Compared with bare-metal stents (BMS),drug-eluting stems (DES)have shown better clinical outcomes for pa- tients undergoing percutaneous coronary intervention (PCI) by inhibition of neo-intirnal hyperplasia.[1]However...Compared with bare-metal stents (BMS),drug-eluting stems (DES)have shown better clinical outcomes for pa- tients undergoing percutaneous coronary intervention (PCI) by inhibition of neo-intirnal hyperplasia.[1]However,early- generation DES produced late thrombotic events,more than l-year,by delaying arterial healing of stented vessels,[2-5] New-generation DES have been developed'with thinner stent struts,more biocompatible polymer coatings for drug release,and a variety of antiproliferative agents with similar or superior anti-restenotic efficacy.[6]This development has led to a significant improvement in the efficacy and safety of new-generation DES,and consistently lower rates of very late stent thrombosis (VLST).[7,8]In fact,use of new-ge- neration DES is the standard treatment in contemporary PCI practice.[9]展开更多
AIM: To evaluate the premise, that biodegradable polymer drug eluting stents(BD-DES) could improve clinical outcomes compared to second generation permanent polymer drug eluting stents(PP-DES), we pooled the data from...AIM: To evaluate the premise, that biodegradable polymer drug eluting stents(BD-DES) could improve clinical outcomes compared to second generation permanent polymer drug eluting stents(PP-DES), we pooled the data from all the available randomized control trials(RCT) comparing the clinical performance of both these stents.METHODS: A systematic literature search of Pub Med, Cochrane, Google scholar databases, EMBASE, MEDLINE and SCOPUS was performed during time period of January 2001 to April 2015 for RCT and comparing safety and efficacy of BD-DES vs second generation PP-DES. The primary outcomes of interest were definite stent thrombosis, target lesion revascularization, myocardial infarction, cardiac deaths and total deaths during the study period. RESULTS: A total of 11 RCT's with a total of 12644 patients were included in the meta-analysis, with 6598 patients in BD-DES vs 6046 patients in second generation PP-DES. The mean follow up period was 16 mo. Pooled analysis showed non-inferiority of BD-DES, comparing events of stent thrombosis(OR = 1.42, 95%CI: 0.79-2.52, P = 0.24), target lesion revascularization(OR = 0.99, 95%CI: 0.84-1.17, P = 0.92), myocardial infarction(OR = 1.06, 95%CI: 0.86-1.29, P = 0.92), cardiac deaths(OR = 1.07, 95%CI 0.82-1.41, P = 0.94) and total deaths(OR = 0.96, 95%CI: 0.80-1.17, P = 0.71).CONCLUSION: BD-DES, when compared to second generation PP-DES, showed no significant advantage and the outcomes were comparable between both the groups.展开更多
Background: To evaluate the safety and efficacy of the EndeavorTM-Stent-Stent (Medtronic Corp., USA) in daily practice. Material and methods: Data come from a prospective single-centre registry. Between 2005 and 2007 ...Background: To evaluate the safety and efficacy of the EndeavorTM-Stent-Stent (Medtronic Corp., USA) in daily practice. Material and methods: Data come from a prospective single-centre registry. Between 2005 and 2007 all patients, who received at least one Endeavor? coronary stent, were included into a registry. Patients were contacted after 12 and 24 - 36 months. Results: 326 patients (97 females, mean age 67.5 ± 10.3 years) were included. From these patients 137 (42%) had a 3-vessel disease, 96 (29%) presented with myocardial infarction ≤ 72 hrs, 19 (6%) with a left ventricular ejection fraction TM-Stent-Stents. Per patient, 0.4 ± 0.7 bare metal stents were implanted. Median follow-up time was 35.3 months, during follow-up 165 patients (50.6%) had repeated angiography. After 12 (24) months overall mortality was 5.8% (7.3%), cardiac mortality 3.1% (3.5%), myocardial infarction rate 1.5% (4.1%), target-vessel revascu-larization rate 8.7% (12.4%), target-lesion revascu-larization rate 6.1% (8.4%), and cumulative MACE-rate 14.1% (21.9%). In total, 2 definite or likely stent-thromboses (0.6%) occurred during follow-up. Logistic regression revealed the treatment of saphenous vein grafts and aorto-coronary ostial lesions as risk factors for target lesion revascularization. Conclusion: The EndeavorTM-Stent-Stent is a safe and effective drug-eluting stent in the treatment of daily-life coronary patients. Treatment of vein grafts and aorto-coronary ostial lesions appear to be associated with a higher need for re-interventions.展开更多
