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Buchanan KD, Kolm P, Iantorno M, Gajanana D, Rogers T, Gai J, Torguson R, Ben-Dor I, Suddath WO, Satler LF, Waksman R. Coronary perfusion pressure and left ventricular hemodynamics as predictors of cardiovascular collapse following percutaneous coronary intervention. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2019; 20:11-15. [DOI: 10.1016/j.carrev.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
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2
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Buchanan KD, Torguson R, Rogers T, Xu L, Gai J, Ben-Dor I, Suddath WO, Satler LF, Waksman R. In-Stent Restenosis of Drug-Eluting Stents Compared With a Matched Group of Patients With De Novo Coronary Artery Stenosis. Am J Cardiol 2018; 121:1512-1518. [PMID: 29627111 DOI: 10.1016/j.amjcard.2018.02.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/21/2018] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
Drug-eluting stents (DES) significantly reduced the incidence of in-stent restenosis (ISR). However, ISR still exists in the contemporary DES era. Previously deemed to be a benign process, ISR leads to complex presentation and intervention. This study aimed to compare the presentation and outcome of DES-ISR versus de novo lesions. We performed a retrospective analysis of 11,666 patients receiving percutaneous coronary intervention from 2003 to 2017 and divided them into 2 groups by de novo stenosis and ISR. They were matched based on common cardiovascular risk factors at a 4:1 ratio, respectively. After matching, a total of 1,888 patients with 3,126 de novo lesions and 472 patients with 508 ISR lesions were analyzed. Patients with ISR presented more often with unstable angina (61% vs 45%, p <0.001) and less often with myocardial infarction (6% vs 14%, p <0.001). One-year composite major adverse cardiovascular event, defined as death, Q-wave myocardial infarction, and target vessel revascularization, was 10% in the de novo group and 17% in the ISR group (hazard ratio 1.98, 95% confidential interval 1.58 to 2.46, p <0.001). After adjusting for myocardial infarction presentation, hazard ratio of major adverse cardiovascular events was still higher for the ISR group at 1 year (2.03, 95% confidential interval 1.62 to 2.55, p <0.001). ISR of DES remains a therapeutic challenge and leads to complex presentation and worse outcomes compared with matched de novo patients. These data show that DES-ISR demands better appreciation and prevention with more precise stent technique and should motivate the continued development of fully bioresorbable scaffolds.
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3
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Koifman E, Gaglia MA, Escarcega RO, Bernardo NL, Lager RA, Gallino RA, Ben-Dor I, Pichard AD, Baker NC, Lipinski MJ, Kiramijyan S, Negi SI, Torguson R, Gai J, Suddath WO, Satler LF, Waksman R. Comparison of transradial and transfemoral access in patients undergoing percutaneous coronary intervention for complex coronary lesions. Catheter Cardiovasc Interv 2016; 89:640-646. [DOI: 10.1002/ccd.26669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/10/2016] [Accepted: 07/03/2016] [Indexed: 11/08/2022]
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4
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Pendyala LK, Loh JP, Kitabata H, Minha S, Torguson R, Chen F, Satler LF, Suddath WO, Pichard AD, Waksman R. The impact of diabetes mellitus on long-term clinical outcomes after percutaneous coronary saphenous vein graft interventions in the drug-eluting stent era. J Interv Cardiol 2016; 27:391-8. [PMID: 25059286 DOI: 10.1111/joic.12136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES We aimed to compare early and late clinical outcomes in diabetic and nondiabetic patients who underwent saphenous vein graft (SVG) percutaneous coronary interventions (PCI) with the use of drug-eluting stents (DES). BACKGROUND Patients with diabetes mellitus are shown to have less favorable outcomes after SVG intervention with the use of bare metal stents. In the DES era, the impact of diabetes mellitus on restenosis and clinical outcomes post-SVG intervention is not clearly defined. METHODS From our institutional PCI registry database, we retrospectively analyzed 477 consecutive patients with prior coronary artery bypass graft surgery undergoing SVG PCI with the implantation of DES stratified by the presence or absence of diabetes mellitus. The primary end-point was 1-year major adverse cardiac event (MACE) rate, defined as death, Q wave myocardial infarction, and target lesion revascularization. RESULTS Baseline clinical characteristics, including mean graft age (120 ± 77 vs. 131 ± 86 months, P = 0.14), were similar between groups, save for a higher prevalence of systemic hypertension and chronic renal insufficiency, and higher body mass index in the diabetic group. Among the 604 SVG lesions treated with DES, the angiographic and procedural characteristics were well matched between groups except for the higher rate of distal protection device use (32% vs. 29%, P = 0.007) in the diabetic group. The rates of 1-year MACE (21% vs. 15%, P = 0.12) and all-cause mortality (7.6% vs. 6.7%, P = 0.86) were similar between groups. After adjustment for the relevant clinical co-variables, diabetic status was not associated with the composite end-point. CONCLUSION In conclusion, DES, when used for the treatment of vein graft lesions, equate the short- and long-term outcomes between diabetic and nondiabetic patients, suggesting that DES should be considered the default stent in diabetic populations undergoing PCI for the treatment of SVG lesions.
