10-Year Follow-Up of Patients With Everolimus-Eluting Versus Bare-Metal Stents After ST-Segment Elevation Myocardial Infarction

Brugaletta, Salvatore; Gomez‐Lara, Josep; Ortega‐Paz, Luis; Díaz, Víctor Jiménez; Jiménez, Marcelo; Jiménez‐Quevedo, Pilar; Diletti, Roberto; Mainar, Vicente; Campo, Gianluca; Silvestro, Antonio; Maristany, Jaume; Flores, Xacobe; Oyarzabal, Loreto; Miguel-Castro, Antonio De; Íñiguez, Andrés; Serra, Antonio; Nombela‐Franco, Luis; Ielasi, Alfonso; Tespili, Maurizio; Lenzen, Mattie J.; Gonzalo, Nieves; Bordes, Pascual; Tebaldi, Matteo; Biscaglia, Simone; Rodríguez-Arias, Juan José; Al‐Shaibani, Soheil; Arévalos, Víctor; Romaguera, Rafael; Gómez‐Hospital, Joan Antoni; Serruys, Patrick W.; Sabaté, Manel

doi:10.1016/j.jacc.2020.12.059

Cited by 40 publications

(20 citation statements)

References 31 publications

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“…The lower tendency of use of DESs in the low-SES group observed in our study has also been reported in American cohorts ( 30 – 32 ), which is a “treatment-risk paradox” in which higher-risk patients are not treated with optimal or evidence-based strategies, and the use of mechanical support devices is reduced, and it may result in prognosis worsening ( 19 , 33 , 34 ). This finding may reflect the fact that differences in outcomes may not only be related to the use of a specific treatment/device in the acute period but to a whole standardized medical approach in which access to secondary prevention may be of utmost importance ( 35 ) and that the health system may override the burden of higher risk subsets.…”

Section: Discussionsupporting

confidence: 81%

Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network

Tizón‐Marcos

Vaquerizo

Ferré

et al. 2022

Front. Cardiovasc. Med.

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BackgroundDespite the spread of ST-elevation myocardial infarction (STEMI) emergency intervention networks, inequalities in healthcare access still have a negative impact on cardiovascular prognosis. The Family Income Ratio of Barcelona (FIRB) is a socioeconomic status (SES) indicator that is annually calculated. Our aim was to evaluate whether SES had an effect on mortality and complications in patients managed by the “Codi IAM” network in Barcelona.MethodsThis is a cohort study with 3,322 consecutive patients with STEMI treated in Barcelona from 2010 to 2016. Collected data include treatment delays, clinical and risk factor characteristics, and SES. The patients were assigned to three SES groups according to FIRB score. A logistic regression analysis was conducted to estimate the adjusted effect of SES on 30-day mortality, 30-day composite cardiovascular end point, and 1-year mortality.ResultsThe mean age of the patients was 65 ± 13% years, 25% were women, and 21% had diabetes mellitus. Patients with low SES were younger, more often hypertensive, diabetic, dyslipidemic (p < 0.003), had longer reperfusion delays (p < 0.03) compared to participants with higher SES. Low SES was not independently associated with 30-day mortality (OR: 0.95;9 5% CI: 0.7–1.3), 30-day cardiovascular composite end point (OR: 1.03; 95% CI: 0.84–1.26), or 1-year all-cause mortality (HR: 1.09; 95% CI: 0.76–1.56).ConclusionAlthough the low-SES patients with STEMI in Barcelona city were younger, had worse clinical profiles, and had longer revascularization delays, their 30-day and 1-year outcomes were comparable to those of the higher-SES patients.

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Section: Discussionsupporting

confidence: 81%

Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network

Tizón‐Marcos

Vaquerizo

Ferré

et al. 2022

Front. Cardiovasc. Med.

