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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/29030347/extracellular-matrix-proteomics-reveals-interplay-of-aggrecan-and-aggrecanases-in-vascular-remodeling-of-stented-coronary-arteries
#1
Gonca Suna, Wojciech Wojakowski, Marc Lynch, Javier Barallobre-Barreiro, Xiaoke Yin, Ursula Mayr, Ferheen Baig, Ruifang Lu, Marika Fava, Robert Hayward, Chris Molenaar, Stephen J White, Tomasz Roleder, Krzysztof Milewski, Pawel Gasior, Piotr P Buszman, Pawel E Buszman, Marjan Jahangiri, Cathy Shanahan, Jonathan M Hill, Manuel Mayr
Background -Extracellular matrix (ECM) remodeling contributes to in-stent restenosis and thrombosis. Despite its important clinical implications little is known about ECM changes post-stent implantation. Methods -Bare-metal (BMS) and drug-eluting stents (DES) were implanted in pig coronary arteries with an overstretch under optical coherence tomography guidance. Stented segments were harvested 1, 3, 7, 14 and 28 days post-stenting for proteomics analysis of the media and neointima. Results -A total of 151 ECM and ECM-associated proteins were identified by mass spectrometry...
October 13, 2017: Circulation
https://www.readbyqxmd.com/read/29027735/temporal-trends-in-percutaneous-coronary-interventions-thru-the-drug-eluting-stent-era-insights-from-18-641-procedures-performed-over-12-year-period
#2
Uri Landes, Tamir Bental, Amos Levi, Abid Assali, Hana Vaknin-Assa, Eli I Lev, Eldad Rechavia, Gabriel Greenberg, Katia Orvin, Ran Kornowski
BACKGROUND: The last decade, regarded as the DES era in PCI, has witnessed significant advances in the management of coronary disease. We aimed to assess temporal trends in the practice and outcome of percutaneous coronary intervention (PCI) during the drug eluting stent (DES) era. METHODS: We analyzed 18,641 consecutive PCI's performed between January 2004 and December 2016, distinguished by procedural date (Q1 : 2004-2006, n = 4,865; Q2 : 2007-2009, n = 4,977; Q3 : 2010-2012, n = 4,230; Q4 : 2013-2016, n = 4,569)...
October 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29021434/effectiveness-of-bare-metal-stent-implantation-for-the-treatment-of-coronary-artery-aneurysm-a-multimodality-imaging-evaluation
#3
Yasuaki Hada, Hiroyuki Fujii, Masato Shimizu, Noriyoshi Yamawake, Mitsuhiro Nishizaki
Coronary artery aneurysm (CAA) after sirolimus-eluting stent (SES) implantation is one of the most troublesome problems associated with first-generation drug-eluting stents. However, the natural course and standard therapy of CAA has been unknown. A 49-year-old man underwent SES implantation for the left anterior descending artery. Follow-up coronary angiography (CAG) revealed CAA in the SES. We performed bare metal stent (BMS) implantation for treatment of CAA. Ten months after the BMS implantation, the size of the CAA had diminished, and a very thin layer of endothelium on the BMS was observed by optical coherence tomography...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28992207/propensity-score-based-methods-in-comparative-effectiveness-research-on-coronary-artery-disease
#4
Alexandra G Ellis, Thomas A Trikalinos, Benjamin S Wessler, John B Wong, Issa J Dahabreh
This review examines the conduct and reporting of observational studies using propensity score-based methods to compare coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or medical therapy for patients with coronary artery disease. A systematic selection process identified 48 studies: 20 CABG vs. PCI; 21 bare-metal stents vs. drug-eluting stents; 5 CABG vs. medical therapy; 1 PCI vs. medical therapy; and 1 drug-eluting stents vs. balloon angioplasty. Of 32 studies reporting information on variable selection, 7 relied exclusively on statistical criteria for the association of covariates with treatment and 5 used such criteria to determine whether product or non-linear terms should be included in the propensity score model...
