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Sharma K, Dani S, Desai D, Kumar P, Bhalani N, Vasavada A, Trivedi R. Two-year safety and efficacy of Indigenous Abluminus Sirolimus Eluting Stent. Does it differ amongst diabetics? - Data from en-ABLe- REGISTRY. J Cardiovasc Thorac Res 2021; 13:162-168. [PMID: 34326971 PMCID: PMC8302901 DOI: 10.34172/jcvtr.2021.31] [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: 01/16/2021] [Accepted: 04/30/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: To evaluate the efficacy/safety profile of the Abluminus DES+ over 2-years follow-up in the "real-world" scenario in diabetics as compared to non-diabetics. Methods: In prospective, all-comers, open-label registry conducted at 31 sites, patients were analyzed for 1 & 2-year outcomes with the primary endpoint defined as 3P-MACE of CV death, target vessel related myocardial infarction (TV-MI), ischemia-driven target lesion revascularization (TLR)/target vessel revascularization (TVR) apart from Stent thrombosis (ST). Results: Of 2500 patients of PCI with 3286 Abluminus-DES+, 1641 (65.64%) were non-diabetics while859 (34.36%) were diabetics. The 3-P MACE for the cohort at 1 & 2 years were 2.9%, and 3.16%; TLR/TVR - 1.4% at both the intervals for 2493 patients at 2 yrs. follow-up. TV-MI & ST were 0.36% and0.56% at 1st and 2nd year respectively. The 3P-MACE was lower in non-diabetics at 1 & 2 years (2.3%vs 4.2%; 2.4% vs 4.7% respectively). For components of MACE, CV mortality (0.9 vs 1.9% at 1 yr ; 1.0vs 2.1% at 2 years) was significant (P < 0.05) while TLR (1.1 vs 1.9% at 1 yr. & 1.1 vs 2.1% at 2 yrs.) and TV-MI (0.9 vs 1.9% at 1 yr. & 1 vs 2.1% at 2 years) were similar for diabetics and non-diabetics so was ST (P > 0.05). Conclusion: Abluminus-DES+ showed excellent 2-year safety and efficacy with low 3-P MACE which was higher in diabetics driven by higher CV death but similar TLR, TV-MI and ST.
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Affiliation(s)
- Kamal Sharma
- Department of Cardiology, UNMICRC, BJ Medical College, Ahmedabad (Gujarat), India
| | - Sameer Dani
- Apollo Hospitals Ahmedabad and Limsar, Ahmedabad (Gujarat), India
| | - Devang Desai
- Unicare Hospital, Mahavir Hospital, Surat (Gujarat) India
| | - Prathap Kumar
- ESIC Hospital Kollam and Meditrina Hospital, Kerala, India
| | - Nirav Bhalani
- Rhythm Hopsital and Sunshine Global, Vadodara (Gujarat), India
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Verhaegen C, Kautbally S, Zapareto DC, Brusa D, Courtoy G, Aydin S, Bouzin C, Oury C, Bertrand L, Jacques PJ, Beauloye C, Horman S, Kefer J. Early thrombogenicity of coronary stents: comparison of bioresorbable polymer sirolimus-eluting and bare metal stents in an aortic rat model. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2020; 10:72-83. [PMID: 32685265 PMCID: PMC7364276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although 1-month dual antiplatelet therapy (DAPT) in patients treated with bare metal stents (BMS) is well established, the optimal duration of DAPT after implantation of a drug-eluting stent (DES) is still a matter of debate. The safety of shortened DAPT is under investigation due to concern about the risk of stent thrombosis. Data on platelet activation and prothrombotic response in vivo following bioresorbable polymer sirolimus-eluting stent (BP-SES) implantation are scarce. OBJECTIVES The aim of our study was to compare the early thrombogenicity of BP-SES with that of BMS in an aortic rat model. METHODS AND RESULTS Overall, 30 rats underwent stent implantation in the abdominal aorta: BMS (Pro-Kinetic Energy; N=15) and BP-SES (Ultimaster Tansei; N=15) were compared in terms of their early thrombogenicity. CD62P exposure at the platelet surface and fibrinogen binding at the integrin receptor were not different between BMS and BP-SES over time. The thrombus coverage of the scaffold (0 vs. 0.1%, P=0.84) was similarly low in both groups at Day 28; thrombotic deposits had totally disappeared at Day 84. The endothelial strut coverage was similarly high at 1 month (90 vs. 95%, P=0.64) and 3 months (87 vs. 97%, P=0.99) following BMS and BP-SES implantation, respectively. CONCLUSIONS This study demonstrates the low early thrombogenicity of a BP-SES implanted in an aortic rat model, which did not differ from a BMS. These data could be helpful to support the safety of a shortened 1-month DAPT duration following BP-SES implantation in the human coronary artery.
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Affiliation(s)
- Carole Verhaegen
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Shakeel Kautbally
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Diego Castanares Zapareto
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
- Division of Intensive Care, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Davide Brusa
- Plateforme de Cytometrie de Flux, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Guillaume Courtoy
- IREC Imaging Platform (2IP), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Selda Aydin
- Division of Anatomical Pathology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Caroline Bouzin
- IREC Imaging Platform (2IP), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Cecile Oury
- GIGA Cardiovascular Sciences, University of LiegeLiege, Belgium
| | - Luc Bertrand
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Pascal J Jacques
- Institute of Mechanics, Materials and Civil Engineering, IMAP, Universite Catholique de Louvain (UCLouvain)Louvain-la-Neuve, Belgium
| | - Christophe Beauloye
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Sandrine Horman
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
| | - Joelle Kefer
- Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain)Brussels, Belgium
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