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Jeong YJ, Hyun J, Lee J, Kim JH, Yang Y, Choe K, Lee JS, Park H, Cho SC, Kang DY, Lee PH, Ahn JM, Park DW, Park SJ. Comparison of Contemporary Drug-Eluting Stents in Patients Undergoing Complex High-Risk Indicated Procedures. JACC Asia 2022; 2:182-193. [PMID: 36339122 PMCID: PMC9627895 DOI: 10.1016/j.jacasi.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/04/2021] [Accepted: 10/18/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Limited data are available on the relative performances of diverse contemporary drug-eluting stents (DES) in patients undergoing complex high-risk indicated procedures (CHIP). OBJECTIVES The purpose of this study was to evaluate the comparative effectiveness of contemporary second-generation DES for CHIP patients in "real-world" settings. METHODS Of 28,843 patients enrolled in the IRIS-DES registry, a total of 6,645 patients with CHIP characteristics who received 5 different types of contemporary DES were finally included: 3,752 with cobalt-chromium everolimus-eluting stents (CoCr-EES), 1,258 with Resolute zotarolimus-eluting stents (Re-ZES), 864 with platinum-chromium EES (PtCr-EES), 437 with ultrathin strut biodegradable-polymer sirolimus-eluting stents (UT-SES), and 334 with bioresorbable polymer SES (BP-SES). The primary outcome was target-vessel failure (a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization) at 12 months. RESULTS At 12 months, the rate of target-vessel failure was highest in the CoCr-EES (7.1%) group; intermediate in the Re-ZES (5.0%), PtCr-EES (4.6%), and BP-SES (4.2%) groups; and lowest in the UT-SES (3.8%) group (overall long-rank P = 0.001). In multiple-treatment propensity-score analysis, the adjusted hazard ratios (HRs) for target-vessel failure were significantly lower in the Re-ZES (HR: 0.71; 95% confidence interval [CI]: 0.52-0.97), the UT-SES (HR: 0.52; 95% CI: 0.29-0.95), and BP-SES (HR: 0.33; 95% CI: 0.16-0.70) groups than in the CoCr-EES group (referent). CONCLUSIONS In this contemporary PCI registry, we observed the differential risks of target-vessel failure according to various types of contemporary DES in patients with CHIP characteristics. However, owing to inherent selection bias, the results should be considered hypothesis-generating, highlighting the need for further randomized trials. (Evaluation of the First, Second, and New Drug-Eluting Stents in Routine Clinical Practice [IRIS-DES]; NCT01186133).
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Affiliation(s)
- Yeong Jin Jeong
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Junho Hyun
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Junghoon Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ju Hyeon Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yujin Yang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyungjin Choe
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ji Sung Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hanbit Park
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Cheol Cho
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Do-Yoon Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Pil Hyung Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung-Min Ahn
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Duk-Woo Park
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Jung Park
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Park JH, Lee CH, Cho YK, Yoon HJ, Nam CW, Park JS, Kim KS, Park HS, Lee BR, Shin ES, Bae JH, Kim YD, Hur SH. Clinical Impact of Lesion Complexity on 2-Year Outcomes After Zotarolimus-Eluting Stents Implantation. JACC Asia 2021; 1:332-341. [PMID: 36341214 PMCID: PMC9627827 DOI: 10.1016/j.jacasi.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND The clinical efficacy and safety of second-generation drug-eluting stents in complex percutaneous coronary interventions (PCIs) are not well established. OBJECTIVES The clinical influence of the lesion complexity after PCI with zotarolimus-eluting stents (ZES) was evaluated. METHODS From a prospective multicenter observational study, a total of 926 patients that underwent successful PCIs with ZES were included. Complex PCIs were defined as patients with ≥3 lesions treated, 3 vessels treated, severe calcified lesions, bifurcated lesions with 2 stents implanted, left main disease, chronic total occlusion lesions, and/or diffuse long (total stent length ≥60 mm) lesions and were compared to the noncomplex group. The primary outcome was incidence of target lesion failures at 2 years, defined as a composite of cardiac death, target lesion-myocardial infarctions, and target lesion revascularization. RESULTS The patients were divided into complex PCI (n = 249) and noncomplex (n = 677) groups. In the complex PCI group, the 2-year risk of a target lesion failure was not significantly higher than in the noncomplex PCI group (4.8% vs 3.7%; adjusted hazard ratio: 1.373; 95% confidence interval: 0.689-2.738; P = 0.367). The same trend was observed for all composites of the clinical outcomes. Older age and advanced chronic kidney disease were independent predictors for the primary outcome. CONCLUSIONS Up to 2 years after a ZES implantation, the clinical outcomes did not differ according to lesion complexity.