July 13, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28941481/does-the-new-generation-of-drug-eluting-stents-render-bare-metal-stents-obsolete
#5
REVIEW
Kyle Buchanan, Arie Steinvil, Ron Waksman
The development of bare metal coronary stents revolutionized the treatment of coronary artery disease by reducing rates of acute vessel closure and restenosis associated with balloon angioplasty. However, bare metal stents (BMS) resulted in high rates of restenosis and led to the development of drug-eluting stents (DES). Those first-generation DES were followed by successive generations of DES that included improvements, such as biodegradable and more biocompatible polymers. Despite the superiority of the current DES compared to BMS, a subset of patients still receives BMS...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28932353/diagnosis-and-management-challenges-of-in-stent-restenosis-in-coronary-arteries
#6
REVIEW
M Chadi Alraies, Fahed Darmoch, Ramyashree Tummala, Ron Waksman
Over the course of the 3 decades, percutaneous coronary intervention (PCI) with stent implantation transformed the practice of cardiology. PCI with stenting is currently the most widely performed procedure for the treatment of symptomatic coronary disease. In large trials, drug-eluting stents (DES) have led to a significant reduction in in-stent restenosis (ISR) rates, one of the major limitations of bare-metal stents. Due to these favorable findings, DES was rapidly and widely adopted enabling more complex coronary interventions...
August 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28915510/drug-eluting-vs-bare-metal-stents-in-patients-with-chronic-kidney-disease-and-coronary-artery-disease-insights-from-a-systematic-review-and-meta-analysis
#7
Alexander Volodarskiy, Sunil Kumar, Radoslaw Pracon, Mandeep Sidhu, Evgeny Kretov, Tomasz Mazurek, Olga Bockeria, Upendra Kaul, Sripal Bangalore
BACKGROUND: Most drug-eluting stent (DES) trials have excluded patients with chronic kidney disease (CKD). The efficacy of DES implantation in patients with CKD is therefore not known. OBJECTIVES: To evaluate the outcomes with DES vs bare-metal stent (BMS) implantation in patients with CKD. METHODS AND RESULTS: MEDLINE, EMBASE, and CENTRAL were searched for studies including at least 100 patients with CKD (estimated glomerular filtration rate ≤60 mL/min/1...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#8
Christian Boehnel, Hans Rickli, Lukas Graf, Micha T Maeder
OBJECTIVES: We aimed to summarize the evidence for periprocedural and long-term strategies to both minimize the bleeding risk and ensure sufficient anticoagulation and antiaggregation in hemophilia patients undergoing coronary angiography with or without percutaneous coronary interventions (PCI). BACKGROUND: Hemophilia patients undergoing coronary angiography and PCI are at risk of bleeding due to deficiency of the essential clotting factors VIII or IX combined with the need of peri-interventional anticoagulation and antiaggregation and dual antiplatelet therapy (DAPT) after PCI...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28894060/-redo-off-pump-coronary-artery-bypass-for-postoperative-vein-graft-stenosis-of-anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-report-of-a-case
#9
Taro Minamida, Takashi Sugiki, Masamichi Itou, Yasuhiro Kamikubo, Makoto Takahira
Bland-White-Garland (BWG) syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease which may result in myocardial infarction, congestive heart failure or sometimes death during the early infantile period. We present a 57-year-old female with BWG syndrome. At the age of 20, she was diagnosed with BWG syndrome and underwent coronary artery bypass grafting of a saphenous vein to the proximal portion of the anterior descending branch of the left coronary artery and ligation of the anomalous artery...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28891163/patient-preferences-prompt-a-peek-at-priorities
#10
EDITORIAL
James C Blankenship
Patients rate the downsides of bare metal stents (higher restenosis rates) as being of similar magnitude to the downsides of drug eluting stents (longer dual anti-platelet therapy). Patient preferences regarding choice of bare metal versus drug eluting stents should be elicited before coronary stenting. This article does not study actual patient preferences for stent type. Future studies should assess how personalized discussions of trade-offs of stent types affect patient preferences.
