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Laricchia A, Bossi I, Latini RA, Lee CY, Pérez IS, Tomai F, Nuruddin AA, Buccheri D, Seresini G, Ocaranza R, Sengottvelu G, Pesenti N, Mangieri A, Cortese B. Sirolimus-coated balloon in acute and chronic coronary syndromes: the PEACE study, a subanalysis of the EASTBOURNE registry. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:527-536. [PMID: 38056772 DOI: 10.1016/j.rec.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES The PEACE study (Performance of a sirolimus-eluting balloon strategy in acute and chronic coronary syndromes) investigated for the first time whether a sirolimus-coated balloon (SCB) (Magic Touch, Concept Medical, India) is associated with different outcomes depending on whether it is used in acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). METHODS This was a post-hoc analysis from the all-comers EASTBOURNE Registry (NCT03085823). Out of 2083 patients enrolled, an SCB was used to treat 968 (46.5%) ACS and 1115 (53.5%) CCS patients. The primary endpoint was target lesion revascularization at 12 months, while secondary endpoints were angiographic success and major adverse cardiovascular events. RESULTS Baseline demographics, mean reference vessel diameter and mean lesion length were comparable between ACS and CCS. Predilatation was more commonly performed in ACS (P=.007). SCB was inflated at a standard pressure in both groups with a slight trend toward longer inflation time in ACS. Angiographic success was high in both groups (ACS 97.4% vs CCS 97.7%, P=.820) with limited bailout stenting. Similarly, at 12 months the cumulative incidence of target lesion revascularization (ACS 6.6% vs CCS 5.2%, P=.258) was comparable between ACS and CCS. Conversely, a higher rate of major adverse cardiovascular events in acute presenters was mainly driven by myocardial infarction recurrencies (ACS 10.4% vs CCS 8.3%, P=.009). In-stent restenosis showed a higher proportion of target lesion revascularization and major adverse cardiovascular events than de novo lesions, independently of the type of presentation at the index procedure. CONCLUSIONS This SCB shows good performance in terms of acute and 1-year outcomes independently of the clinical presentation.
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Affiliation(s)
- Alessandra Laricchia
- Cardiology Department, Ospedale San Carlo Borromeo, Milan, Italy; Cardiology Department, Ospedale Fatebenefratelli, Milan, Italy
| | - Irene Bossi
- Cardiology Department, Ospedale Niguarda, Milan, Italy
| | | | - Chuey Y Lee
- Cardiology Department, Sultanah Aminah Hospital Johor Bahru, Johor, Malaysia
| | - Ignacio S Pérez
- Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | - Amin A Nuruddin
- Cardiology Department, Institute Jantung Negara, Kuala Lumpur, Malaysia
| | - Dario Buccheri
- Cardiology Department, Ospedale S. Antonio Abate, Trapani, Italy
| | | | | | | | - Nicola Pesenti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology, and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Antonio Mangieri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy, and Humanitas Clinical and Research Center IRCCS, Rozzano-Milan, Italy
| | - Bernardo Cortese
- Fondazione Ricerca e Innovazione Cardiovascolare, Milan, Italy; DCB Academy, Milan, Italy.
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2
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Park S, Rha SW, Choi BG, Seo JB, Choi IJ, Woo SI, Kim SH, Ahn TH, Kim JS, Her AY, Ahn JH, Lee HC, Choi J, Byon JS, Sinurat MR, Choi SY, Cha J, Hyun SJ, Choi CU, Park CG. Efficacy and Safety of Sirolimus-Eluting Stent With Biodegradable Polymer Ultimaster™ in Unselected Korean Population: A Multicenter, Prospective, Observational Study From Korean Multicenter Ultimaster Registry. Korean Circ J 2024; 54:339-350. [PMID: 38767441 PMCID: PMC11169905 DOI: 10.4070/kcj.2024.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease. METHODS This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. RESULTS A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS). At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. CONCLUSIONS The present registry shows that Ultimaster™ stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.