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Key Words
- CKD, chronic kidney disease
- DES, drug-eluting stent(s)
- IVUS, intravascular ultrasound
- MACE, major adverse cardiac events
- MI, myocardial infarction
- OCT, optical coherence tomography
- PCI, percutaneous coronary intervention
- TLF, target lesion failure
- TLR, target lesion revascularization
- ZES, zotarolimus-eluting stent(s)
- complex percutaneous coronary artery intervention
- coronary artery disease
- drug-eluting stents
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Affiliation(s)
- Jung-Ho Park
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Cheol Hyun Lee
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Yun-Kyeong Cho
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Hyuck-Jun Yoon
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Chang-Wook Nam
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Jong Seon Park
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Kee-Sik Kim
- Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, South Korea
| | - Hun Sik Park
- Division of Cardiology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
| | - Bong-Ryeol Lee
- Division of Cardiology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Eun-Seok Shin
- Division of Cardiology, Department of Internal Medicine, Ulsan University Hospital, Seoul, South Korea
| | - Jang-Ho Bae
- Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Nonsan, South Korea
| | - Young Dae Kim
- Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - Seung-Ho Hur
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
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Tanaka K, Okamura A, Iwamoto M, Watanabe S, Nagai H, Sumiyoshi A, Suzuki S, Tanaka H, Koyama Y, Iwakura K, Fujii K. Wire Cutting Method Using Rotational Atherectomy for Stretched Spring Wire During Coronary Intervention. JACC Case Rep 2021; 3:1842-8. [PMID: 34917965 DOI: 10.1016/j.jaccas.2021.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022]
Abstract
During removal of an entrapped guidewire, the core wire can fracture, allowing stretching of the spring wire while the distal guidewire is still entrapped. We resolved this issue with rotational atherectomy, allowing cutting of the spring wire at the intended site, regardless of the proximal spring wire fracture. (Level of Difficulty: Advanced.)
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Yang Y, Hyun J, Lee J, Kim JH, Lee JB, Kang DY, Lee PH, Ahn JM, Park DW, Park SJ. Effectiveness and Safety of Contemporary Drug-Eluting Stents in Patients With Diabetes Mellitus. JACC Asia 2021; 1:173-184. [PMID: 36338165 PMCID: PMC9627859 DOI: 10.1016/j.jacasi.2021.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/30/2021] [Accepted: 07/12/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is a well-known risk factor for adverse cardiovascular events in patients receiving percutaneous coronary intervention (PCI). Limited data are available on the relative performance of different types of contemporary drug-eluting stents (DES) for diabetic patients. OBJECTIVES The authors investigated the effectiveness and safety profiles of several contemporary DES in patients with DM in a "real-world" clinical setting. METHODS Among 24,516 patients enrolled in a multicenter, prospective registry, 7,823 patients with DM were treated with 4 contemporary DES: 2,877 with a cobalt chromium everolimus-eluting stent (EES), 789 with a biodegradable polymer biolimus-eluting stent, 2,286 with a platinum chromium-EES, and 1,871 with a Resolute zotarolimus-eluting stent. The primary outcome was target vessel failure (TVF) (a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization). RESULTS The median follow-up duration was 2.9 years. Observed 3-year rates of TVF were not significantly different according to different DES types. On multigroup propensity-score analysis, the adjusted HRs for TVF were similar in between-group comparisons: biodegradable polymer biolimus-eluting stent (HR: 0.94; 95% CI: 0.76-1.16; P = 0.57), platinum chromium-EES (HR: 0.94; 95% CI: 0.81-1.09; P = 0.41), and Resolute zotarolimus-eluting stent (HR: 1.01; 95% CI: 0.86-1.18; P = 0.93) compared with the cobalt chromium-EES (reference). This trend was maintained in patients with non-insulin- and insulin-treated DM. CONCLUSIONS In this multicenter clinical-practice PCI registry, no significant between-group differences were found for a 3-year risk of TVF in patients with DM undergoing PCI with various types of contemporary DES. (Evaluation of the First, Second, and New Drug-Eluting Stents in Routine Clinical Practice [IRIS-DES]; NCT01186133).