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28888408/atrial-fibrillation-and-stent-selection-bare-metal-vs-drug-eluting-from-medicare-claims
#11
Greg Dadekian, Aaron V Kaplan, Chiang-Hua Chang, Nancy E Morden
In treating coronary artery disease, many factors influence the choice of bare metal stent (BMS) or drug-eluting stent (DES), including bleed risk and suitability for prolonged dual antiplatelet therapy. Atrial fibrillation (AF) further complicates this choice, due to common use of anticoagulation. We examined stent selection in the United States by AF status and across academic medical centers (AMCs) to explore how cardiologists are managing this complex choice. Using a 100% Medicare denominator file and associated claims (2008 to 2012), we identified patients over age 65 receiving inpatient coronary artery stents...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28866142/in-vitro-and-in-vivo-degradation-of-rapamycin-eluting-mg-nd-zn-zr-alloy-stents-in-porcine-coronary-arteries
#12
Yongjuan Shi, Lei Zhang, Jiahui Chen, Jian Zhang, Feng Yuan, Li Shen, Chenxin Chen, Jia Pei, Zhonghua Li, Jinyun Tan, Guangyin Yuan
In this work, rapamycin-eluting poly (d, l-lactic acid) coating (PDLLA/RAPA) was prepared on biodegradable Mg-Nd-Zn-Zr alloy (JDBM) for both in vitro and in vivo investigation of the degradation behaviors of the magnesium alloy stent platform. Electrochemical tests and hydrogen evolution test demonstrated significant in vitro protection of the polymeric coating against magnesium degradation both in short and long term. The 3-month in vivo study on the RAPA-eluting JDBM stent implanted into porcine coronary arteries confirmed its favorable safety, and in the meanwhile revealed similar neointima proliferation compared to the second generation DES Firebird 2 with no occurrence of adverse complications...
November 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28864322/impact-of-body-mass-index-on-5-year-clinical-outcomes-in-patients-with-st-segment-elevation-myocardial-infarction-after-everolimus-eluting-or-bare-metal-stent-implantation
#13
Elisabetta Moscarella, Giosafat Spitaleri, Salvatore Brugaletta, Sara Sentí Farrarons, Alberto Pernigotti, Luis Ortega-Paz, Angel Cequier, Andrés Iñiguez, Antonio Serra, Pilar Jiménez-Quevedo, Vicente Mainar, Gianluca Campo, Maurizio Tespili, Peter den Heijer, Armando Bethencourt, Nicolás Vazquez, Marco Valgimigli, Patrick W Serruys, Manel Sabaté
Patients with high body mass index (BMI) seem to have better outcomes after percutaneous coronary intervention than normal-weight patients. However, contrasting results have been reported on the "obesity paradox" in patients presenting with ST-elevation myocardial infarction (STEMI). The aim of our study was to investigate the impact of BMI on mortality in the population enrolled in the Evaluation of the Xience-V stent in Acute Myocardial INfArcTION (EXAMINATION) trial. The EXAMINATION trial randomized 1,498 patients with STEMI to a bare-metal stent or an everolimus-eluting stent...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862960/selection-of-stent-type-in-patients-with-atrial-fibrillation-presenting-with-acute-myocardial-infarction-an-analysis-from-the-action-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#14
Amit N Vora, Tracy Y Wang, Shuang Li, Karen Chiswell, Connie Hess, Renato D Lopes, Sunil V Rao, Eric D Peterson
BACKGROUND: Patients receiving oral anticoagulation in addition to dual-antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug-eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI). METHODS AND RESULTS: From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines, we identified 14 427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28844032/state-of-the-art-coronary-artery-stents-past-present-and-future
#15
Giulio G Stefanini, Robert A Byrne, Stephan Windecker, Adnan Kastrati