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Affiliation(s)
- Soohyung Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
- Cardiovascular Research Institute, Korea University, Seoul, Korea.
| | - Byoung Geol Choi
- Cardiovascular Research Institute, Korea University, Seoul, Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ik Jun Choi
- Division of Cardiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Sung-Il Woo
- Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Soo-Han Kim
- Department of Cardiology, Hallym Hospital, Incheon, Korea
| | - Tae Hoon Ahn
- Department of Cardiology, Na-Eun Hospital, Incheon, Korea
| | - Jae Sang Kim
- Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea
| | - Ae-Young Her
- Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ji-Hun Ahn
- Division of Cardiology, Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea
| | - Han Cheol Lee
- Division of Cardiology, Department of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jaewoong Choi
- Division of Cardiology, Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, School of Medicine, Seoul, Korea
| | - Jin Soo Byon
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Soonchunhyang University Gumi Hospital, Gumi, Korea
| | | | - Se Yeon Choi
- Cardiovascular Research Institute, Korea University, Seoul, Korea
| | - Jinah Cha
- Cardiovascular Research Institute, Korea University, Seoul, Korea
| | - Su Jin Hyun
- Cardiovascular Research Institute, Korea University, Seoul, Korea
| | - Cheol Ung Choi
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
| | - Chang Gyu Park
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
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3
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Cimci M, Polad J, Mamas M, Iniguez-Romo A, Chevalier B, Abhaichand R, Aminian A, Roguin A, Maluenda G, Angioi M, Cassel G, Kuramitsu S, Jacobs L, Debrus R, Malik F, Hildick-Smith D, Laanmets P, Roffi M. Outcomes and regional differences in practice in a worldwide coronary stent registry. Heart 2022; 108:1310-1318. [PMID: 35012960 PMCID: PMC9340045 DOI: 10.1136/heartjnl-2021-320116] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/08/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The primary objective was to assess the performance of a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer in an all comer population. The secondary objective was to detail differences in contemporary percutaneous coronary intervention (PCI) practice worldwide. METHODS e-Ultimaster was an all-comer, prospective, global registry (NCT02188355) with independent event adjudication enrolling patients undergoing PCI with the study stent. The primary outcome measure was target lesion failure (TLF) at 1 year, defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularisation. Data were stratified according to 4 geographical regions. RESULTS A total of 37 198 patients were enrolled (Europe 69.2%, Asia 17.8%, Africa/Middle East 6.6% and South America/Mexico 6.5%) and 1-year follow-up was available for 35 389 patients (95.1%). One-year TLF occurred in 3.2% of the patients, ranging from 2% (Africa/Middle East) to 4.1% (South America/Mexico). In patients with acute coronary syndrome, potent P2Y12 inhibitors were prescribed in 48% of patients at discharge, while at 1 year 72% were on any dual antiplatelet therapy. Lipid-lowering treatment was administered in 80.9% and 75.5% of patients at discharge and 1 year, respectively. Regional differences in the profile of the treated patients as well as in PCI practice were reported. CONCLUSIONS In this investigation with worldwide representation, contemporary PCI using a new generation thin-strut sirolimus-eluting coronary stent with abluminal biodegradable polymer was associated with low 1-year TLF across clinical presentations and continents. Suboptimal adherence to current recommendations around antiplatelet and lipid lowering treatments was detected.