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Key Words
- DES, drug-eluting stent(s)
- DM, diabetes mellitus
- HbA1c, glycosylated hemoglobin
- MACE, major adverse cardiovascular event(s)
- MI, myocardial infarction
- PCI, percutaneous coronary intervention
- PES, paclitaxel-eluting stent(s)
- SES, sirolimus-eluting stent(s)
- TVF, target vessel failure
- TVR, target vessel revascularization
- coronary artery disease
- diabetes mellitus
- drug-eluting stent
- percutaneous coronary intervention
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Affiliation(s)
- Yujin Yang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Junho Hyun
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Junghoon Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ju Hyeon Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeong Bok Lee
- Division of Clinical Epidemiology and Biostatistics, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Do-Yoon Kang
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Pil Hyung Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung-Min Ahn
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Duk-Woo Park
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seung-Jung Park
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Avadhani SA, Kamran H, Farhan S, Tarricone A, Krishnan P. Aneurysmal Dilatation of the Superficial Femoral Artery After Endovascular Intervention. JACC Case Rep 2021; 3:425-426. [PMID: 34317550 PMCID: PMC8311142 DOI: 10.1016/j.jaccas.2021.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Abstract
A patient with occlusion of the left superficial femoral artery (SFA) underwent endovascular intervention. Six-month follow-up angiography revealed aneurysmal dilatation of the previously stented artery. This finding may be a result of maladaptive vascular remodeling or arterial injury resulting in aneurysmal dilatation secondary to subintimal crossing, atherectomy, and paclitaxel therapies. (Level of Difficulty: Beginner.)
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Affiliation(s)
- Sriya A Avadhani
- Mount Sinai Heart, Mount Sinai Medical Center, New York, New York, USA
| | - Haroon Kamran
- Mount Sinai Heart, Mount Sinai Medical Center, New York, New York, USA
| | - Serdar Farhan
- Mount Sinai Heart, Mount Sinai Medical Center, New York, New York, USA
| | - Arthur Tarricone
- Mount Sinai Heart, Mount Sinai Medical Center, New York, New York, USA
| | - Prakash Krishnan
- Mount Sinai Heart, Mount Sinai Medical Center, New York, New York, USA
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Lee JM, Lee SH, Shin D, Choi KH, van de Hoef TP, Kim HK, Samady H, Kakuta T, Matsuo H, Koo BK, Fearon WF, Escaned J. Physiology-Based Revascularization: A New Approach to Plan and Optimize Percutaneous Coronary Intervention. JACC Asia 2021; 1:14-36. [PMID: 36338358 PMCID: PMC9627934 DOI: 10.1016/j.jacasi.2021.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 06/12/2023]
Abstract
Coronary physiological assessment using fractional flow reserve or nonhyperemic pressure ratios has become a standard of care for patients with coronary atherosclerotic disease. However, most evidence has focused on the pre-interventional use of physiological assessment to aid revascularization decision-making, whereas post-interventional physiological assessment has not been well established. Although evidence for supporting the role of post-interventional physiological assessment to optimize immediate revascularization results and long-term prognosis has been reported, a more thorough understanding of these data is crucial in incorporating post-interventional physiological assessment into daily practice. Recent scientific efforts have also focused on the potential role of pre-interventional fractional flow reserve or nonhyperemic pressure ratio pullback tracings to characterize patterns of coronary atherosclerotic disease to better predict post-interventional physiological outcomes, and thereby identify the appropriate revascularization target. Pre-interventional pullback tracings with dedicated post-processing methods can provide characterization of focal versus diffuse disease or major gradient versus minor gradient stenosis, which would result in different post-interventional physiological results. This review provides a comprehensive look at the current evidence regarding the evolving role of physiological assessment as a functional optimization tool for the entire process of revascularization, and not merely as a pre-interventional tool for revascularization decision-making.
