1
|
Zheng B, Liu Y, Zhang R, Yang W, Su F, Wang R, Chen D, Shen G, Qiu Y, Wang L, Chen C, Wu Z, Li F, Li J, Li C, Gao C, Tao L. A novel biodegradable polymer-coated sirolimus-eluting stent: 1-year results of the HELIOS registry. Chin Med J (Engl) 2023; 136:1848-1854. [PMID: 37306407 PMCID: PMC10405989 DOI: 10.1097/cm9.0000000000002324] [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: 12/23/2022] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The HELIOS stent is a sirolimus-eluting stent with a biodegradable polymer and titanium oxide film as the tie-layer. The study aimed to evaluate the safety and efficacy of HELIOS stent in a real-world setting. METHODS The HELIOS registry is a prospective, multicenter, cohort study conducted at 38 centers across China between November 2018 and December 2019. A total of 3060 consecutive patients were enrolled after application of minimal inclusion and exclusion criteria. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, non-fatal target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR) at 1-year follow-up. Kaplan-Meier methods were used to estimate the cumulative incidence of clinical events and construct survival curves. RESULTS A total of 2998 (98.0%) patients completed the 1-year follow-up. The 1-year incidence of TLF was 3.10% (94/2998, 95% closed interval: 2.54-3.78%). The rates of cardiac death, non-fatal target vessel MI and clinically indicated TLR were 2.33% (70/2998), 0.20% (6/2998), and 0.70% (21/2998), respectively. The rate of stent thrombosis was 0.33% (10/2998). Age ≥60 years, diabetes mellitus, family history of coronary artery disease, acute myocardial infarction at admission, and device success were independent predictors of TLF at 1 year. CONCLUSION The 1-year incidence rates of TLF and stent thrombosis were 3.10% and 0.33%, respectively, in patients treated with HELIOS stents. Our results provide clinical evidence for interventional cardiologists and policymakers to evaluate HELIOS stent. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03916432.
Collapse
Affiliation(s)
- Bo Zheng
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Yi Liu
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Ruining Zhang
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Wangwei Yang
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Fangju Su
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Rutao Wang
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
- Department of Cardiology, Radboud University, Nijmegen, The Netherlands
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Dapeng Chen
- Internal Medicine of Heart Centre, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750003, China
| | - Guidong Shen
- Department of Cardiology, Ankang City Central Hospital, Ankang, Shaanxi 725099, China
| | - Yumin Qiu
- Department of Cardiovascular, Cardio-cerebrovascular Hospital affiliated to Ningxia Medical University, Yinchuan, Ningxia 750002, China
| | - Lianmin Wang
- Department of Cardiology, Mudanjiang Cardiovascular hospital, Mudanjiang, Harbin 157011, China
| | - Chang Chen
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Zhongwei Wu
- Department of Cardiology, Western Central Hospital of Hainan Province, Danzhou, Hainan 571700, China
| | - Fei Li
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Jiayi Li
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Chengxiang Li
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| | - Chao Gao
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
- Department of Cardiology, Radboud University, Nijmegen, The Netherlands
- Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi 710032, China
| |
Collapse
|
2
|