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Affiliation(s)
- Murat Cimci
- Division of Cardiology, University Hospitals Geneva, Geneva, Switzerland
| | - Jawed Polad
- Department of Cardiology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Center for Prognosis Research, Keele University, Keele, UK
- Department of Cardiology, University Hospital of North Midlands, Stoke-on-Trent, UK
| | | | - Bernard Chevalier
- Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France
| | - Rajpal Abhaichand
- Department of Cardiology, GKNM Hospital, Coimbatore, Tamil Nadu, India
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Ariel Roguin
- Departmement of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
- Faculty of Medicine, Technion Israel Institute of Technology The Ruth and Bruce Rappaport, Haifa, Israel
| | - Gabriel Maluenda
- Cardiology, Hospital Clinico San Borja Arriaran, Santiago, Chile
| | | | - Graham Cassel
- Netcare Milpark Hospital, Johannesburg, South Africa
| | | | - Lotte Jacobs
- Medical and Clinical Division, Terumo Europe NV, Leuven, Belgium
| | - Roxane Debrus
- Medical and Clinical Division, Terumo Europe NV, Leuven, Belgium
| | - Fazila Malik
- National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | | | - Peep Laanmets
- North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - Marco Roffi
- Division of Cardiology, University Hospitals Geneva, Geneva, Switzerland
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4
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Fitzgerald S, Thiele H. Primary and Rescue PCI in STEMI. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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5
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Piccolo R, Bonaa KH, Efthimiou O, Varenne O, Urban P, Kaiser C, Räber L, de Belder A, Remkes W, Van't Hof AWJ, Stankovic G, Lemos PA, Wilsgaard T, Reifart J, Rodriguez AE, Ribeiro EE, Serruys PWJC, Abizaid A, Sabaté M, Byrne RA, de la Torre Hernandez JM, Wijns W, Esposito G, Jüni P, Windecker S, Valgimigli M. Drug-Eluting or Bare-Metal Stents for Left Anterior Descending or Left Main Coronary Artery Revascularization. J Am Heart Assoc 2021; 10:e018828. [PMID: 34622669 PMCID: PMC8751874 DOI: 10.1161/jaha.120.018828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background New-generation drug-eluting stents (DES) reduce target-vessel revascularization compared with bare-metal stents (BMS), and recent data suggest that DES have the potential to decrease the risk of myocardial infarction and cardiovascular mortality. We evaluated the treatment effect of DES versus BMS according to the target artery (left anterior descending [LAD] and/or left main [LM] versus other territories [no-LAD/LM]). Methods and Results The Coronary Stent Trialist (CST) Collaboration gathered individual patient data of randomized trials of DES versus BMS for the treatment of coronary artery disease. The primary outcome was the composite of cardiac death or myocardial infarction. Hazard ratios (HRs) with 95% CIs were derived from a 1-stage individual patient data meta-analysis. We included 26 024 patients across 19 trials: 13 650 (52.4%) in the LAD/LM and 12 373 (47.6%) in the no-LAD/LM group. At 6-year follow-up, there was strong evidence that the treatment effect of DES versus BMS depended on the target vessel (P-interaction=0.024). Compared with BMS, DES reduced the risk of cardiac death or myocardial infarction to a greater extent in the LAD/LM (HR, 0.76; 95% CI, 0.68-0.85) than in the no-LAD/LM territories (HR, 0.93; 95% CI, 0.83-1.05). This benefit was driven by a lower risk of cardiac death (HR, 0.83; 95% CI, 0.70-0.98) and myocardial infarction (HR, 0.74; 95% CI, 0.65-0.85) in patients with LAD/LM disease randomized to DES. An interaction (P=0.004) was also found for all-cause mortality with patients with LAD/LM disease deriving benefit from DES (HR, 0.86; 95% CI, 0.76-0.97). Conclusions As compared with BMS, new-generation DES were associated with sustained reduction in the composite of cardiac death or myocardial infarction if used for the treatment of LAD or left main coronary stenoses. Registration URL: https://www.crd.york.ac.uk/PROSPERO; Unique identifier: CRD42017060520.
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Affiliation(s)
- Raffaele Piccolo
- Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy
| | - Kaare H Bonaa
- Department of Community Medicine University of Tromsø-The Arctic University of Norway Tromsø Norway
| | - Orestis Efthimiou
- Institute of Social and Preventive Medicine University of Bern Switzerland
