scholarly journals COBRA PzF™ coronary stent in clinical and preclinical studies: setting the stage for new antithrombotic strategies?

2021 ◽  
Author(s):  
Anne Cornelissen ◽  
Atsushi Sakamoto ◽  
Yu Sato ◽  
Rika Kawakami ◽  
Masayuki Mori ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Bare Metal Stents ◽  
Bleeding Risk ◽  
Coronary Stent ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Preclinical Studies ◽  
Coronary Artery Stent ◽  
Drug Eluting

Major advances have been made in coronary artery stent technology over the last decades. Drug-eluting stents reduced in-stent restenosis and have shown better outcomes compared with bare metal stents, yet some limitations still exist to their use. Because they delay healing of the vessel wall, longer dual antiplatelet therapy is mandatory to mitigate against stent thrombosis and this limitation is most concerning in subjects at high risk for bleeding. The COBRA PzF nanocoated coronary stent has been associated with accelerated endothelialization relative to drug-eluting stents, reduced inflammation and thromboresistance in preclinical studies, suggesting more flexible dual antiplatelet therapy requirement with potential benefits especially in those at high bleeding risk. Here, we discuss the significance of COBRA PzF in light of recent experimental and clinical studies.

scholarly journals Impact of medication adherence to dual antiplatelet therapy on the long-term outcome of drug-eluting or bare-metal stents

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244062
Author(s):  
Jung Min Choi ◽  
Seung-Hwa Lee ◽  
Mira Kang ◽  
Jin-Ho Choi
Keyword(s):  
Medication Adherence ◽  
Clinical Outcome ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Bare Metal Stents ◽  
Clinical Event ◽  
Metal Stents ◽  
Bare Metal ◽  
Long Term Outcome ◽  
Drug Eluting

Background In percutaneous coronary intervention, drug-eluting stent (DES) showed better clinical outcome compared to bare-metal stent (BMS) but mostly with different DAPT durations. Hypothesis The clinical superiority of DES over BMS may depend on the medication adherence to dual antiplatelet therapy (DAPT). Methods We retrospectively enrolled all Koreans PCI patients in year 2011 (n = 47,291). Medication adherence to DAPT was assessed by proportion of days covered (PDC) per 6 months. Analysis adjusted with the clinical propensity for receiving DES or BMS and DAPT PDC of the first 6 month was performed. Primary outcome was the 5-year major adverse clinical event (MACE) risk consisting all-cause death, revascularization, shock, or stroke. Results Patients with DES (n = 46,356) showed higher PDC (78% versus 60%, p<0.001) and lower MACE risk (39% versus 56%, p<0.001) compared to patients with BMS (n = 935). In the propensity-matched 1,868 patients, MACE risk was lower with DES than BMS (46% versus 54%, HR = 0.80, 95% CI = 0.70–0.91, p<0.001). In both DES and BMS, patients with good medication adherence (PDC ≥80%) showed much lower MACE risk compared to patients with PDC <80% (HR = 0.36, 95% CI = 0.30–0.44; HR = 0.40, 95%CI = 0.33–0.48, p<0.001, all). Patients with DES and PDC <80% showed higher MACE risk compared to BMS with and PDC ≥80% (HR = 1.30, 95%CI = 1.03–1.64, p = 0.027). Conclusions Good medication adherence to DAPT in the first 6 month was prerequisite for better clinical outcome in both DES and BMS. DES with poor adherence to DAPT showed worse outcome compared with BMS with good adherence.

scholarly journals Impact of medication adherence to dual antiplatelet therapy on the long-term outcome of drug-eluting or bare-metal stents

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.H Choi ◽  
J.M Choi ◽  
S.H Lee ◽  
Y.J Jang ◽  
M Kang ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Clinical Outcome ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Bare Metal Stents ◽  
Clinical Event ◽  
Metal Stents ◽  
Bare Metal ◽  
Long Term Outcome ◽  
Drug Eluting

Abstract Objective In percutaneous coronary intervention, drug-eluting stent (DES) showed better clinical outcome compared to bare-metal stent (BMS) but mostly with different DAPT durations. This study investigated the clinical superiority of DES over BMS with regard to the medication adherence to dual antiplatelet therapy (DAPT). Methods We retrospectively enrolled all Koreans PCI patients in year 2011 (n=47,291). Medication adherence to DAPT was assessed by proportion of days covered (PDC) per 6 months. Analysis adjusted with the clinical propensity for receiving DES or BMS and DAPT PDC of the first 6 month was performed. Primary outcome was the 5-year major adverse clinical event (MACE) risk consisting all-cause death, revascularization, shock, or stroke. Results Patients with DES (n=46,356) showed higher PDC (78% versus 60%, p&lt;0.001) and lower MACE risk (39% versus 56%, p&lt;0.001) compared to patients with BMS (n=935). In the propensity-matched 1,868 patients, MACE risk was lower with DES than BMS (46% versus 54%, HR=0.80, 95% CI: 0.70–0.91, p&lt;0.001). Patients with good medication adherence (PDC ≥80%) showed much lower MACE risk compared to patients with PDC &lt;80% regardless of DES or BMS (HR=0.36, 95% CI: 0.30–0.44; HR=0.40, 95% CI: 0.33–0.48, p&lt;0.001, all). Patients with DES and PDC &lt;80% showed higher MACE risk compared to BMS with and PDC ≥80% (HR=1.30, 95% CI: 1.03–1.64, p=0.027). Conclusions Good medication adherence to DAPT in the first 6 month was prerequisite for better clinical outcome in both DES and BMS. DES with poor adherence to DAPT showed worse outcome compared with BMS with good adherence. Impact of medication adherence to dual antiplatelet therapy. Funding Acknowledgement Type of funding source: None

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