文摘Compared with bare-metal stents (BMS),drug-eluting stems (DES)have shown better clinical outcomes for pa- tients undergoing percutaneous coronary intervention (PCI) by inhibition of neo-intirnal hyperplasia.[1]However,early- generation DES produced late thrombotic events,more than l-year,by delaying arterial healing of stented vessels,[2-5] New-generation DES have been developed'with thinner stent struts,more biocompatible polymer coatings for drug release,and a variety of antiproliferative agents with similar or superior anti-restenotic efficacy.[6]This development has led to a significant improvement in the efficacy and safety of new-generation DES,and consistently lower rates of very late stent thrombosis (VLST).[7,8]In fact,use of new-ge- neration DES is the standard treatment in contemporary PCI practice.[9]
文摘AIM: To evaluate the premise, that biodegradable polymer drug eluting stents(BD-DES) could improve clinical outcomes compared to second generation permanent polymer drug eluting stents(PP-DES), we pooled the data from all the available randomized control trials(RCT) comparing the clinical performance of both these stents.METHODS: A systematic literature search of Pub Med, Cochrane, Google scholar databases, EMBASE, MEDLINE and SCOPUS was performed during time period of January 2001 to April 2015 for RCT and comparing safety and efficacy of BD-DES vs second generation PP-DES. The primary outcomes of interest were definite stent thrombosis, target lesion revascularization, myocardial infarction, cardiac deaths and total deaths during the study period. RESULTS: A total of 11 RCT's with a total of 12644 patients were included in the meta-analysis, with 6598 patients in BD-DES vs 6046 patients in second generation PP-DES. The mean follow up period was 16 mo. Pooled analysis showed non-inferiority of BD-DES, comparing events of stent thrombosis(OR = 1.42, 95%CI: 0.79-2.52, P = 0.24), target lesion revascularization(OR = 0.99, 95%CI: 0.84-1.17, P = 0.92), myocardial infarction(OR = 1.06, 95%CI: 0.86-1.29, P = 0.92), cardiac deaths(OR = 1.07, 95%CI 0.82-1.41, P = 0.94) and total deaths(OR = 0.96, 95%CI: 0.80-1.17, P = 0.71).CONCLUSION: BD-DES, when compared to second generation PP-DES, showed no significant advantage and the outcomes were comparable between both the groups.
文摘Background: To evaluate the safety and efficacy of the EndeavorTM-Stent-Stent (Medtronic Corp., USA) in daily practice. Material and methods: Data come from a prospective single-centre registry. Between 2005 and 2007 all patients, who received at least one Endeavor? coronary stent, were included into a registry. Patients were contacted after 12 and 24 - 36 months. Results: 326 patients (97 females, mean age 67.5 ± 10.3 years) were included. From these patients 137 (42%) had a 3-vessel disease, 96 (29%) presented with myocardial infarction ≤ 72 hrs, 19 (6%) with a left ventricular ejection fraction TM-Stent-Stents. Per patient, 0.4 ± 0.7 bare metal stents were implanted. Median follow-up time was 35.3 months, during follow-up 165 patients (50.6%) had repeated angiography. After 12 (24) months overall mortality was 5.8% (7.3%), cardiac mortality 3.1% (3.5%), myocardial infarction rate 1.5% (4.1%), target-vessel revascu-larization rate 8.7% (12.4%), target-lesion revascu-larization rate 6.1% (8.4%), and cumulative MACE-rate 14.1% (21.9%). In total, 2 definite or likely stent-thromboses (0.6%) occurred during follow-up. Logistic regression revealed the treatment of saphenous vein grafts and aorto-coronary ostial lesions as risk factors for target lesion revascularization. Conclusion: The EndeavorTM-Stent-Stent is a safe and effective drug-eluting stent in the treatment of daily-life coronary patients. Treatment of vein grafts and aorto-coronary ostial lesions appear to be associated with a higher need for re-interventions.