| | - Olivier Varenne
- Department of Cardiology Hôpital CochinAP-HP Paris France.,Faculté de Médecine Université de Paris France
| | | | - Christoph Kaiser
- Department of Cardiology University Hospital BaselUniversity of Basel Switzerland
| | - Lorenz Räber
- Department of Cardiology Bern University HospitalUniversity of Bern Switzerland
| | - Adam de Belder
- Department of Cardiology Sussex Cardiac Centre Brighton and Sussex University Hospitals Brighton United Kingdom
| | - Wouter Remkes
- Department of Cardiology Isala Heart Centre Zwolle the Netherlands
| | - Arnoud W J Van't Hof
- Department of Cardiology Maastricht University Medical Center Maastricht the Netherlands.,Department of Cardiology Zuyderland Medical Center Heerlen the Netherlands
| | - Goran Stankovic
- Department of Cardiology Clinical Center of Serbia University of Belgrade Serbia
| | - Pedro A Lemos
- Heart Institute (InCor) University of São Paulo Medical School São Paulo Brazil.,Hospital Israelita Albert Einstein Sao Paulo-SP Brazil
| | - Tom Wilsgaard
- Department of Community Medicine University of Tromsø-The Arctic University of Norway Tromsø Norway
| | - Jörg Reifart
- Department of Cardiology Kerckhoff Klinik Bad Nauheim Germany
| | - Alfredo E Rodriguez
- Cardiac Unit Cardiology Fellow Training Program Otamendi HospitalBuenos Aires School of Medicine Buenos Aires Argentina
| | | | - Patrick W J C Serruys
- International Centre for Circulatory Health National Heart and Lung InstituteImperial College, London London United Kingdom
| | - Alex Abizaid
- Department of Invasive Cardiology Institute Dante Pazzanese of Cardiology São Paulo Brazil
| | - Manel Sabaté
- Cardiology Department Cardiovascular Institute (ICCV) and Hospital ClínicIDIBAPSUniversity of Barcelona Spain
| | - Robert A Byrne
- Dublin Cardiovascular Research Institute Mater Private Hospital Dublin Ireland.,School of Pharmacy and Biomolecular Sciences Royal College of Surgeons in Ireland Dublin Ireland
| | | | - William Wijns
- The Lambe Institute for Translational Medicine and Curam Galway Ireland.,Department of Cardiology National University of Ireland Galway Galway Ireland
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy
| | - Peter Jüni
- Department of Medicine Applied Health Research Centre of the Li Ka Shing Knowledge Institute St Michael's HospitalUniversity of Toronto Ontario Canada
| | - Stephan Windecker
- Department of Cardiology Bern University HospitalUniversity of Bern Switzerland
| | - Marco Valgimigli
- Department of Cardiology Bern University HospitalUniversity of Bern Switzerland.,CardioCentro Ticino Lugano Switzerland
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Ijichi T, Nakazawa G, Torii S, Nagamatsu H, Yoshikawa A, Nakamura S, Souba J, Isobe A, Hagiwara H, Ikari Y. Late neointimal volume reduction is observed following biodegradable polymer-based drug eluting stent in porcine model. IJC HEART & VASCULATURE 2021; 34:100792. [PMID: 34036146 PMCID: PMC8134975 DOI: 10.1016/j.ijcha.2021.100792] [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: 02/28/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The BP-SES has an abluminally applied biodegradable polymer that is fully resorbed after 3-4 months but may have longer-lasting effects. The aim of this study was to determine the long-term vascular response to the novel Ultimaster™ sirolimus-eluting stent (BP-SES). METHODS BP-SESs, everolimus-eluting stents (DP-EESs), and bare metal stents were implanted in 22 coronary arteries of 15 mini-swine. All animals underwent optical frequent domain imaging (OFDI) to assess neointimal volume and quality at either 1 (n = 7) or 3 (n = 8) months and at 9 (n = 15) months and were euthanized at 9 months. Stents were subsequently histologically investigated to analyze the vascular response and maturity of neointimal tissue according to cell density. RESULTS OFDI revealed greater regression in neointimal volume from 3 to 9 months with BP-SESs than with DP-EESs (-0.6 ± 0.5 mm2 vs. 0.00 ± 0.4 mm2, p = 0.07). Although there was no significant difference between BP-SESs and DP-EESs in the inflammation score (BMS, BP-SES, and DP-EES: 0.1 ± 0.1, 0.3 ± 0.4, and 0.4 ± 0.4, respectively; p < 0.0001) in histological analysis, BP-SESs showed slightly greater maturity than DP-EESs (1.8 ± 0.3, 1.7 ± 0.3, and 1.6 ± 0.3, p = 0.09). CONCLUSIONS While both BP-SESs and DP-EESs showed minimal inflammatory responses at 9 months, BP-SESs showed a trend for greater neointimal maturity and regression, which may be related to earlier completion of the vascular response.