Dai Y, Wang R, Chen F, Zhang Y, Liu Y, Huang H, Yang P, Zhang R, Zheng B, Gao C, Chen Y, Tao L. Clinical outcomes in 2481 unselected real-world patients treated with a polymer-free sirolimus-eluting stent: 3 years results from the NANO multicenter Registry. BMC Cardiovasc Disord 2021; 21:537. [PMID: 34772347 PMCID: PMC8588634 DOI: 10.1186/s12872-021-02356-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To evaluate the 3-year clinical outcomes of a polymer-free sirolimus-eluting, Nano plus stent for the treatment of coronary artery disease in the NANO multicenter Registry. BACKGROUND The long-term clinical data evaluating the safety and efficacy of the novel polymer-free sirolimus-eluting Nano plus stent (Lepu Medical, Beijing, China) is limited. METHODS The NANO all-comers Registry trial was a prospective, multicenter clinical registry conducted in 26 centers in China between August 2016 and January 2017. A total of 2481 consecutive patients were exclusively treated with the Nano plus stent. The primary clinical endpoint, target lesion failure (TLF, defined as cardiac death, target vessel nonfatal myocardial infarction, and clinically driven target lesion revascularization [CD-TLR]), was analyzed at 3 years. RESULTS At 3 years, 2295 patients (92.5%) were followed. The incidence of TLF was 6.8% (168/2481). The rate of cardiac death was 3.8% (94/2481), target vessel nonfatal myocardial infarction 0.7% (18/2481), and CD-TLR 2.9% (68/2481). The rate of definite/probable stent thrombosis was 0.5% (13/2481). The risk factors of diabetes mellitus, acute myocardial infarction, age, chronic renal failure, in-stent restenosis, chronic total occlusion, and left ventricular ejection fraction < 40% were the independent predictors of 3-year TLF. CONCLUSIONS At three years, the rate of TLF was relatively low in patients treated with the polymer-free Nano plus stent. The polymer-free Nano plus stent showed a favorable safety and efficacy profile in real-world patients. Clinical trial registration URL: https://www.clinicaltrials.gov/ . Unique identifier: NCT02929030.
Collapse
Affiliation(s)
- Yi Dai
- Medical School of Nankai University, Tianjin, China
| | - Rutao Wang
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fengying Chen
- Department of Cardiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Yaojun Zhang
- Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Yi Liu
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - He Huang
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, China
| | - Ping Yang
- Department of Cardiology, China Japan Union Hospital of Jilin University, Changchun, China
| | - Ruining Zhang
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Bo Zheng
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chao Gao
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China.
- Xijing Hospital, 127 Changle west road, Xi'an, 710032, China.
| | - Yundai Chen
- Medical School of Nankai University, Tianjin, China.
- Department of Cardiology, The Chinese PLA General Hospital, 28 Fu xing road, Beijing, 100853, China.
| | - Ling Tao
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China.
- Xijing Hospital, 127 Changle west road, Xi'an, 710032, China.
| |
Collapse
|
3
|
Cha JJ, Kim GC, Hur SH, Bae JH, Choi JW, Jin DK, Woo SI, Lee SU, Park JS, Cho YH, Choi CU, Lim DS, Ahn TH. Efficacy and Safety of Dual-Drug-Eluting Stents for de Novo Coronary Lesions in South Korea-The Effect Trial. J Clin Med 2020; 10:jcm10010069. [PMID: 33375486 PMCID: PMC7795129 DOI: 10.3390/jcm10010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Drug-eluting stents (DESs) are commonly used in percutaneous coronary intervention (PCI) procedures; however, complications including in-stent restenosis and stent thrombosis are significant challenges. The dual-DES is a stent that elutes two drugs to target various stages of the restenosis reaction. This study investigated the safety and efficacy of dual-DES in clinical practice. Methods: This study included 375 patients who underwent PCI with Cilotax™ or DXR™ dual-DESs at one of 13 centers in South Korea. The primary endpoint was target lesion failure (TLF) within 1 year. The secondary endpoints were cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis. Results: The rates of TLF in dual-DESs (3.7%) were comparable to those reported in conventional DES. In addition, the DXR™ group had a significantly lower rate of TLF than the Cilotax™ group. In multivariate analysis, the DXR™ group had a lower risk of TLF (adjusted hazard ratio (HR) 0.30, 95% CI 0.09–0.92, p = 0.036) and MI (adjusted HR 0.16, 95% CI 0.03–0.82, p = 0.027) than the Cilotax™ group. Conclusion: Dual-DESs had similar clinical outcomes regarding efficacy and safety as conventional DES. Among the dual-DES, the DXR™ stent as a new generation dual-DES had more favorable clinical outcomes than the Cilotax™ stent.