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Key Words
- CI, confidence interval
- DES, drug-eluting stent(s)
- FFR, fractional flow reserve
- HR, hazard ratio
- MACE, major adverse cardiac event(s)
- NHPR, nonhyperemic pressure ratio
- PCI, percutaneous coronary intervention
- TVF, target vessel failure
- VOCE, vessel-related composite event
- fractional flow reserve
- iFR, instantaneous wave-free ratio
- instantaneous wave-free ratio
- nonhyperemic pressure ratios
- percutaneous coronary intervention
- prognosis
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Affiliation(s)
- Joo Myung Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seung Hun Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Doosup Shin
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Ki Hong Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tim P. van de Hoef
- Department of Clinical and Experimental Cardiology, Amsterdam UMC–University of Amsterdam, Amsterdam, the Netherlands
| | - Hyun Kuk Kim
- Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, University of Chosun College of Medicine, Gwangju, Republic of Korea
| | - Habib Samady
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Tsunekazu Kakuta
- Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - William F. Fearon
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Javier Escaned
- Hospital Clínico San Carlos, IDISSC, and Universidad Complutense de Madrid, Madrid, Spain
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Choi KH, Song YB, Lee JM, Park TK, Yang JH, Hahn JY, Choi JH, Choi SH, Kim HS, Chun WJ, Hur SH, Han SH, Rha SW, Chae IH, Jeong JO, Heo JH, Yoon J, Lim DS, Park JS, Hong MK, Doh JH, Cha KS, Kim DI, Lee SY, Chang K, Hwang BH, Choi SY, Jeong MH, Hong SJ, Nam CW, Koo BK, Gwon HC. Differential Long-Term Effects of First- and Second-Generation DES in Patients With Bifurcation Lesions Undergoing PCI. JACC Asia 2021; 1:68-79. [PMID: 36338362 PMCID: PMC9627880 DOI: 10.1016/j.jacasi.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is a paucity of data regarding the long-term clinical outcomes of first- versus second-generation drug-eluting stent (DES), especially when used to treat complex lesions such as bifurcation lesions. OBJECTIVES The current study compares the efficacy and safety of first- versus second-generation DES at the 5-year follow-up in patients who underwent bifurcation percutaneous coronary intervention (PCI). METHODS A total of 5,498 patients with a bifurcation lesion who underwent PCI were pooled at a single patient level from COBIS (Coronary Bifurcation Stenting) registries II and III. Five-year target lesion failure (TLF) (the composite of cardiac death, myocardial infarction [MI], and target lesion revascularization [TLR]) and cardiac death or MI were compared between the use of first-generation DES (n = 2,436) and second-generation DES (n = 3,062) during PCI. Propensity score matching was performed to reduce selection bias. RESULTS After a 1:1 propensity score matching procedure was conducted, the cohort consisted of 1,702 matched pairs. Patients treated with second-generation DES had a significantly lower risk of TLF at 5 years than those treated with first-generation DES in both overall and propensity-matched populations (matched hazard ratio [HRmatched]: 0.576; 95% confidence interval [CI]: 0.456 to 0.727; p <0.001). There were no significant differences in risk of a composite of cardiac death or MI between the 2 groups (HRmatched: 0.782; 95% CI: 0.539 to 1.133, P = 0.193). However, among patients who required a 2-stent technique, use of the second-generation DES reduced cardiac death or MI (HRmatched:0.422; 95% CI: 0.209 to 0.851, P = 0.016). On the other hand, among patients who required a one-stent technique, the risk of a composite of cardiac death or MI was similar between the 2 groups (HRmatched: 1.046; 95% CI: 0.664 to 1.650, P = 0.845). There was a significant interaction between stent generation and treatment strategy for cardiac death or MI (interaction P = 0.029). CONCLUSIONS In patients treated with PCI for a bifurcation lesion, the use of second-generation DES was associated with a significantly reduced risk of 5-year TLF than the use of first-generation DES. (Korean Coronary Bifurcation Stenting Registry II [NCT01642992]; COBIS II) (Korean Coronary Bifurcation Stenting Registry III [NCT03068494] COBIS III).