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Affiliation(s)
- Takeshi Ijichi
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Ayako Yoshikawa
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | | | - Junko Souba
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | - Atsushi Isobe
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | | | - Yuji Ikari
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
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7
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Sim HW, Thong EH, Djohan AH, Chen JZ, Ser JS, Loh PH, Lee CH, Chan MY, Low AF, Tay EL, Chan KH, Tan HC, Loh JP. Long-term clinical outcomes of biodegradable polymer drug eluting stents versus second-generation durable polymer drug eluting stents for ST-segment elevation myocardial infarction. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 35:98-103. [PMID: 33893053 DOI: 10.1016/j.carrev.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Biodegradable polymer drug eluting stents (BP-DES) may offer the advantage of vascular healing in ST-segment elevation myocardial infarction (STEMI). Long-term outcome data comparing BP-DES and second-generation durable polymer drug eluting stents (DP-DES) in STEMI is lacking. This study aims to compare the long-term clinical outcomes of BP-DES versus second-generation DP-DES in STEMI. METHODS This is an observational study of consecutive patients with STEMI who received either BP-DES (n = 854) or DP-DES (n = 708) during primary percutaneous coronary intervention (PCI) from 1st February 2007 to 31st December 2016. The primary outcome was target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction (MI), and target lesion revascularization with follow up till 30th November 2019. RESULTS The baseline demographics, lesion and procedural characteristic were similar between the two groups except for more prior MI and chronic obstructive pulmonary disease in the BP-DES group. At a median follow up of 4.2 years (interquartile range: 2.6-6.2 years), the incidence of TLF was similar between BP-DES and DP-DES (adjusted hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.70-1.26). Likewise, incidence of major adverse cardiovascular events (MACE: all-cause death, any MI or target vessel revascularization) and definite stent thrombosis were similar in both groups (MACE: adjusted HR 1.04, 95% CI 0.82-1.32; definite stent thrombosis: adjusted HR 1.06, 95% CI 0.31-3.64). CONCLUSION Among patients with STEMI who underwent primary PCI, BP-DES and DP-DES implantation was associated with similar long-term clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Chi-Hang Lee
- National University Heart Center, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mark Y Chan
- National University Heart Center, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Adrian F Low
- National University Heart Center, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Edgar L Tay
- National University Heart Center, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Huay Cheem Tan
- National University Heart Center, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua P Loh
- National University Heart Center, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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8
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Ploumen EH, Buiten RA, Zocca P, Doggen CJM, Jessurun GAJ, Schotborgh CE, Roguin A, Danse PW, Benit E, Aminian A, Anthonio RL, Somi S, Linssen GCM, Hartmann M, Kok MM, von Birgelen C. Acute myocardial infarction treated with novel Resolute Onyx and Orsiro stents in the randomized BIONYX trial. Catheter Cardiovasc Interv 2021; 98:E188-E196. [PMID: 33694294 PMCID: PMC8451772 DOI: 10.1002/ccd.29594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/01/2021] [Accepted: 02/19/2021] [Indexed: 01/23/2023]
Abstract
Objectives To compare 2‐year outcome following treatment with drug‐eluting stents (DES) for acute myocardial infarction (MI) versus non‐MI clinical syndromes. In acute MI patients, a stent‐level comparison was performed, comparing Resolute Onyx versus Orsiro stents. Background In patients presenting with acute MI, higher adverse event rates have been reported. So far, no clinical results >1 year have been published of acute MI patients treated with Resolute Onyx. Methods This post‐hoc analysis of the randomized BIONYX trial(NCT02508714) assessed the main outcome target vessel failure (TVF: cardiac death, target vessel MI, or target vessel revascularization) with Kaplan–Meier methods. Results Of all 2,488 trial participants, acute MI patients (n = 1,275[51.2%]) were significantly younger and had less comorbidities than non‐MI patients (n = 1,213[48.8%]). TVF rates were lower in acute MI patients (77/1,275[6.1%] vs. 103/1,213[8.6%], HR:0.70, 95%‐CI 0.52–0.94; plog‐rank = 0.02), mainly driven by target vessel revascularization (4.1 vs. 6.1%, plog‐rank = 0.03). Multivariate analysis showed no independent association of clinical syndrome with TVF (adjusted‐HR: 0.81, 95%‐CI 0.60–1.10; p = .17). In MI patients treated with Resolute Onyx (n = 626) versus Orsiro (n = 649), there was no difference in TVF (6.2 vs. 6.1%; plog‐rank = 0.97) and its components. There was only 1(0.2%) definite‐or‐probable stent thrombosis in RO‐ZES and 8(1.2%) in O‐SES (p = .053). Conclusions Two years after treatment with thin‐strut DES in this randomized trial, patients treated for acute MI had lower adverse event rates than non‐MI patients. Yet, these findings were mainly attributable to between‐group differences in patient and lesion characteristics. In patients who underwent PCI for acute MI, both Resolute Onyx and Orsiro showed favorable and similar 2‐year outcomes.