Collapse
Affiliation(s)
- Jung-Joon Cha
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (J.-J.C.); (D.-S.L.)
| | - Gi Chang Kim
- Department of Cardiology, Shihwa General Hospital, Siheung 15034, Korea;
| | - Seung Ho Hur
- Department of Cardiology, Keimyung University Hospital, Daegu 41931, Korea;
| | - Jang Ho Bae
- Department of Cardiology, Konyang University Hospital, Daejeon 35365, Korea;
| | - Jae Woong Choi
- Department of Cardiology, Nowon Eulji Medical Center, Seoul 01830, Korea;
| | - Dong-Kyu Jin
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea;
| | - Seong Il Woo
- Division of Cardiology, Department of Internal Medicine, Inha University School of Medicine, Incheon 22332, Korea;
| | - Seung Uk Lee
- Department of Cardiology, Gwangju Christian Hospital, Gwangju 61661, Korea;
| | - Jong Seon Park
- Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea;
| | - Yun-Hyeong Cho
- Department of Internal Medicine, Hanyang University Myongji Hospital, Goyang 10475, Korea;
| | - Cheol Ung Choi
- Department of Internal Medicine, Cardiovascular Center, Division of Cardiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea;
| | - Do-Sun Lim
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (J.-J.C.); (D.-S.L.)
| | - Tae Hoon Ahn
- Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Korea; (J.-J.C.); (D.-S.L.)
- Department of Internal Medicine, Gachon University Gil Hospital, Incheon 21565, Korea
- Correspondence: ; Tel.: +82-2-920-5445
| |
Collapse
|
4
|
Twelve-month clinical outcomes of sirolimus-eluting stent in coronary artery disease: An experience in real-world Indian patients. Anatol J Cardiol 2020; 24:364-369. [PMID: 33253136 PMCID: PMC7791295 DOI: 10.14744/anatoljcardiol.2020.98452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Supraflex (Sahajanand Medical Technologies Pvt. Ltd, Surat, India) is the latest generation of biodegradable polymer-coated sirolimus-eluting coronary stent designed on ultra-thin (60 µm) cobalt–chromium platform with flexible “S-link.” The present study was designed to establish the safety and clinical performance of Supraflex in real-world Indian patients with coronary artery disease. Methods: The study included 839 consecutive patients with coronary artery disease who were implanted with Supraflex from January 2014 to August 2017 at six different tertiary care centers in India. Follow-up was performed at 30 days, 6 months, and 12 months after the index procedure. The primary end-point of the study was the incidence of major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) at the 12-month follow-up. The occurrence of stent thrombosis was analyzed as safety end-point. Results: A total of 1025 lesions were treated by implantation of 1098 Supraflex stents. At the 12-month follow-up, MACE was 4.92%, including 7 (0.86%) cardiac deaths, 16 (1.97%) MI, and 17 (2.09%) TLR. Only three incidences of stent thrombosis were found at the 12-month follow-up. Conclusion: The study results showed excellent safety and clinical effectiveness of Supraflex in a high proportion of high-risk real-world Indian patients with coronary artery disease. (Anatol J Cardiol 2020; 24: 364-9)
Collapse
|
5
|
Chandrasekhar J, Dangas G, Baber U, Sartori S, Qadeer A, Aquino M, Vogel B, Faggioni M, Vijay P, Claessen BE, Goel R, Moreno P, Krishnan P, Kovacic JC, Kini A, Mehran R, Sharma S. Impact of insulin treated and non‐insulin‐treated diabetes compared to patients without diabetes on 1‐year outcomes following contemporary PCI. Catheter Cardiovasc Interv 2020; 96:298-308. [DOI: 10.1002/ccd.28841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/11/2020] [Accepted: 02/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Jaya Chandrasekhar
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - George Dangas
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Usman Baber
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Samantha Sartori
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Abdul Qadeer
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Melissa Aquino
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Birgit Vogel
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Michela Faggioni
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Pooja Vijay
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Bimmer E. Claessen
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Ridhima Goel
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Pedro Moreno
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Prakash Krishnan
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Jason C. Kovacic
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Annapoorna Kini
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Roxana Mehran
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| | - Samin Sharma
- Department of Cardiology, Icahn School of Medicine at Mount Sinai New York New York USA
| |
Collapse
|
6
|