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Gaglia MA, Torguson R, Lipinski MJ, Gai J, Koifman E, Kiramijyan S, Negi S, Rogers T, Steinvil A, Suddath WO, Satler LF, Pichard AD, Waksman R. Frequency of Angina Pectoris After Percutaneous Coronary Intervention and the Effect of Metallic Stent Type. Am J Cardiol 2016; 117:526-531. [PMID: 26739394 DOI: 10.1016/j.amjcard.2015.11.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
Although metallic coronary stents significantly reduce angina pectoris compared with optimal medical therapy, angina after percutaneous coronary intervention (PCI) remains frequent. We, therefore, sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents. Metallic stent type was classified as bare metal stent, Cypher, Taxus Express, Xience V, Promus Element, and Resolute. The primary end point was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year. Overall, 8,804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI. Major adverse cardiovascular events, a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6.8% for patients without angina, 10.0% for patients with class 1 or 2 angina, and 19.7% for patients with class 3 or 4 angina (p <0.001 for trend). After multivariable adjustment, there was no significant association between stent type and angina at 1 year after PCI. Baseline Canadian Cardiovascular Society class 3 or 4 angina, history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina. In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI.
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Gaglia MA, Lipinski MJ, Torguson R, Gai J, Ben-Dor I, Bernardo NL, Suddath WO, Satler LF, Pichard AD, Waksman R. CRT-200.31 Angina Following Percutaneous Coronary Intervention Is Common and Not Affected by Stent Type. JACC Cardiovasc Interv 2016. [DOI: 10.1016/j.jcin.2015.12.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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7
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Lee RC, Lipinski MJ, Tariq MU, Torguson R, Suddath WO, Waksman R. CRT-200.58 Acute MI With and Without Hemodynamic Support: A Network Meta-Analysis and Systematic Review. JACC Cardiovasc Interv 2016. [DOI: 10.1016/j.jcin.2015.12.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Tian W, Mahmoudi M, Lhermusier T, Kiramijyan S, Chen F, Torguson R, Suddath WO, Satler LF, Pichard AD, Waksman R. The influence of advancing age on implantation of drug-eluting stents. Catheter Cardiovasc Interv 2015; 88:516-521. [DOI: 10.1002/ccd.26333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 10/26/2015] [Indexed: 11/08/2022]
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9
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Negi SI, Didier R, Kang WY, Kiramijyan S, Koifman E, Gai J, Torguson R, Ben Dor I, Suddath WO, Pichard A, Satler LF, Waksman R. TCT-399 Long-Term Impact Of Iatrogenic Dissection Of A Left Main Coronary Artery During Percutaneous Coronary Intervention. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Magalhaes MA, Minha S, Torguson R, Baker NC, Escarcega RO, Omar AF, Lipinski MJ, Chen F, Suddath WO, Satler LF, Pichard AD, Waksman R. The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era. EUROINTERVENTION 2015; 11:625-33. [DOI: 10.4244/eijv11i6a124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Ota H, Magalhaes MA, Torguson R, Negi S, Kollmer MR, Spad MA, Gai J, Satler LF, Suddath WO, Pichard AD, Waksman R. The influence of lipid-containing plaque composition assessed by near-infrared spectroscopy on coronary lesion remodelling. Eur Heart J Cardiovasc Imaging 2015; 17:821-31. [DOI: 10.1093/ehjci/jev221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/10/2015] [Indexed: 11/12/2022] Open
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12
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Tian W, Mahmoudi M, Lhermusier T, Kiramijyan S, Ota H, Chen F, Torguson R, Suddath WO, Satler LF, Pichard AD, Waksman R. Comparison of Rotational Atherectomy, Plain Old Balloon Angioplasty, and Cutting-Balloon Angioplasty Prior to Drug-Eluting Stent Implantation for the Treatment of Heavily Calcified Coronary Lesions. THE JOURNAL OF INVASIVE CARDIOLOGY 2015; 27:387-391. [PMID: 26332873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The optimal technique for lesion preparation in heavily calcified coronary lesions (HCCL) prior to drug-eluting stent (DES) implantation has not been described. The aim of this study was to compare the clinical outcomes of lesion preparation with rotational atherectomy (ROTA), plain old balloon angioplasty (POBA), or cutting-balloon angioplasty (CBA) in patients with HCCL who were treated with DES. METHODS The study cohort comprised 737 consecutive patients (874 lesions) who underwent RA (n = 264), POBA (n = 220), or CBA (n = 253) for HCCL at our institution and were treated with DES. Patients with mild or moderate calcified lesions, restenotic lesions, treatment with bare-metal stent (BMS), or history of prior coronary artery bypass graft (CABG) were excluded. The analyzed clinical parameters were the 1-month, 6-month, and 12-month rates of death (all-cause and cardiac), Q-wave myocardial infarction (MI), target-lesion revascularization (TLR), definite stent thrombosis (ST), and major adverse cardiac event (MACE), defined as the composite of death, Q-wave MI, or TLR. RESULTS The patients were well matched for their baseline characteristics except for age (RA = 71.9 ± 10.4 years; POBA = 68.0 ± 10.8 years; CBA = 68.7 ± 11.8 years; P<.001) and hypertension (RA = 90.9%; POBA = 80.9%; CBA = 84.2%; P=.01), which were different among the three cohorts. The three cohorts had similar clinical outcomes at both short-term and long-term follow-up. The 12-month results were all-cause death (RA = 9.8%; POBA = 8.2%; CBA = 4.5%; P=.18), cardiac death (RA = 3.1%; POBA = 2.5%; CBA = 1.3%; P=.61), Q-wave MI (RA = 0%; POBA = 0%; CBA = 0.7%; P>.99), TLR (RA = 5.2%; POBA = 3.5%; CBA = 3.9%; P=.76), ST (RA = 0%; POBA = 0%; CBA = 0.6%; P=.63) and MACE (RA = 14.6%; POBA = 12.3%; CBA = 8.3%; P=.20). The 1-year MACE-free survival rates were also similar among the three cohorts (log-rank P=.20). CONCLUSION A strategy of lesion preparation with RA, POBA, or CBA in HCCL may be associated with similar clinical outcomes in patients undergoing percutaneous intervention with DES. The RA group had a trend toward greater MACE, death, and TLR.