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Affiliation(s)
- Eline H Ploumen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.,Department of Health Technology and Services Research, Faculty BMS, Technical Medical Center, University of Twente, Enschede, The Netherlands
| | - Rosaly A Buiten
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.,Department of Health Technology and Services Research, Faculty BMS, Technical Medical Center, University of Twente, Enschede, The Netherlands
| | - Paolo Zocca
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Carine J M Doggen
- Department of Health Technology and Services Research, Faculty BMS, Technical Medical Center, University of Twente, Enschede, The Netherlands
| | - Gillian A J Jessurun
- Department of Cardiology, Treant Zorggroep, Scheper Hospital, Emmen, The Netherlands
| | | | - Ariel Roguin
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera and B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa, Israel
| | - Peter W Danse
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Edouard Benit
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Adel Aminian
- Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium
| | - Rutger L Anthonio
- Department of Cardiology, Treant Zorggroep, Scheper Hospital, Emmen, The Netherlands
| | - Samer Somi
- Department of Cardiology, Haga Hospital, The Hague, The Netherlands
| | - Gerard C M Linssen
- Department of Cardiology, Hospital Group Twente, Almelo and Hengelo, Almelo, The Netherlands
| | - Marc Hartmann
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Marlies M Kok
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.,Department of Health Technology and Services Research, Faculty BMS, Technical Medical Center, University of Twente, Enschede, The Netherlands
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9
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One-Year COMBO Stent Outcomes in Acute Coronary Syndrome: from the COMBO Collaboration. Cardiovasc Drugs Ther 2021; 35:309-320. [PMID: 33515411 DOI: 10.1007/s10557-020-07087-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The COMBO biodegradable polymer sirolimus-eluting stent includes endothelial progenitor cell capture (EPC) technology for rapid endothelialization, which may offer advantage in acute coronary syndromes (ACS). We sought to analyze the performance of the COMBO stent by ACS status and ACS subtype. METHODS The COMBO collaboration (n = 3614) is a patient-level pooled dataset from the MASCOT and REMEDEE registries. We evaluated outcomes by ACS status, and ACS subtype in patients with ST segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) versus unstable angina (UA). The primary endpoint was 1-year target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Secondary outcomes included stent thrombosis (ST). RESULTS We compared 1965 (54%) ACS and 1649 (46.0%) non-ACS patients. ACS presentations included 40% (n = 789) STEMI, 31% (n = 600) NSTEMI, and 29% (n = 576) UA patients. Risk of 1-year TLF was greater in ACS patients (4.5% vs. 3.3%, HR 1.51 95% CI 1.01-2.25, p = 0.045) without significant differences in definite/probable ST (1.1% vs 0.5%, HR 2.40, 95% CI 0.91-6.31, p = 0.08). One-year TLF was similar in STEMI, NSTEMI, and UA (4.8% vs 4.8% vs. 3.7%, p = 0.60), but definite/probable ST was higher in STEMI patients (1.9% vs 0.5% vs 0.7%, p = 0.03). Adjusted outcomes were not different in MI versus UA patients. CONCLUSIONS Despite the novel EPC capture technology, COMBO stent PCI was associated with somewhat greater risk of 1-year TLF in ACS than in non-ACS patients, without significant differences in stent thrombosis. No differences were observed in 1-year TLF among ACS subtypes.