Liu Y, Zhang Y, Li Y, Qi T, Pan D, Wang H, Liu C, Ma D, Fang Z, Zhang R, Mou F, Tao L. One-year clinical results of the NANO registry: A multicenter, prospective all-comers registry study in patients receiving implantation of a polymer-free sirolimus-eluting stent. Catheter Cardiovasc Interv 2020; 95 Suppl 1:658-664. [PMID: 31961057 DOI: 10.1002/ccd.28734] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES We aimed to evaluate the safety and efficacy of Nano+™ (Lepu Medical, Beijing, China) stent implantation in all-comer patients at the 1-year follow-up. BACKGROUND The Nano+™ stent is a novel polymer-free sirolimus-eluting stent polymer that employs nanoporous stent surface technology to control drug-delivery. The Nano+™ stent is one of the most widely used drug-eluting stent (DES) in China. METHODS A total of 2,481 consecutive patients were included in the multicenter and prospective NANO registry. In this study, the primary endpoint was target lesion failure (TLF) at 1-year follow-up, defined as a composite of cardiac death, target vessel nonfatal myocardial infarction (TV-MI), and clinically driven target lesion revascularization (TLR). The safety endpoint was the occurrence of definite or probable stent thrombosis (ST). RESULTS Up to 40.2% of patients presented with acute myocardial infarction (AMI). A total of 63.9% of the 2,904 lesions were American College of Cardiology/American Heart Association (ACC/AHA) type B2 or C lesions. One-year follow-up data were available for 98.4% of patients. The 1-year rate of TLF was 3.1% with rates of 1.3, 1.8, and 0.4% for clinically driven TLR, cardiac death, and TV-MI, respectively. ST occurred in 0.4% of patients. Diabetes mellitus, AMI, left ventricular ejection fraction <40% and long lesions (>40 mm) were independent predictors of 1-year TLF. CONCLUSIONS The 1-year clinical outcomes were excellent for Nano+™ polymer-free SES implantation in an all-comer patient population. Follow-up will be extended up to 5 years, to further elucidate the potential long-term clinical benefits. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02929030.
Collapse
Affiliation(s)
- Yi Liu
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yaojun Zhang
- Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou, China
| | - Yue Li
- Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Tianjun Qi
- Department of Cardiology, Central Hospital of Zibo, Zibo, Shandong, China
| | - Defeng Pan
- Department of Cardiology, The Affiliated Hospital of Xu Zhou Medical University, Xuzhou, Jiangsu, China
| | - Haichang Wang
- Department of Cardiology, The Second Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Changhui Liu
- Department of Cardiology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, China
| | - Dengfeng Ma
- Department of Cardiology, Tai Yuan Central Hospital, Taiyuan, Shanxi, China
| | - Zhenfei Fang
- Department of Cardiology, The Second XIANGYA Hospital of Central South University, Changsha, Hunan, China
| | - Ruining Zhang
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fangjun Mou
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Ling Tao
- Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China
| | | |
Collapse
|
7
|
Krackhardt F, Waliszewski M, Wan Ahmad WA, Kočka V, Toušek P, Janek B, Trenčan M, Krajči P, Lozano F, Garcia-San Roman K, Otaegui Irurueta I, Garcia del Blanco B, Wachowiak L, Vilalta del Olmo V, Fernandez Nofrerías E, Ho Jeong M, Jung BC, Han KR, Piot C, Sebagh L, Rischner J, Pansieri M, Leschke M, Ahn TH. Polymer-free sirolimus-eluting stent use in Europe and Asia: Ethnic differences in demographics and clinical outcomes. PLoS One 2020; 15:e0226606. [PMID: 31929543 PMCID: PMC6957170 DOI: 10.1371/journal.pone.0226606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/29/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The objective of this study was to assess regional and ethnic differences in an unselected patient population treated with polymer-free sirolimus-eluting stents (PF-SES) in Asia and Europe. METHODS Two all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined for data analysis to assure sufficient statistical power. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 9-12 months. RESULTS Of the total population of 7243 patients, 44.0% (3186) were recruited in the Mediterranean region and 32.0% (2317) in central Europe. The most prominent Asian region was South Korea (17.6%, 1274) followed by Malaysia (5.7%, 413). Major cardiovascular risk factors varied significantly across regions. The overall rates for accumulated TLR and MACE were low with 2.2% (140/6374) and 4.4% (279/6374), respectively. In ACS patients, there were no differences in terms of MACE, TLR, MI and accumulated mortality between the investigated regions. Moreover, dual antiplatelet therapy (DAPT) regimens were substantially longer in Asian countries even in patients with stable coronary artery disease as compared to those in Europe. CONCLUSIONS PF-SES angioplasty is associated with low clinical event rates in all regions. Further reductions in clinical event rates seem to be associated with longer DAPT regimens.