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MESH Headings
- Aged
- Aged, 80 and over
- Angioplasty, Balloon, Coronary/adverse effects
- Angioplasty, Balloon, Coronary/methods
- Atherectomy, Coronary/adverse effects
- Atherectomy, Coronary/methods
- Calcinosis
- Coronary Artery Disease/diagnosis
- Coronary Artery Disease/etiology
- Coronary Artery Disease/surgery
- Coronary Restenosis/diagnosis
- Coronary Restenosis/surgery
- Drug-Eluting Stents/adverse effects
- Female
- Humans
- Intraoperative Care/methods
- Male
- Middle Aged
- Outcome Assessment, Health Care
- Plaque, Atherosclerotic/pathology
- Plaque, Atherosclerotic/surgery
- Retrospective Studies
- United States
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Magalhaes MA, Minha S, Chen F, Torguson R, Omar AF, Loh JP, Escarcega RO, Lipinski MJ, Baker NC, Kitabata H, Ota H, Suddath WO, Satler LF, Pichard AD, Waksman R. Response to letter regarding article, "Clinical presentation and outcomes of coronary in-stent restenosis across 3-stent generations". Circ Cardiovasc Interv 2015; 8:CIRCINTERVENTIONS.115.002459. [PMID: 25805572 DOI: 10.1161/circinterventions.115.002459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Ota H, Mahmoudi M, Kitabata H, Torguson R, Chen F, Satler LF, Suddath WO, Pichard AD, Waksman R. Safety and efficacy of limus-eluting stents and balloon angioplasty for sirolimus-eluting in-stent restenosis. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2015; 16:84-9. [DOI: 10.1016/j.carrev.2015.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 01/23/2015] [Indexed: 10/24/2022]
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15
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Kiramijyan S, Magalhaes MA, Koifman E, Escarcega RO, Baker NC, Torguson R, Lipinski MJ, Ota H, Negi SI, Didier R, Lhermusier T, Kang WY, Tian W, Okubagzi P, Suddath WO, Ben-Dor I, Satler LF, Pichard AD, Waksman R. CRT-824 Does Angio-Seal Have a Role in Femoral Vascular Closure Following Transcatheter Aortic Valve Replacement? JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Ota H, Magalhaes MA, Negi S, Didier R, Kang WY, Baker NC, Escarcega RO, Koifman E, Kiramijyan S, Torguson R, Kollmer MR, Satler LF, Suddath WO, Pichard AD, Waksman R. CRT-409 The Closed Association between Lipid-Containing Plaque Composition Measured by Near-Infrared Spectroscopy and Coronary Arterial Remodeling with Progression of Coronary Stenosis. JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Ota H, Magalhaes MA, Negi S, Kang WY, Didier R, Baker NC, Escarcega RO, Koifman E, Kiramijyan S, Torguson R, Kollmer MR, Satler LF, Suddath WO, Pichard AD, Waksman R. CRT-410 Lipid-containing Plaque Distribution In Native Coronary Arteries: A Near-infrared Spectroscopy Study. JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Kiramijyan S, Escarcega RO, Torguson R, Salmon JS, Kumar S, Weaver M, Spad MA, Sesaba KT, Koifman E, Magalhaes MA, Baker NC, Lipinski MJ, Negi SI, Hideaki O, Kang WY, Didier R, Jerusalem ZD, Okubagzi P, Ben-Dor I, Suddath WO, Satler LF, Pichard AD, Waksman R. CRT-810 Contemporary Outcomes of Patients Undergoing Balloon Aortic Valvuloplasty who were Initially Excluded from Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Negi SI, Didier R, Kiramijyan S, Koifman E, Baker N, Escarcega RO, Ben-Dor I, Suddath WO, Pichard AD, Satler LF, Waksman R. CRT-166 Gender Based Differences In Presentation And Outcomes Of Vascular Brachytherapy For Drug Eluting Stent Failure. JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Escárcega RO, Baker NC, Magalhaes MA, Lipinski MJ, Minha S, Torguson R, Satler LF, Pichard AD, Suddath WO, Waksman R. Safety and efficacy of everolimus-eluting stents compared with first-generation drug-eluting stents in patients undergoing primary percutaneous coronary intervention. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2014; 15:334-9. [PMID: 25440506 DOI: 10.1016/j.carrev.2014.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the safety and efficacy everolimus-eluting stents (EES) compared with first-generation drug-eluting stents (DES) in patients with acute myocardial infarction (MI) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND EES have been associated with improved clinical outcomes compared to paclitaxel-eluting stents (PES) and with similar outcomes compared to sirolimus-eluting stents (SES). METHODS A total of 520 patients who presented with ST-elevation myocardial infarction (STEMI) from 2003 to 2013, who underwent primary PCI with DES, were retrospectively analyzed. Of these, 247 received SES, 136 PES, and 137 EES. Patients were followed up to 2 years for major adverse cardiac events (MACE). Univariate and multivariate models detected correlates to outcome. RESULTS EES implantation, compared with PES and SES, resulted in comparable rates of MACE (8.8% vs. 16.2%, p=0.06 and 8.8% vs. 12.6%, respectively, p=0.26), stent thrombosis, MI, and target lesion revascularization. Patients who received EES had lower rates of all-cause mortality (3.7% vs. 12.6% vs. 9.4%, p=0.03) at 1-year follow up. However, in the univariate and multivariate analyses, stent type was not independently associated with the primary outcome or with all-cause mortality. Diabetes mellitus and number of stents implanted were independently associated with the primary outcome. CONCLUSION While EES seem to be associated with better outcome when compared to PES, the main correlates of STEMI patients are the presence of diabetes and number of stents implanted, and not the type of stent used for intervention.