The first percutaneous coronary intervention (PCI) was performed in September 1977 by Andreas Grüntzig using a rudimentary balloon angioplasty catheter mounted on a fixed wire. PCI was immediately recognised as a potential breakthrough in cardiovascular medicine, but uptake in clinical practice was limited by unpredictable acute outcomes and a need for surgical standby. The introduction of bare metal stents (BMS) in the 1980s improved procedure reproducibility and clinical outcomes through a permanent scaffolding of the coronary vessel, preventing abrupt occlusion and acute recoil...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28841230/rationale-and-design-of-the-drug-eluting-stents-vs-bare-metal-stents-in-saphenous-vein-graft-angioplasty-diva-trial
#16
Emmanouil S Brilakis, Subhash Banerjee, Robert Edson, Kendrick Shunk, Steven Goldman, David R Holmes, Deepak L Bhatt, Sunil V Rao, Mark W Smith, Mike Sather, Cindy Colling, Biswajit Kar, Lori Nielsen, Todd Conner, Todd Wagner, Bavana V Rangan, Beverly Ventura, Ying Lu, Mark Holodniy, Mei-Chiung Shih
VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28838462/drug-eluting-balloons-a-new-tool-in-the-treatment-of-cardiac-allograft-vasculopathy-a-case-series
#17
B Skoric, J Bulum, M Cikes, H Jurin, D Lovric, J Ljubas-Macek, J Samardzic, M Pasalic, D Milicic
Percutaneous coronary intervention in patients with cardiac allograft vasculopathy is burdened with a lot of difficulties. Although they have allowed significant progress in comparison with plain balloon angioplasty and bare metal stents, drug-eluting stents have not fully overcome problems of diffuse lesions and small-vessel disease that are so common in transplant coronary artery disease. There is growing evidence that drug-eluting balloons might be a better choice for patients with small vessel atherosclerotic coronary disease and yet there is no experience with this technology in patients with cardiac allograft vasculopathy...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28833489/coronary-revascularization-for-acute-myocardial-infarction-in-the-hiv-population
#18
Vikas Singh, Rodrigo Mendirichaga, Ghanshyambhai T Savani, Alexis P Rodriguez, Nitika Dabas, Anish Munagala, Carlos E Alfonso, Mauricio G Cohen, Sammy Elmariah, Igor F Palacios
OBJECTIVE: To analyze trends in management and outcomes of patients infected with the human immunodeficiency virus (HIV) undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction (AMI) in the United States. BACKGROUND: Infection with HIV is an independent risk factor for accelerated atherosclerosis associated with higher rates of AMI. Current trends and outcomes of HIV-infected individuals presenting with AMI in the United States remain unknown...
August 22, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28832903/drug-eluting-stents-versus-bare-metal-stents-for-acute-coronary-syndrome
#19
REVIEW
Joshua Feinberg, Emil Eik Nielsen, Janette Greenhalgh, Juliet Hounsome, Naqash J Sethi, Sanam Safi, Christian Gluud, Janus C Jakobsen
BACKGROUND: Approximately 3.7 million people died from acute coronary syndrome worldwide in 2012. Acute coronary syndrome, also known as myocardial infarction or unstable angina pectoris, is caused by a sudden blockage of the blood supplied to the heart muscle. Percutaneous coronary intervention is often used for acute coronary syndrome, but previous systematic reviews on the effects of drug-eluting stents compared with bare-metal stents have shown conflicting results with regard to myocardial infarction; have not fully taken account of the risk of random and systematic errors; and have not included all relevant randomised clinical trials...
August 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28810900/polymer-free-dual-drug-eluting-stents-evaluated-in-a-porcine-model
#20
Bin Zhang, Bo Zheng, Xingang Wang, Qiuping Shi, Jia Jia, Yong Huo, Chunshui Pan, Jingyan Han, Ming Chen
BACKGROUND: Although drug-eluting stents have dramatically reduced the rates of restenosis and target lesion revascularization, they are associated with stent thrombosis (ST), a catastrophic event likely due to delayed endothelialization and chronic inflammation caused by the polymer and the metal scaffolds. To increase the safety and efficacy of stents, polymer-free dual drug-eluting stents (DDES) have been developed. METHODS: A total 160 stents (Bare-metal stents (BMS), polymer-free probucol stents (PrES), sirolimus-eluting stents (SES) and DDES) were randomly implanted in the coronary arteries of 80 pigs...
August 15, 2017: BMC Cardiovascular Disorders
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