Collapse
Affiliation(s)
- Florian Krackhardt
- Department of Internal Medicine and Cardiology, Charité–Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
- * E-mail:
| | - Matthias Waliszewski
- Department of Internal Medicine and Cardiology, Charité–Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
- Medical Scientific Affairs, B.Braun Melsungen AG, Berlin, Germany
| | | | - Viktor Kočka
- University Hospital Královské Vinohrady Prague, Czech Republic
| | - Petr Toušek
- University Hospital Královské Vinohrady Prague, Czech Republic
| | | | | | | | - Fernando Lozano
- Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | | | | | - Lucie Wachowiak
- Medical Scientific Affairs, B.Braun France, Saint-Cloud, France
| | | | | | | | | | - Kyu-Rock Han
- Kangdong Sacred Heart Hospital, Kangdong, South Korea
| | | | | | | | | | | | - Tae Hoon Ahn
- Gachon University Gil Medical Center, Incheon, South Korea
| |
Collapse
|
8
|
Ajmera P, Pothineni R, Chawla KK, Mantravadi SS, Jariwala PV, Vijan V, Vijan V. Real-World Use Of Ultrathin-Strut Biodegradable Polymer-Coated Sirolimus-Eluting Stents In Patients With Coronary Artery Disease: 6-Month Clinical Outcomes. Vasc Health Risk Manag 2019; 15:439-447. [PMID: 31695399 PMCID: PMC6805243 DOI: 10.2147/vhrm.s200699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 09/16/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Although a number of drug-eluting stents have been developed with different design, composition, and polymers, the search for an ideal drug-eluting stent is ongoing. The Tetriflex (Sahajanand Medical Technology, Surat, India) is a newer-generation, ultrathin (60 µm) biodegradable polymer-coated sirolimus-eluting stent (SES) designed with a unique long dual Z-link on a cobalt-chromium alloy. The present registry aimed to evaluate the safety and clinical outcomes of the Tetriflex SES at 6-month post-implantation. METHODS This was an investigator-initiated, retrospective, multicenter, single-arm, observational registry conducted at five tertiary-care centers in India. A total of 1,269 consecutive patients with coronary artery disease who underwent implantation of at least one Tetriflex SES between March 2017 and March 2018 were included. The primary outcome was considered a composite of cardiac death, myocardial infarction and target-lesion revascularization (TLR) at 6-month follow-up. Stent thrombosis was evaluated as a safety outcome at 6-month follow-up. RESULTS The mean age of patients was 54.99±10.80 years. Among 1,515 lesions treated with 1,682 Tetriflex SES, 58.3% were type C lesions. Six-month follow-up was done for 1,245 of 1,269 (98.1%) patients. At 6 months, composite events had occurred in 31 (2.5%) patients, consisting of ten (0.8%) cardiac deaths, 16 (1.3%) myocardial infarctions, and five (0.4%) TLRs. Stent thrombosis was observed in seven (0.56%) cases at 6 months. A subgroup analysis between diabetic and nondiabetic patients did not reveal any statistically significant difference for clinical outcomes at 6-month follow-up. CONCLUSION The results of the current registry outline the safety and effectiveness of the Tetriflex SES in real-world patients, as it displayed favorable clinical outcomes at 6-month follow-up, with low incidence of TLR and stent thrombosis.