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Magalhaes MA, Minha S, Chen F, Torguson R, Omar AF, Loh JP, Escarcega RO, Lipinski MJ, Baker NC, Kitabata H, Ota H, Suddath WO, Satler LF, Pichard AD, Waksman R. Clinical Presentation and Outcomes of Coronary In-Stent Restenosis Across 3-Stent Generations. Circ Cardiovasc Interv 2014; 7:768-76. [DOI: 10.1161/circinterventions.114.001341] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Clinical presentation of bare metal stent in-stent restenosis (ISR) in patients undergoing target lesion revascularization is well characterized and negatively affects on outcomes, whereas the presentation and outcomes of first- and second-generation drug-eluting stents (DESs) remains under-reported.
Methods and Results—
The study included 909 patients (1077 ISR lesions) distributed as follows: bare metal stent (n=388), first-generation DES (n=425), and second-generation DES (n=96), categorized into acute coronary syndrome (ACS) or non-ACS presentation mode at the time of first target lesion revascularization. ACS was further classified as myocardial infarction (MI) and unstable angina. For bare metal stent, first-generation DES and second-generation DES, ACS was the clinical presentation in 67.8%, 71.0%, and 66.7% of patients, respectively (
P
=0.470), whereas MI occurred in 10.6%, 10.1%, and 5.2% of patients, respectively (
P
=0.273). The correlates for MI as ISR presentation were current smokers (odds ratio, 3.02; 95% confidence interval [CI], 1.78–5.13;
P
<0.001), and chronic renal failure (odds ratio, 2.73; 95% CI, 1.60–4.70;
P
<0.001), with a protective trend for the second-generation DES ISR (odds ratio, 0.35; 95% CI, 0.12–1.03;
P
=0.060). ACS presentations had an independent effect on major adverse cardiac events (death, MI, and re-target lesion revascularization) at 6 months (MI versus non-ACS: adjusted hazard ratio, 4.06; 95% CI, 1.84–8.94;
P
<0.001; unstable angina versus non-ACS: adjusted hazard ratio, 1.98; 95% CI, 1.01–3.87;
P
=0.046).
Conclusions—
ISR clinical presentation is similar irrespective of stent type. MI as ISR presentation seems to be associated with patient and not device-related factors. ACS as ISR presentation has an independent effect on major adverse cardiac events, suggesting that ISR remains a hazard and should be minimized.
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Minha S, Loh JP, Satler LF, Pendyala LK, Barbash IM, Magalhaes MA, Suddath WO, Pichard AD, Torguson R, Waksman R. Transfer distance effect on reperfusion: timeline of ST-elevation patients transferred for primary percutaneous coronary intervention. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2014; 15:369-74. [DOI: 10.1016/j.carrev.2014.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 11/25/2022]
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23
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Baker NC, Magalhaes MA, Escarcega RO, Minha S, Lipinski MJ, Lhermusier T, Pendyala L, Tian W, Ota H, Suddath WO, Satler LF, Pichard A, Torguson R, Waksman R. TCT-763 Clinical Profiles and Outcomes of Nonagenarians Undergoing Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Lipinski MJ, Lhermusier T, Escarcega RO, Baker NC, Magalhães MA, Torguson R, Suddath WO, Satler LF, Pichard AD, Waksman R. Bivalirudin versus heparin for percutaneous coronary intervention: an updated meta-analysis of randomized controlled trials. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2014; 15:315-22. [DOI: 10.1016/j.carrev.2014.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 08/29/2014] [Indexed: 11/29/2022]
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25
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Baker NC, Lipinski MJ, Escarcega RO, Magalhaes MA, Minha S, Lhermusier T, Ota H, Pendyala L, Satler LF, Pichard A, Suddath WO, Torguson R, Waksman R. TCT-844 Active Versus Passive Anchoring Vascular Closure Devices: A Safety and Efficacy Comparative Analysis. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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