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Gherbesi E, Danzi GB. The Ultimaster coronary stent system: 5-year worldwide experience. Future Cardiol 2020; 16:251-261. [DOI: 10.2217/fca-2019-0093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Newer generation drug-eluting stents have significantly improved outcomes in patients undergoing percutaneous coronary intervention by reducing the risk of restenosis and stent thrombosis. In comparison with first-generation ones, contemporary drug-eluting stents have thinner struts and more biocompatible polymers, which reduce inflammation, promote endothelialization and decrease neointimal proliferation. The Ultimaster™/Ultimaster™ Tansei™ coronary stent system is a cobalt–chromium, biodegradable polymer, sirolimus-eluting stent (Terumo, Tokyo, Japan) that received the Conformitè Européenne mark approval for clinical use in 2014/2018. This device has been the object of intense clinical evaluation in controlled randomized studies and observational registries. In this article, we analytically reviewed the available clinical data with a focus on the latest real-world evidence that demonstrates excellent performance in all of the clinical subsets.
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Affiliation(s)
- Elisa Gherbesi
- Department of Cardiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
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11
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Gao C, Wang R, Sharif F, Takahashi K, Ono M, Hara H, Tomaniak M, Kawashima H, Modolo R, van Geuns RJM, Capodanno D, Byrne RA, Wijns W, Onuma Y, Serruys PW. The year in review: coronary interventions. EUROINTERVENTION 2020; 15:1534-1547. [DOI: 10.4244/eij-d-19-01124] [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: 01/09/2023]
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12
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Iñiguez A, Chevalier B, Richardt G, Neylon A, Jiménez VA, Kornowski R, Carrie D, Moreno R, Barbato E, Serra‐Peñaranda A, Guiducci V, Valdés‐Chávarri M, Yajima J, Wijns W, Saito S. Comparison of long-term clinical outcomes in multivessel coronary artery disease patients treated either with bioresoarbable polymer sirolimus-eluting stent or permanent polymer everolimus-eluting stent: 5-year results of the CENTURY II randomized clinical trial. Catheter Cardiovasc Interv 2020; 95:175-184. [PMID: 31033154 PMCID: PMC7064960 DOI: 10.1002/ccd.28224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/30/2019] [Accepted: 03/23/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To assess the long-term safety and efficacy of a sirolimus-eluting stent with bioresorbable polymer (BP-SES; Ultimaster), in comparison to a benchmark everolimus-eluting, permanent polymer stent (PP-EES; Xience), in a prespecified subgroup of patients with multivessel coronary artery disease (MVD) enrolled in the CENTURY II trial. BACKGROUND The use of coronary stenting in high-risk subgroups, like MVD patients, is rising. The clinical evidence, including long-term comparative analysis of the efficacy and safety benefits of different new-generation drug eluting stents, however, remains insufficient. METHODS Among 1,119 patients (intention-to-treat) enrolled in the CENTURY II prospective, randomized, single-blind, multicenter trial, a prespecified subgroup of 456 MVD patients were allocated by stratified randomization to treatment with BP-SES (n = 225) or PP-EES (n = 231). The previously reported primary endpoint of this study was freedom from target lesion failure (TLF: a composite of cardiac death, target vessel-related myocardial infarction [MI] and clinically-indicated target lesion revascularization) at 9 months. RESULTS In this MVD substudy, baseline patient, lesion and procedure characteristics were similar between the treatment arms. At 1 and 5 years, both BP-SES and PP-EES displayed low and comparable rates of TLF (5.3 vs. 7.8%; p = .29 and 10.2 vs. 13.4%; p = .29), and definite or probable stent thrombosis (0.4 vs. 1.3%; p = .33 and 0.9 vs. 1.7%; p = .43), respectively. Composite endpoint of cardiac death and MI, and patient-oriented composite endpoint of any death, MI, and coronary revascularizations were also similar. CONCLUSIONS These results confirm good long-term safety and efficacy of the studied bioresorbable polymer stent in this high-risk patient population.