Collapse
Affiliation(s)
- Prakash Ajmera
- Department of Cardiology, Malla Reddy Narayana Multispeciality Hospital, Hyderabad, Telangana 500055, India
| | - Ramesh Pothineni
- Department of Cardiology, Ramesh Hospitals, Vijayawada, Andhra Pradesh520008, India
| | - Kamal Kumar Chawla
- Department of Cardiology, Malla Reddy Narayana Multispeciality Hospital, Hyderabad, Telangana 500055, India
| | | | - Pankaj Vinod Jariwala
- Department of Cardiology, Yashoda Hospitals, Somajiguda, Hyderabad, Telangana, 500082, India
| | - Vinod Vijan
- Department of Cardiology, Vijan Cardiac and Critical Care Centre, Nashik, Maharashtra 422005, India
| | - Vikrant Vijan
- Department of Cardiology, Vijan Cardiac and Critical Care Centre, Nashik, Maharashtra 422005, India
| |
Collapse
|
9
|
Testa L, Pero G, Bollati M, Casenghi M, Popolo Rubbio A, Cuman M, Moreno R, Serra A, Gomez JA, Bedogni F. XLIMus drug eluting stent: A randomIzed controlled Trial to assess endothelialization. The XLIMIT trial. IJC HEART & VASCULATURE 2019; 23:100363. [PMID: 31061876 PMCID: PMC6487315 DOI: 10.1016/j.ijcha.2019.100363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/15/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Thin strut 3rd generation drug eluting stents offer the potential advantage over the previous generation of better technical performance and reduced neointimal proliferation parameters, which are linked to mid and late term device failure. AIM To evaluate the performance of the Xlimus sirolimus-eluting stent (SES) against the Synergy everolimus-eluting stent (EES) in terms of device reendothelialization in patients undergoing PCI for coronary artery disease (CAD). METHODS XLIMIT is a multicenter randomized controlled trial targeting 180 patients requiring percutaneous coronary interventions (PCI). Patients will be treated with Xlimus SES or Synergy EES implantation and randomization will be performed in a 2:1 ratio. The primary endpoint will be the reendothelialization grade of the Xlimus stent in terms of strut coverage and neointimal hyperplasia volume as compared to Synergy. Secondary endpoints will be represented by clinical and procedural outcomes. The first patient was enrolled on February 2019. CONCLUSIONS A clearer understanding of the endothelialization process of new generation DES could significantly impact the treatment with dual antiplatelet therapy in the future. Moreover, although not powered for clinical end-points, the XLIMIT trial will provide randomized data in a population with minimal exclusion criteria. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03745053. Registered on November 19, 2018.
