repeat revascularization [target lesion revascularization (TLR): 16.4% vs. 7.8% p<0.001, TVR: 20.2% vs.13.1% p<0.003]. There was no significant increase in death and non-fatal Q-wave MI with DES. Conclusions: The utilization of DES for non-FDA approved indications proved to be efficacious and safe when compared to a propensity-matched BMS cohort. These findings support broadening the current FDA indications for DES use.

scholarly journals Effectiveness of Teicoplanin Versus β-lactam for Bacteremia Due to Methicillin-Susceptible Staphylococcus Aureus: A Propensity Score-Based Study

2020 ◽  
Author(s):  
Chen-Hsiang Lee ◽  
Ching-Yen Tsai ◽  
I-Ling Chen
Keyword(s):  
Staphylococcus Aureus ◽  
Risk Factor ◽  
Treatment Group ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Clinical Outcomes ◽  
Significant Risk ◽  
Outcome Analysis ◽  
Significant Difference ◽  
Before And After

Abstract Background: Many studies have shown that vancomycin is inferior to β-lactam antibiotics in terms of effectiveness in the treatment of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. However, limited data are available regarding the comparison of clinical outcomes between patients receiving initial teicoplanin and those receiving β-lactam antibiotics for MSSA bacteremia.Methods: Eighty-four adults with MSSA bacteremia were included: initial teicoplanin treatment group (n=28) and β-lactam treatment group (n=56). The two groups were further stratified based on propensity score matching according to the outcome analysis using a logistic regression model. We investigated the clinical outcomes between the groups before and after propensity score matching after treatment completion.Results: Pittsburgh bacteremia score ≥4 (odds ratio, 60.6; 95%CI, 7.4–496.8) was an independent risk factor for unfavorable outcome. After propensity score matching, the initial teicoplanin treatment group and the β-lactam treatment group consisted of 28 patients each. No statistically significant differences were observed in the proportions of patients with favorable outcomes and 30-day overall mortality rates between the groups before and after propensity score matching after the completion of teicoplanin or β-lactam treatment. The Kaplan-Meier 30-day survival curve also showed no significant difference between the patients receiving initial teicoplanin treatment and those receiving β-lactam treatment before and after matching (hazard ratio, 1.84, 95%CI, 0.60–5.64; and 3.12, 95%CI, 0.98–9.99, respectively).Conclusions: There were no significant difference in clinical outcomes between initial teicoplanin treatment and β-lactam treatment among patients with MSSA bacteremia. Pittsburgh bacteremia score ≥4 was a significant risk factor for mortality.

scholarly journals Excessive Iodine Intake Does Not Increase the Recurrence Rate of Graves' Disease after Withdrawal of the Antithyroid Drug in an Iodine-Replete Area

2015 ◽  
Vol 4 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Sun Mi Park ◽  
Yoon Young Cho ◽  
Ji Young Joung ◽  
Seo Young Sohn ◽  
Sun Wook Kim ◽  
...  
Keyword(s):  
Treatment Group ◽  
Clinical Outcomes ◽  
Iodine Intake ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Urinary Iodine Concentration ◽  
Repeated Treatment ◽  
Excessive Iodine ◽  
Significant Difference ◽  
Excessive Iodine Intake

Background and Objectives: The relationship between iodine intake and effects of antithyroid drugs (ATD) for Graves' disease, especially in iodine-deficient areas, has been demonstrated in many studies. However, it was not clear how chronic high iodine intake influenced the effectiveness of ATD in an iodine-replete area. This study aimed to clarify the effect of iodine intake on clinical outcomes of Graves' disease after discontinuation of ATD in Korea, an iodine-replete area. Methods: A total of 142 patients with Graves' disease who visited the outpatient clinic regularly and stopped their ATD between October 2011 and April 2013 were enrolled in our study. Urinary iodine concentration (UIC) was measured just before and after the discontinuation of ATD. Results: Median UIC was not significantly different between the remission and relapse groups, as well as among the four treatment groups (group 1, remission after initial treatment; group 2, remission after repeated treatment; group 3, early relapse within a year; group 4, late relapse after a year). Remission rates did not show a significant difference between the excessive iodine intake (UIC ≥300 μg/l) and average iodine intake groups (UIC <300 μg/l). Conclusions: The present study suggests that excessive iodine intake does not have an effect on the clinical outcomes of Graves' disease in an iodine-replete area, and therefore diet control with iodine restriction might not be necessary in the management of Graves' disease.

Robotically Assisted Hybrid Coronary Revascularization: Does Sequence of Intervention Matter?

2013 ◽  
Vol 8 (3) ◽  
pp. 177-183 ◽  
Author(s):  
Mukta C. Srivastava ◽  
Mark R. Vesely ◽  
Jeffrey D. Lee ◽  
Eric J. Lehr ◽  
Brody Wehman ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Surgical Techniques ◽  
Coronary Intervention ◽  
Optimal Sequence ◽  
Intention To Treat ◽  
Minimally Invasive Surgical ◽  
Significant Difference ◽  
Hybrid Coronary Revascularization

Objective Hybrid coronary revascularization (HCR) is a treatment strategy for the revascularization of multivessel coronary disease that combines the advantages of both minimally invasive surgical techniques and percutaneous coronary intervention (PCI). The optimal sequence by which revascularization should be accomplished has not been determined. We investigated clinical outcomes in a series of patients planned for HCR via robotically assisted totally endoscopic coronary artery bypass (TECAB) and standard PCI based on revascularization sequence. Methods A total of 238 patients planned for HCR between 2001 and 2011 were divided into three groups based on treatment sequence: (a) TECAB before PCI, (b) PCI before TECAB, and (c) same-session procedure. Multiple procedural and clinical end points before discharge and up to 2 years after the procedure were compared between the three groups in an intention-to-treat analysis. Demographic features were reviewed to determine baseline differences between each group. Results Of the 238 patients, 175 (73.5%) underwent TECAB before PCI, 38 patients (16.0%) underwent PCI before TECAB, and 25 (10.5%) underwent a simultaneous revascularization procedure. At baseline, the patients undergoing TECAB before PCI were significantly older. There was a significantly higher incidence of previous myocardial infarction in the PCI-first group (P < 0.001). There was a significant difference in intensive care unit (ICU) length of stay (LOS), with shorter ICU stays in the simultaneous revascularization group (P = 0.031) and shorter hospital LOS in the PCI before TECAB group (P = 0.021). Conclusions In conclusion, revascularization sequence did not dramatically impact clinical outcomes in our observational study. The patients undergoing PCI-first and same-session interventions had shorter hospital and ICU LOS compared with the patients undergoing surgery first. Our findings suggest that no revascularization approach is arbitrarily superior and that revascularization sequence should be individualized on the basis of patient presentation and anatomical considerations.

Sign in / Sign up

Export Citation Format

Share Document