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Affiliation(s)
- Andrés Iñiguez
- Cardiology DepartmentHospital Alvaro Cunqueiro, University Hospital of VigoVigoSpain
| | - Bernard Chevalier
- Interventional Cardiology DepartmentInstitut Cardiovasculaire Paris SudMassyFrance
| | - Gert Richardt
- Department of CardiologySegeberger KlinikenBad SegebergGermany
| | - Antoinette Neylon
- SAOLTA Health Care Group, Galway University Hospital and NUIGalwayIreland
| | - Victor A. Jiménez
- Cardiology DepartmentHospital Alvaro Cunqueiro, University Hospital of VigoVigoSpain
| | - Ran Kornowski
- Cardiology DepartmentRabin Medical Centre, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael
| | - Didier Carrie
- Department of CardiologyRangueil University HospitalToulouseFrance
| | - Raul Moreno
- Interventional Cardiology DepartmentLa Paz University HospitalMadridSpain
| | - Emanuele Barbato
- Cardiovascular Centre, Onze Lieve Vrouwe Ziekenhuis, Aalst, Belgium and Division of Cardiology, Department of Advanced Biomedical SciencesUniversity of Naples Federico IINaplesItaly
| | - Antoni Serra‐Peñaranda
- Cardiology DepartmentHospital de la Santa Creu i Sant Pau, IIB‐SantPau, CIBERCV, Universidad Autónoma de BarcelonaBarcelonaSpain
| | - Vincenzo Guiducci
- Interventional Cardiology Unit, S. Maria Nuova HospitalReggio EmiliaItaly
| | - Mariano Valdés‐Chávarri
- Cardiology Department, Hospital Universitario Virgen de la Arrixaca, IMIB‐ArrixacaMurciaSpain
| | - Junji Yajima
- Department of Cardiovascular Medicine, The Cardiovascular InstituteTokyoJapan
| | | | - Shigeru Saito
- Department of Cardiology and Catheterization LaboratoryShonan Kamakura General HospitalKamakuraJapan
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Chevalier B. Primary PCI. J Am Coll Cardiol 2019; 74:2585-2587. [DOI: 10.1016/j.jacc.2019.09.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
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Moscarella E, Ielasi A, Beneduce A, Ferrante G, Pivato AC, Chiarito M, Cappelletti A, Perfetti G, Magni V, Prati E, Falcone S, Pierri A, De Martini S, Montorfano M, Parisi R, Rutigliano D, Locuratolo N, Anzuini A, Calabrò P, Tespili M, Margonato A, Benassi A, Briguori C, Fabbiocchi F, Reimers B, Bartorelli A, Colombo A, Godino C. One‐year clinical outcome of biodegradable polymer sirolimus‐eluting stent in patients presenting with acute myocardial infarction: Insight from the ULISSE registry. Catheter Cardiovasc Interv 2019; 94:972-979. [DOI: 10.1002/ccd.28305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/19/2019] [Accepted: 04/10/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Elisabetta Moscarella
- Department of Translational Medical SciencesUniversity of Campania Caserta Italy
- Cardiology Unit, Ospedale “Sant'Anna e San Sebastiano” Caserta Italy
| | - Alfonso Ielasi
- Cardiology Unit, Ospedale Bolognini, ASST Bergamo Est Seriate Italy
- Clinical and Interventional Cardiology UnitSant'Ambrogio Cardio‐Thoracic Center Milan Italy
| | | | | | | | - Mauro Chiarito
- Interventional Cardiology Unit, Ospedale Humanitas Rozzano Italy
| | | | | | | | | | - Stefania Falcone
- Cardiology Unit, Ospedale Humanitas Mater Domini Castellanza Italy
| | - Adele Pierri
- Cardiology Unit, Clinica Mediterranea Naples Italy
| | | | | | - Rosario Parisi
- Cardiology Unit, Ospedali Riuniti Marche Nord Pesaro Italy
| | | | | | - Angelo Anzuini
- Cardiology Unit, Ospedale Humanitas Mater Domini Castellanza Italy
| | - Paolo Calabrò
- Department of Translational Medical SciencesUniversity of Campania Caserta Italy
- Cardiology Unit, Ospedale “Sant'Anna e San Sebastiano” Caserta Italy
| | - Maurizio Tespili
- Cardiology Unit, Ospedale Bolognini, ASST Bergamo Est Seriate Italy
- Clinical and Interventional Cardiology UnitSant'Ambrogio Cardio‐Thoracic Center Milan Italy
| | | | | | | | | | - Bernhard Reimers
- Interventional Cardiology Unit, Ospedale Humanitas Rozzano Italy
| | | | | | - Cosmo Godino
- Cardiology Unit, Ospedale San Raffaele Milan Italy
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Sabaté M. The MASTER trial: a new version of the oculostenotic reflex. EUROINTERVENTION 2019; 14:e1806-e1808. [PMID: 30956178 DOI: 10.4244/eijv14i18a316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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