Introduction: Type 2 diabetes mellitus (T2DM) is a risk factor for the development of coronary artery disease (CAD). In patients with acute coronary syndrome (ACS), guidelines recommend a potent P2Y12 inhibitor in addition to aspirin. For those with complicated and advanced CAD requiring complex percutaneous coronary intervention (PCI), the risk for adverse ischemic events is even higher. Prolonged dual antiplatelet therapy (DAPT) use is controversial. A new antiplatelet regimen after PCI should be considered. In this analysis, we aimed to systematically show the impact of long-term ticagrelor monotherapy after a short course of DAPT use on the outcomes in patients with T2DM following PCI. Methods: Electronic databases were searched Hong Wang and Xiaoya Xie are co-first authors.
A knowledge graph is defined as a collection of interlinked descriptions of concepts, relationships, entities and events. Medical knowledge graphs have been the most recent advances in technology, therapy and medicine. Nowadays, a number of specific uses and applications rely on knowledge graphs. The application of the knowledge graph, another form of artificial intelligence (AI) in cardiology and cardiovascular medicine, is a new concept, and only a few studies have been carried out on this particular aspect. In this brief literature review, the use and importance of disease-specific knowledge graphs in exploring various aspects of Kawasaki disease were described. A vision of individualized knowledge graphs (iKGs) in cardiovascular medicine was also discussed. Such iKGs would be based on a modern informatics platform of exchange and inquiry that could comprehensively integrate biologic knowledge with medical histories and health outcomes of individual patients. This could transform how clinicians and scientists discover, communicate and apply new knowledge. In addition, we also described how a study based on the comprehensive longitudinal evaluation of dietary factors associated with acute myocardial infarction and fatal coronary heart disease used a knowledge graph to show the dietary factors associated with cardiovascular diseases in Nurses’ Health Study data. To conclude, in this fast-developing world, medical knowledge graphs have emerged as attractive methods of data storage and hypothesis generation. They could be a major and effective tool in cardiology and cardiovascular medicine and play an important role in reaching effective clinical decisions during treatment and management of patients in the cardiology department.
Background Diabetes mellitus (DM) and cardiovascular diseases often co-exist. Today, percutaneous coronary intervention (PCI) is the preferred revascularization procedure for majority of patients with coronary artery disease. Polymer-free amphilimus-eluting stents (AES) represent a novel elution technology in the current era of drug-eluting stents. In this analysis, we aimed to systematically compare the cardiovascular outcomes which are associated with polymer-free amphilimus-eluting stents (AES) versus the durable polymer zotarolimus-eluting stents (ZES) for the treatment of patients with DM. Methods Http://www.ClinicalTrials.gov, EMBASE, Web of Science, MEDLINE, Cochrane database and Google Scholar were searched for publications comparing polymer-free AES versus durable polymer ZES in patients with DM. Selective cardiovascular outcomes were assessed. Statistical analysis was carried out by the latest version of the RevMan software. Risk ratio (RR) with 95% confidence interval (CI) was used to represent the data analysis. Results Four studies with a total number of 1795 participants with DM whereby 912 patients were assigned to be revascularized by the polymer-free AES and 883 patients were assigned to be revascularized by the durable polymer ZES were included in this analysis. In patients with DM, at one year, polymer-free AES were associated with significantly lower risk of major adverse cardiac events (MACEs) (RR: 0.69, 95% CI: 0.54–0.88; P = 0.002) and target lesion failure (TLF) (RR: 0.66, 95% CI: 0.48–0.91; P = 0.01) compared to durable polymer ZES. However, there was no significant change in all-cause mortality (RR: 0.79, 95% CI: 0.51–1.22; P = 0.28), cardiac death and the other cardiovascular outcomes. Similar risk of total stent thrombosis (RR: 1.13, 95% CI: 0.60–2.13; P = 0.70), including definite stent thrombosis (RR: 1.12, 95% CI: 0.38–3.31; P = 0.84), probable stent thrombosis (RR: 0.87, 95% CI: 0.37–2.09; P = 0.76), possible stent thrombosis (RR: 1.19, 95% CI: 0.50–2.87; P = 0.69) and late stent thrombosis (RR: 1.00, 95% CI: 0.17–5.72; P = 1.00) as between polymer-free AES and durable polymer ZES in patients with DM. Conclusions At 1 year follow-up, polymer-free AES were associated with significantly lower MACEs and TLF compared to durable polymer ZES in these patients with DM, without any increase in mortality, stent thrombosis and other cardiovascular outcomes. However, this analysis is only based on a follow-up time period of one year, therefore, future research should focus on the long term follow-up time period.
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