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Affiliation(s)
- Ki Hong Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Bin Song
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joo Myung Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Taek Kyu Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joo-Yong Hahn
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin-Ho Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seung-Hyuk Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Woo Jung Chun
- Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Seung-Ho Hur
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Seung Hwan Han
- Division of Cardiology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Seung-Woon Rha
- Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - In-Ho Chae
- Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
| | - Jin-Ok Jeong
- Division of Cardiology, Department of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jung Ho Heo
- Division of Cardiology, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
| | - Junghan Yoon
- Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Do-Sun Lim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jong-Seon Park
- Division of Cardiology, Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Myeong-Ki Hong
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joon-Hyung Doh
- Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Kwang Soo Cha
- Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Doo-Il Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Goyang, Republic of Korea
| | - Sang Yeub Lee
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung-Hee Hwang
- Division of Cardiology, Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Yeon Choi
- Division of Cardiology, Department of Internal Medicine, Ajou University Hospital, Suwon, Republic of Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Soon-Jun Hong
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Chang-Wook Nam
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Bon-Kwon Koo
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeon-Cheol Gwon
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Gupta A, Datta R, Chhikara S, Dhagat PK, Vijayvergiya R. Coronary Artery Aneurysm After Drug-Eluting Stent Implantation Causing Coronary-Bronchial Fistula. JACC Case Rep 2020; 2:1692-1697. [PMID: 34317036 PMCID: PMC8312138 DOI: 10.1016/j.jaccas.2020.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022]
Abstract
Coronary artery aneurysm (CAA) after drug-eluting stent implantation is rare, with a reported incidence of 0.3% to 6.0%. Most of these aneurysms are asymptomatic. Hemoptysis as a presentation of CAA is very rare. The patient in our case had CAA after zotarolimus-eluting stent implantation and presented with hemoptysis resulting from a leaking coronary-bronchial fistula. (Level of Difficulty: Intermediate.).
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Key Words
- BMS, bare metal stent(s)
- CAA, coronary artery aneurysm
- CT, computed tomography
- DES, drug-eluting stent(s)
- ECG, electrocardiogram
- LA, left atrial
- LAD, left anterior descending
- LCX, left circumflex
- LM, left main (coronary artery)
- LV, left ventricular
- NC, noncompliant
- PCI, percutaneous coronary intervention
- complication
- coronary angiography
- percutaneous coronary intervention
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Affiliation(s)
- Ankush Gupta
- Department of Cardiology, Base Hospital Delhi Cantt, New Delhi, India
| | - Rajat Datta
- Department of Cardiology, Army Hospital Research and Referral, New Delhi, India
| | - Sanya Chhikara
- Department of Cardiology, Base Hospital Delhi Cantt, New Delhi, India
| | - Peeyush K. Dhagat
- Department of Radiology, Base Hospital Delhi Cantt, New Delhi, India
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Singh G, Schreiter NA, Schreiter SW. Widowmaker Right Coronary Artery Treated With Drug-Eluting Stent Implantation. JACC Case Rep 2019; 1:421-423. [PMID: 34316843 PMCID: PMC8288789 DOI: 10.1016/j.jaccas.2019.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/17/2019] [Accepted: 07/10/2019] [Indexed: 11/15/2022]
Abstract
We present a case of a single coronary artery system arising from the right sinus of Valsalva found to have an obstructive mid-vessel lesion with functional evidence of ischemia on stress testing. She was treated with a first-generation Cypher (Cordis, Johnson & Johnson, Hialeah, Florida) drug-eluting stent and remains asymptomatic at 14-year follow-up. (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Gurpreet Singh
