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Yang YX, Zhang HP, Li C, Fu Y, He KZ, Liu XM, Wang HJ, Xia K, Xu L, Zhong JC, Chen ML, Wang LF. Comparisons of drug-eluting balloon versus drug-eluting stent for the treatment of cancer patients presenting with acute myocardial infarction. Eur J Med Res 2023; 28:334. [PMID: 37689799 PMCID: PMC10492280 DOI: 10.1186/s40001-023-01316-y] [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: 05/11/2023] [Accepted: 08/25/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Treatment for cancer patients presenting with acute myocardial infarction (AMI) remains challenging. The objective of the study was to investigate the safety and efficiency of drug eluting balloon (DEB) versus drug eluting stent (DES) in this high-risk group. METHODS Between 1st January 2017 and 1st January 2022, cancer patients admitted to Beijing Chaoyang Hospital with AMI were retrospectively enrolled. The primary endpoint was major adverse cardiovascular event (MACE). The secondary endpoints included major bleeding events, heart failure and cardiac complications. RESULTS A total of 164 cancer patients presenting with AMI were included in the final analysis. Patients treated with DEB had a numerically lower rate of MACE than those treated with DES during a median follow-up of 21.8 months (22.9% vs. 37.1%, p = 0.23). Patients treated with DEB had a trend towards lower rate of major bleeding events than patients treated with DES (6.3% vs. 18.1%, HR 2.96, 95% CI [0.88, 9.92], p = 0.08). There were no significant differences between the two groups with regards to the rate of heart failure (4.2% vs. 9.5%, p = 0.32) and cardiac complications (0.0% vs. 2.6%, p = 0.56). CONCLUSIONS The present study demonstrated that in cancer patients with AMI, DEB had a trend towards lower rate of major bleeding events and a numerically lower rate of MACE compared with DES.
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Affiliation(s)
- Yi-Xing Yang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Huai-Peng Zhang
- Department of Cardiology, Heze Municipal Hospital, No. 2888, Caozhou Road, Mudan District, Heze, 274000, Shandong, China
| | - Chuang Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Yuan Fu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Kui-Zheng He
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Xin-Ming Liu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Hong-Jiang Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Kun Xia
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Li Xu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Jiu-Chang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Mu-Lei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China
| | - Le-Feng Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongti South Road, Chaoyang District, Beijing, 100020, China.
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Occurrence and predictive factors of restenosis in coronary heart disease patients underwent sirolimus-eluting stent implantation. Ir J Med Sci 2020; 189:907-915. [PMID: 31989420 DOI: 10.1007/s11845-020-02176-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/20/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND This study aimed to investigate the occurrence and predictive factors of restenosis in coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES). METHODS Demographic data, clinical features, and laboratory tests of 398 CHD patients underwent PCI with SES were retrospectively reviewed. Coronary angiography was performed to evaluate coronary stenosis before PCI and in-stent restenosis at 1-year follow-up. RESULTS There were 37 (9.3%) patients suffered restenosis, but 361 (90.7%) patients did not develop restenosis at 1-year follow-up. Demographic characteristic (age), cardiovascular risk factors (hypertension and hyperuricemia), biochemical indexes (fasting blood-glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (HsCRP)), cardiac function index (cardiac troponin I), lesion features (multivessel artery lesions, target lesion at left circumflex artery (LCX), two target lesions and length of target lesion), and operation procedure (length of stent) were correlated with higher restenosis risk. Moreover, age, hypertension, diabetes mellitus, LDL-C, HsCRP, and target lesion at LCX were independent predictive factors for raised restenosis risk. Based on these independent predictive factors, we established a restenosis risk prediction model, and receiver-operating characteristic curves displayed that this model exhibited an excellent predictive value for higher restenosis risk (areas under the curve 0.953 (95% CI 0.926-0.981)). CONCLUSION Our findings provide a new insight into the prediction for restenosis in CHD patients underwent PCI with SES.
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Qian H, Luo Z, Xiao C, Chen J, Li D, Xu H, He P, Zhou X, Zhang T, Min X. Red cell distribution width in coronary heart disease: prediction of restenosis and its relationship with inflammatory markers and lipids. Postgrad Med J 2018; 94:489-494. [PMID: 30301834 DOI: 10.1136/postgradmedj-2018-135806] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/14/2018] [Accepted: 08/26/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Red cell distribution width (RDW) is associated with a poor prognosis and adverse events in cardiovascular diseases. The aims of this study were to investigate the relationship between serum RDW levels and outcomes after percutaneous coronary intervention and to identify potential novel laboratory markers for evaluating the risk of in-stent restenosis (ISR) with stable angina pectoris. METHODS A total of 261 patients with coronary heart disease from Dongfeng General Hospital implanted with a coronary drug-eluting stent (DES) were enrolled in the study. We retrospectively analysed the role and prognosis values of serum parameters that were measured before angiography at the first admission. According to the results of the second angiogram, the patients were divided into two groups as follows: the non-ISR group (n=143) and the ISR group (n=118). The clinical characteristics and all laboratory data were considered for univariate and multivariate logistic regression analyses. RESULTS The white cell count, RDW, neutrophil count, C-reactive protein (CRP), total cholesterol, low-density lipoprotein cholesterol (LDL-C), blood urea nitrogen and uric acid levels were higher in the ISR group than in the non-ISR group. There were no differences in the rates of hypertension, fasting plasma glucose, red cell count, neutrophil to lymphocyte ratio, platelet count, triglyceride, high-density lipoprotein cholesterol and creatinine levels. In the univariate regression analysis, age, diabetes, white cell count, neutrophil count, RDW, CRP, total cholesterol, LDL-C, blood urea nitrogen, Gensini score and number of stents were predictors of ISR. According to the multiple logistic regression analysis, age, RDW and number of stents were independent predictors of ISR. CONCLUSIONS Preprocedural blood parameters can independently predict ISR. Our study results demonstrated that a high preprocedural RDW is an independent predictor of DES restenosis.
