1
|
Zhang B, Wang X, Wang D, Guo M, Ren C, Han W, Uyama H, Li Q. Improved Antithrombogenicity of a Poly(lactic acid) Surface Grafted with Chondroitin Sulfate. ACS APPLIED BIO MATERIALS 2021; 4:2696-2703. [DOI: 10.1021/acsabm.0c01629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Bo Zhang
- School of Mechanics Science and Safety Engineering, Zhengzhou University, Zhengzhou 450002, China
- National Center for International Research of Micro-Nano Molding Technology, Key Laboratory of Henan Province for Micro Molding Technology, Zhengzhou 450002, China
| | - Xiaofeng Wang
- School of Mechanics Science and Safety Engineering, Zhengzhou University, Zhengzhou 450002, China
- National Center for International Research of Micro-Nano Molding Technology, Key Laboratory of Henan Province for Micro Molding Technology, Zhengzhou 450002, China
| | - Dongfang Wang
- School of Mechanics Science and Safety Engineering, Zhengzhou University, Zhengzhou 450002, China
- National Center for International Research of Micro-Nano Molding Technology, Key Laboratory of Henan Province for Micro Molding Technology, Zhengzhou 450002, China
| | - Meng Guo
- School of Mechanics Science and Safety Engineering, Zhengzhou University, Zhengzhou 450002, China
- National Center for International Research of Micro-Nano Molding Technology, Key Laboratory of Henan Province for Micro Molding Technology, Zhengzhou 450002, China
| | - Cuihong Ren
- School of Mechanics Science and Safety Engineering, Zhengzhou University, Zhengzhou 450002, China
- National Center for International Research of Micro-Nano Molding Technology, Key Laboratory of Henan Province for Micro Molding Technology, Zhengzhou 450002, China
| | - Wenjuan Han
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450002, China
| | - Hiroshi Uyama
- Department of Applied Chemistry, Graduate School of Engineering, Osaka University, Suita, Japan
| | - Qian Li
- School of Mechanics Science and Safety Engineering, Zhengzhou University, Zhengzhou 450002, China
- National Center for International Research of Micro-Nano Molding Technology, Key Laboratory of Henan Province for Micro Molding Technology, Zhengzhou 450002, China
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450002, China
| |
Collapse
|
2
|
Stone GW, Maehara A, Ali ZA, Held C, Matsumura M, Kjøller-Hansen L, Bøtker HE, Maeng M, Engstrøm T, Wiseth R, Persson J, Trovik T, Jensen U, James SK, Mintz GS, Dressler O, Crowley A, Ben-Yehuda O, Erlinge D. Percutaneous Coronary Intervention for Vulnerable Coronary Atherosclerotic Plaque. J Am Coll Cardiol 2020; 76:2289-2301. [PMID: 33069847 DOI: 10.1016/j.jacc.2020.09.547] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Acute coronary syndromes most commonly arise from thrombosis of lipid-rich coronary atheromas that have large plaque burden despite angiographically appearing mild. OBJECTIVES This study sought to examine the outcomes of percutaneous coronary intervention (PCI) of non-flow-limiting vulnerable plaques. METHODS Three-vessel imaging was performed with a combination intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) catheter after successful PCI of all flow-limiting coronary lesions in 898 patients presenting with myocardial infarction (MI). Patients with an angiographically nonobstructive stenosis not intended for PCI but with IVUS plaque burden of ≥65% were randomized to treatment of the lesion with a bioresorbable vascular scaffold (BVS) plus guideline-directed medical therapy (GDMT) versus GDMT alone. The primary powered effectiveness endpoint was the IVUS-derived minimum lumen area (MLA) at protocol-driven 25-month follow-up. The primary (nonpowered) safety endpoint was randomized target lesion failure (cardiac death, target vessel-related MI, or clinically driven target lesion revascularization) at 24 months. The secondary (nonpowered) clinical effectiveness endpoint was randomized lesion-related major adverse cardiac events (cardiac death, MI, unstable angina, or progressive angina) at latest follow-up. RESULTS A total of 182 patients were randomized (93 BVS, 89 GDMT alone) at 15 centers. The median angiographic diameter stenosis of the randomized lesions was 41.6%; by near-infrared spectroscopy-IVUS, the median plaque burden was 73.7%, the median MLA was 2.9 mm2, and the median maximum lipid plaque content was 33.4%. Angiographic follow-up at 25 months was completed in 167 patients (91.8%), and the median clinical follow-up was 4.1 years. The follow-up MLA in BVS-treated lesions was 6.9 ± 2.6 mm2 compared with 3.0 ± 1.0 mm2 in GDMT alone-treated lesions (least square means difference: 3.9 mm2; 95% confidence interval: 3.3 to 4.5; p < 0.0001). Target lesion failure at 24 months occurred in similar rates of BVS-treated and GDMT alone-treated patients (4.3% vs. 4.5%; p = 0.96). Randomized lesion-related major adverse cardiac events occurred in 4.3% of BVS-treated patients versus 10.7% of GDMT alone-treated patients (odds ratio: 0.38; 95% confidence interval: 0.11 to 1.28; p = 0.12). CONCLUSIONS PCI of angiographically mild lesions with large plaque burden was safe, substantially enlarged the follow-up MLA, and was associated with favorable long-term clinical outcomes, warranting the performance of an adequately powered randomized trial. (PROSPECT ABSORB [Providing Regional Observations to Study Predictors of Events in the Coronary Tree II Combined with a Randomized, Controlled, Intervention Trial]; NCT02171065).
Collapse
Affiliation(s)
- Gregg W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Cardiovascular Research Foundation, New York, New York.
| | - Akiko Maehara
- Cardiovascular Research Foundation, New York, New York; NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York
| | - Ziad A Ali
- Cardiovascular Research Foundation, New York, New York; NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York
| | - Claes Held
- Uppsala University and Uppsala Clinical Research, Uppsala, Sweden
| | | | | | | | | | | | - Rune Wiseth
- St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jonas Persson
- Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - Thor Trovik
- University Hospital of North Norway, Tromsö, Norway
| | | | - Stefan K James
- Uppsala University and Uppsala Clinical Research, Uppsala, Sweden
| | - Gary S Mintz
- Cardiovascular Research Foundation, New York, New York
| | | | - Aaron Crowley
- Cardiovascular Research Foundation, New York, New York
| | - Ori Ben-Yehuda
- Cardiovascular Research Foundation, New York, New York; University of California San Diego, San Diego, California
| | | | | |
Collapse
|