- Department of Cardiovascular Medicine, Mayo Clinic Health Systems, Eau Claire, Wisconsin
| | - Nicholas A Schreiter
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Steven W Schreiter
- Department of Cardiovascular Medicine, Mayo Clinic Health Systems, Eau Claire, Wisconsin
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Vanags LZ, Tan JT, Galougahi KK, Schaefer A, Wise SG, Murphy A, Ali ZA, Bursill CA. Apolipoprotein A-I Reduces In-Stent Restenosis and Platelet Activation and Alters Neointimal Cellular Phenotype. JACC Basic Transl Sci 2018; 3:200-209. [PMID: 30062205 PMCID: PMC6060078 DOI: 10.1016/j.jacbts.2017.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/20/2017] [Accepted: 11/13/2017] [Indexed: 11/04/2022]
Abstract
Even the most advanced drug-eluting stents evoke unresolved issues, including chronic inflammation, late thrombosis, and neoatherosclerosis. This highlights the need for novel strategies that improve stent biocompatibility. Our studies show that apolipoprotein A-I (apoA-I) reduces in-stent restenosis and platelet activation, and enhances endothelialization. These findings have therapeutic implications for improving stent biocompatibility.
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Key Words
- ABCA1, ATP-binding cassette transporter A1
- CAD, coronary artery disease
- DES, drug-eluting stent(s)
- HDL, high-density lipoprotein
- PBS, phosphate-buffered saline
- PCI, percutaneous coronary intervention
- PPAR, peroxisome proliferator-activated receptor
- SMC, smooth muscle cell
- apoA-I, apolipoprotein A-I
- apoE−/−, apolipoprotein E deficient
- apolipoprotein A-I
- endothelialization
- neointimal hyperplasia
- platelet activation
- rHDL, reconstituted high- density lipoprotein
- stent biocompatibility
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Affiliation(s)
- Laura Z. Vanags
- Immunobiology Group, The Heart Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Joanne T.M. Tan
- Immunobiology Group, The Heart Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Keyvan K. Galougahi
- Center for Interventional Vascular Therapy, Columbia University, New York, New York
- Cardiovascular Research Foundation, New York, New York
| | - Andreas Schaefer
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Steven G. Wise
- Immunobiology Group, The Heart Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Andrew Murphy
- Haematopoiesis and Leukocyte Biology Group, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Immunology, Monash University, Melbourne, Australia
| | - Ziad A. Ali
- Center for Interventional Vascular Therapy, Columbia University, New York, New York
- Cardiovascular Research Foundation, New York, New York
| | - Christina A. Bursill
- Immunobiology Group, The Heart Research Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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Sosa A, Chao H, Guerra A, Han H, Christopoulos G, Christakopoulos GE, Tarar MNJ, de Lemos JA, Obel O, Addo T, Roesle M, Haagen D, Rangan BV, Banerjee S, Brilakis ES. Paclitaxel-eluting vs. bare metal stent implantation in saphenous vein graft lesions: Very long-term follow-up of the SOS (Stenting of Saphenous vein grafts) trial. Int J Cardiol 2015; 186:261-3. [PMID: 25828130 DOI: 10.1016/j.ijcard.2015.03.267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 03/19/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Alan Sosa
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Howard Chao
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Andres Guerra
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Henry Han
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Georgios Christopoulos
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Georgios E Christakopoulos
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Muhammad Nauman J Tarar
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - James A de Lemos
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Owen Obel
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Tayo Addo
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Michele Roesle
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Donald Haagen
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Bavana V Rangan
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Subhash Banerjee
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - Emmanouil S Brilakis
- VA North Texas Health Care System, University of Texas Southwestern Medical School, Dallas, TX, United States.
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