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“…In terms of long follow-up, recently, the EXAMINATION-EXTEND (10-Years Follow-Up of the EXAMINATION Trial) study demonstrated the superiority of CoCr-EES ( N = 751) in combined patient- and device-oriented composite endpoints, compared with BMS ( N = 747), in patients with STEMI (patient-oriented composite endpoint: 32.4% vs. 38.0%, HR 0.81, 95% CI 0.68–0.96, p = 0.013; device-oriented composite endpoint: 13.6% vs. 18.4%, HR 0.72, 95% CI 0.55–0.93, p = 0.012, respectively) [ 139 ]. These results were driven mainly by TLR (5.7% vs. 8.8%; p = 0.018).…”

Section: Practical Recommendation For Primary Pcimentioning

confidence: 99%

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022

Ozaki

Hara

Onuma

et al. 2022

Cardiovasc Interv and Ther

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101

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Primary Percutaneous Coronary Intervention (PCI) has significantly contributed to reducing the mortality of patients with ST-segment elevation myocardial infarction (STEMI) even in cardiogenic shock and is now the standard of care in most of Japanese institutions. The Task Force on Primary PCI of the Japanese Association of Cardiovascular Interventional and Therapeutics (CVIT) society proposed an expert consensus document for the management of acute myocardial infarction (AMI) focusing on procedural aspects of primary PCI in 2018. Updated guidelines for the management of AMI were published by the European Society of Cardiology (ESC) in 2017 and 2020. Major changes in the guidelines for STEMI patients included: (1) radial access and drug-eluting stents (DES) over bare-metal stents (BMS) were recommended as a Class I indication, (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. In 2020, updated guidelines for Non-ST-Elevation Myocardial Infarction (NSTEMI) patients, the followings were changed: (1) an early invasive strategy within 24 h is recommended in patients with NSTEMI as a Class I indication, (2) complete revascularization in NSTEMI patients without cardiogenic shock is considered as Class IIa recommendation, and (3) in patients with atrial fibrillation following a short period of triple antithrombotic therapy, dual antithrombotic therapy (e.g., DOAC and single oral antiplatelet agent preferably clopidogrel) is recommended, with discontinuation of the antiplatelet agent after 6 to 12 months. Furthermore, an aspirin-free strategy after PCI has been investigated in several trials those have started to show the safety and efficacy. The Task Force on Primary PCI of the CVIT group has now proposed the updated expert consensus document for the management of AMI focusing on procedural aspects of primary PCI in 2022 version.

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“…Rapamycin-eluting stents, the most common, currently used DES, have been found to be highly efficacious and significantly reduces the risk of restenosis and target lesion revascularization after angioplasty. 23,24 Interestingly, rapamycin is a natural macrocyclic compound that was initially isolated from Streptomyces hygroscopicus. 25 Previous studies demonstrated that rapamycin can inhibit the mTOR signaling pathway and regulate cell cycle-related proteins, resulting in a cell-cycle arrest between the G1 to S transition.…”

Section: Discussionmentioning

confidence: 99%

Icariside II Attenuates Vascular Remodeling Via Wnt7b/CCND1 Axis

Wen

et al. 2022

Journal of Cardiovascular Pharmacology

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:Angioplasty often fails due to the abnormal proliferation of vascular smooth muscle cells (VSMCs). Success rates of angioplasty may increase following the administration of an agent that effectively ameliorates aberrant vascular remodeling. Icariside II (ICS-II) is a natural flavonol glycoside extract from the Chinese herbal medicine Epimedii that possesses several medicinal qualities that are beneficial in humans. Nevertheless, the role of ICS-II in addressing aberrant vascular remodeling have yet to be clarified. The current investigation studies the molecular effects of ICS-Ⅱ on balloon-inflicted neointimal hyperplasia in rats in vivo and on platelet-derived growth factor–induced vascular proliferation in primary rat aortic smooth muscle cells (VSMCs) in vitro. ICS-II was found to be as effective as rapamycin, the positive control used in this study. ICS-II inhibited neointimal formation in injured rat carotid arteries and notably reduced the expression of Wnt7b. ICS-Ⅱ significantly counteracted platelet-derived growth factor–induced VSMCs proliferation. Cell cycle analysis showed that ICS-II triggered cell cycle arrest during the G1/S transition. Western blot analysis further indicated that this cell cycle arrest was likely through Wnt7b suppression that led to CCND1 inhibition. In conclusion, our findings demonstrate that ICS-II possesses significant antiproliferative qualities that counteracts aberrant vascular neointimal hyperplasia. This phenomenon most likely occurs due to the suppression of the Wnt7b/CCND1 axis.

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10-Year Follow-Up of Patients With Everolimus-Eluting Versus Bare-Metal Stents After ST-Segment Elevation Myocardial Infarction

Cited by 40 publications

References 31 publications

Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network

Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network

CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022

Icariside II Attenuates Vascular Remodeling Via Wnt7b/CCND1 Axis

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