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Affiliation(s)
- Hang Qian
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Zhihuan Luo
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Chunmei Xiao
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Jishun Chen
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Dongfeng Li
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Hao Xu
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Peigen He
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Xintao Zhou
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Tao Zhang
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
| | - Xinwen Min
- Department of Cardiology, Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China
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Alexander GC, Vines JB, Hwang P, Kim T, Kim JA, Brott BC, Yoon YS, Jun HW. Novel Multifunctional Nanomatrix Reduces Inflammation in Dynamic Conditions in Vitro and Dilates Arteries ex Vivo. ACS APPLIED MATERIALS & INTERFACES 2016; 8:5178-5187. [PMID: 26849167 PMCID: PMC5179142 DOI: 10.1021/acsami.6b00565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Inflammatory responses play a critical role in tissue-implant interactions, often limiting current implant utility. This is particularly true for cardiovascular devices. Existing stent technology does little to avoid or mitigate inflammation or to influence the vasomotion of the artery after implantation. We have developed a novel endothelium-mimicking nanomatrix composed of peptide amphiphiles that enhances endothelialization while decreasing both smooth muscle cell proliferation and platelet adhesion. Here, we evaluated whether the nanomatrix could prevent inflammatory responses under static and physiological flow conditions. We found that the nanomatrix reduced monocyte adhesion to endothelial cells and expression of monocyte inflammatory genes (TNF-α, MCP-1, IL-1β, and IL-6). Furthermore, the nitric-oxide releasing nanomatrix dramatically attenuated TNF-α-stimulated inflammatory responses as demonstrated by significantly reduced monocyte adhesion and inflammatory gene expression in both static and physiological flow conditions. These effects were abolished by addition of a nitric oxide scavenger. Finally, the nanomatrix stimulated vasodilation in intact rat mesenteric arterioles after constriction with phenylephrine, demonstrating the bioavailability and bioactivity of the nanomatrix, as well as exhibiting highly desired release kinetics. These results demonstrate the clinical potential of this nanomatrix by both preventing inflammatory responses and promoting vasodilation, critical improvements in stent and cardiovascular device technology.
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Affiliation(s)
| | | | | | | | | | | | - Young-Sup Yoon
- School of Medicine, Division of Cardiology, Emory University , Atlanta, Georgia 30322, United States
- Severance Biomedical Science Institute, Yonsei University College of Medicine , Seoul, Korea
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Morii J, Miura SI, Ike A, Shiga Y, Sugihara M, Iwata A, Kawamura A, Nishikawa H, Saku K. Comparison of the efficacies of irbesartan and olmesartan after successful coronary stent implantation. Intern Med 2013; 52:713-9. [PMID: 23545664 DOI: 10.2169/internalmedicine.52.9261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We compared the efficacies of irbesartan and olmesartan after successful stent implantation in patients with stable angina. METHODS Twenty-six patients were randomly divided into irbesartan and olmesartan groups and treated for approximately eight months (at follow-up coronary angiography). RESULTS There were no differences in blood pressure (BP) reduction or late loss between the groups. The BP levels in both groups at follow-up were significantly reduced. The equality of variance of systolic (S)BP (i.e., the intragroup standard deviation of SBP) in the irbesartan group was significantly smaller than that observed in the olmesartan group at follow-up. In addition, log[pentraxin-3] was significantly decreased in all of the patients at follow-up, with no differences between the groups. Interestingly, the levels of log[high-sensitive C-reactive protein (hs-CRP)] measured at 0 weeks were positively associated with in-stent late loss, and among independent biochemical variables in addition to age, gender, body mass index and the kind of angiotensin receptor blockers at 0 weeks, only these levels were related to in-stent late loss, as assessed by a multivariate analysis. CONCLUSION The ability of irbesartan to reduce BP is comparable to that of olmesartan, and irbesartan exhibits a lower variance of systolic BP after treatment. The level of log[hs-CRP] before stent implantation is a predictor of in-stent late loss.
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Affiliation(s)
- Joji Morii
- Department of Cardiology, Fukuoka University School of Medicine, Japan
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