Background There were limited data comparing the major clinical outcomes between first-generation （1G）-drug eluting stentts （DES） and second-generation （2G）-DES in patients with acute myocardial infarction （AMI...Background There were limited data comparing the major clinical outcomes between first-generation （1G）-drug eluting stentts （DES） and second-generation （2G）-DES in patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI） during very long follow-up periods. We thought to investigate the comparative efficacy and safety of 2G-DES compared with 1G-DES in AMI patients during 5-year follow-up periods. Method A total of 1016 eligible AMI patients who underwent PCI with 1G-DES [paclitaxel-, sirolimus-, 1G-zotarolimus-eluting stent （endeavor~ or endeavor sprintS）, n = 554] or 2G-DES [2G-zotarolimus （endeavor resolute~）- or everolimus-eluting stent, n = 462] were enrolled. The primary endpoint was the occurrence of major adverse cardiac events （MACE） defined as total death, non-fatal myocardial infarction （MI）, target lesion revascularization （TLR）, target vessel revascularization （TVR）, non-target vessel revascularization （Non-TVR） and the secondary endpoint was stem thrombosis （ST） at 5 years. Results Two propensity score-ma- tched （PSM） groups （232 pairs, n = 464, C-statistic = 0.802） were generated. During the 5-year follow-up period, the cumulative incidence of TLR [hazard ratio （HR）： 3.133; 95% confidence interval （CI）： 1.539-6.376; P = 0.002], TVR （HR： 3.144; 95% CI： 1.59645.192; P = 0.001） and total revascularization rate （FIR： 1.874; 95% CI： 1.086-3.140; P = 0.023） were significantly higher in 1G-DES compared with 2G-DES after PSM. However, the incidence of total death, non-fatal MI and ST were similar between the two groups. Conclusion In this single-center and all-comers registry, 2G-DES＇s superiorities for TLR, TVP, and total revascularization in AMI patients suggested during 5-year clinical follow-up periods.展开更多
Background Smoking and other risk factors have been well known as important factors of variant angina or coronary artery spasm （CAS）. However, clinical features related to age on coronary artery spasm have been rare...Background Smoking and other risk factors have been well known as important factors of variant angina or coronary artery spasm （CAS）. However, clinical features related to age on coronary artery spasm have been rarely evaluated. Methods We evaluated 3155 consecutive patients with insignificant coronary artery lesion. Patients underwent Acetylcholine （Ach） provocation test for induction of CAS. CAS was defined as 〉 70% luminal narrowing of coronary arteries during Ach provocation test. The results of Ach provocation test were compared among age groups; 〈 45 years （Group 1）, 45-54 years （Group 2）, 55-64 years （Group 3）, and 〉_ 65 years （Group 4）. Results Older patients had higher incidence of hypertension, diabetes, but lower incidence rate of current smoking, male sex compared with younger patients. Positive Ach provocation test finding was frequently showed with aging （47.36% vs. 58.3% vs. 62.6% vs. 61.5%; P 〈 0.001）. Multivariate logistic analysis showed that age, male, and myocardial bridge were independent predictors of CAS induced by Ach provocation test. Conclusion Our present study showed that old age was independent predictor for Ach-induced significant coronary artery spasm.展开更多
文摘Background There were limited data comparing the major clinical outcomes between first-generation （1G）-drug eluting stentts （DES） and second-generation （2G）-DES in patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI） during very long follow-up periods. We thought to investigate the comparative efficacy and safety of 2G-DES compared with 1G-DES in AMI patients during 5-year follow-up periods. Method A total of 1016 eligible AMI patients who underwent PCI with 1G-DES [paclitaxel-, sirolimus-, 1G-zotarolimus-eluting stent （endeavor~ or endeavor sprintS）, n = 554] or 2G-DES [2G-zotarolimus （endeavor resolute~）- or everolimus-eluting stent, n = 462] were enrolled. The primary endpoint was the occurrence of major adverse cardiac events （MACE） defined as total death, non-fatal myocardial infarction （MI）, target lesion revascularization （TLR）, target vessel revascularization （TVR）, non-target vessel revascularization （Non-TVR） and the secondary endpoint was stem thrombosis （ST） at 5 years. Results Two propensity score-ma- tched （PSM） groups （232 pairs, n = 464, C-statistic = 0.802） were generated. During the 5-year follow-up period, the cumulative incidence of TLR [hazard ratio （HR）： 3.133; 95% confidence interval （CI）： 1.539-6.376; P = 0.002], TVR （HR： 3.144; 95% CI： 1.59645.192; P = 0.001） and total revascularization rate （FIR： 1.874; 95% CI： 1.086-3.140; P = 0.023） were significantly higher in 1G-DES compared with 2G-DES after PSM. However, the incidence of total death, non-fatal MI and ST were similar between the two groups. Conclusion In this single-center and all-comers registry, 2G-DES＇s superiorities for TLR, TVP, and total revascularization in AMI patients suggested during 5-year clinical follow-up periods.
文摘Background Smoking and other risk factors have been well known as important factors of variant angina or coronary artery spasm （CAS）. However, clinical features related to age on coronary artery spasm have been rarely evaluated. Methods We evaluated 3155 consecutive patients with insignificant coronary artery lesion. Patients underwent Acetylcholine （Ach） provocation test for induction of CAS. CAS was defined as 〉 70% luminal narrowing of coronary arteries during Ach provocation test. The results of Ach provocation test were compared among age groups; 〈 45 years （Group 1）, 45-54 years （Group 2）, 55-64 years （Group 3）, and 〉_ 65 years （Group 4）. Results Older patients had higher incidence of hypertension, diabetes, but lower incidence rate of current smoking, male sex compared with younger patients. Positive Ach provocation test finding was frequently showed with aging （47.36% vs. 58.3% vs. 62.6% vs. 61.5%; P 〈 0.001）. Multivariate logistic analysis showed that age, male, and myocardial bridge were independent predictors of CAS induced by Ach provocation test. Conclusion Our present study showed that old age was independent predictor for Ach-induced significant coronary artery spasm.