Collapse
Affiliation(s)
- Luca Testa
- Dept. of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy
| | - Gaetano Pero
- Dept. of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy
| | - Mario Bollati
- Dept. of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy
| | - Matteo Casenghi
- Dept. of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy
| | | | - Magdalena Cuman
- Dept. of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy
| | | | - Antoni Serra
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | |
Collapse
|
10
|
de la Torre Hernandez JM, Moreno R, Gonzalo N, Rivera R, Linares JA, Veiga Fernandez G, Gomez Menchero A, Garcia Del Blanco B, Hernandez F, Benito Gonzalez T, Subinas A, Escaned J. The Pt-Cr everolimus-eluting stent with bioabsorbable polymer in the treatment of patients with acute coronary syndromes. Results from the SYNERGY ACS registry. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 20:705-710. [PMID: 30414798 DOI: 10.1016/j.carrev.2018.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/08/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES We investigated the safety and efficacy of the bioabsorbable polymer-coated, everolimus-eluting coronary stent (SYNERGY) stent in a real-world study population with acute coronary syndromes (ACS). BACKGROUND A number of clinical trials support the overall efficacy and safety of the SYNERGY stent. However, a recent trial (TIDES-ACS) in the context of ACS reported worrying figures of infarction and definite/probable stent thrombosis in the SYNERGY control arm. METHODS This is a multicenter registry (10 centers) including consecutive patients with ACS (unstable angina, non-ST elevated myocardial infarction, ST elevated myocardial infarction) who underwent percutaneous revascularization with the implantation of SYNERGY stent. The primary endpoint was the composite of cardiac death, myocardial infarction and target lesion revascularization at 12 months. RESULTS A total of 1008 patients were included with age 65.4 ± 14.8 years, 23.8% females and a 24.5% diabetics. Regarding presentation, a 15.2% with unstable angina, 43% with non-ST elevated myocardial infarction and 41.8% with ST elevated myocardial infarction. Primary outcome was met in 3% (7% in SYNERGY TIDES-ACS arm, P superiority <0.01 and 6.3% in OPTIMAX TIDES-ACS arm, P superiority <0.01). Cardiac death was 1.3% (1.6%, p = 0.8 and 0.5%, P superiority =0.1 respectively). Myocardial infarction was 1.6% (4.6%, p < 0.01 and 1.8%, P superiority = 0.9 respectively). Target lesion revascularization was 1% (3.4%, p < 0.01 and 5.4%, P superiority <0.01 respectively). Definite or probable thrombosis was 0.9% (2.8%, p ≤ 0.01 and 1.1%, P superiority = 0.8 respectively). CONCLUSIONS The results of this registry show a very good safety and efficacy profile at 12 months for the SYNERGY stent in patients with ACS. SUMMARY A recent trial (TIDES-ACS) in the context of acute coronary syndromes (ACS) reported worrying figures of infarction and definite/probable stent thrombosis in the SYNERGY stent control arm. We investigated the safety of SYNERGY stent in a real-world study population with ACS applying the same inclusion/exclusion criteria as used in the TIDES-ACS trial. Primary endpoint was the composite of cardiac death, myocardial infarction and TLR at 12 months. A total of 1008 patients have been included. Primary outcome was met in 3% (7% in SYNERGY TIDES-ACS arm, P superiority <0.01 and 6.3% in OPTIMAX TIDES-ACS arm, P superiority <0.01).
Collapse
Affiliation(s)
| | - Raul Moreno
- Hospital La Paz, Dpt. of Interventional Cardiology, Madrid, Spain
| | - Nieves Gonzalo
- Hospital Clinico San Carlos, Dpt. of Interventional Cardiology, Madrid, Spain
| | - Ricardo Rivera
- Hospital Virgen de las Nieves, Dpt. of Interventional Cardiology, Granada, Spain
| | - Jose A Linares
- Hospital Lozano Blesa, Dpt. of Interventional Cardiology, Zaragoza, Spain
| | - Gabriela Veiga Fernandez
- Hospital Universitario Marques de Valdecilla, Dpt. of Interventional Cardiology, IDIVAL, Santander, Spain
| | | | | | - Felipe Hernandez
- Hospital 12 de Octubre, Dpt. of Interventional Cardiology, Madrid, Spain
| | | | - Asier Subinas
- Hospital de Galdacano, Dpt. of Interventional Cardiology, Bilbao, Spain
| | - Javier Escaned
- Hospital Clinico San Carlos, Dpt. of Interventional Cardiology, Madrid, Spain
| |
Collapse
|
11
|
Urban P, Chevalier B. Polymer-free drug-coated stents: workhorse or “niche horse”? EUROINTERVENTION 2018; 14:732-735. [DOI: 10.4244/eijv14i7a128] [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: 11/23/2022]
|