Angiographic and clinical performance of polymer‐free biolimus‐eluting stent in patients with ST‐segment elevation acute myocardial infarction in a metropolitan public hospital: The BESAMI MUCHO study

Sgueglia, Gregory A.; D’Errico, Fabrizio; Gioffrè, Gaetano; Santis, Antonella De; Summaria, Francesco; Piccioni, Fabiana; Gaspardone, Achille

doi:10.1002/ccd.27206

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…Stroke was defined as a major ischemic or hemorrhagic cerebrovascular accident resulting in disabling neurological symptoms for at least 24 hr. Repeat target‐vessel revascularization was defined as recurrent ischemic symptoms that resulted in the need for revascularization by either PCI or coronary bypass surgery …”

Section: Methodsmentioning

confidence: 99%

“…In total 45 patients with no reflow or slow flow after PCI received intracoronary bolus of glycoprotein IIb/IIIa inhibitors (tirofiban, 10 μg/kg) with a subsequent intravenous infusion (0.15 μg/kg per minute) for 12–24 hr. After the procedure, patients routinely received dual anti‐platelet therapy with aspirin 100 mg and a P2Y12 inhibitor (either clopidogrel 75 mg daily, or ticagrelor 90 twice a day) for 12 months after the primary PCI, and 100 mg aspirin daily was prescribed indefinitely …”

Section: Methodsmentioning

confidence: 99%

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Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

Dong

et al. 2018

Cathet Cardio Intervent

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Objectives We aimed to investigate the determinants of thrombus burden (TB) and the impact of thrombus aspiration (TA) on outcome in young adults with ST segment elevation myocardial infarction (STEMI). Background The determinants of TB in young STEMI patients are not fully understood now. Methods The 182 young (age ≤ 45 years) STEMI patients, who underwent coronary angiography and percutaneous coronary intervention (PCI) in our hospital from January 2013 to September 2016, were included. Angiographic TB and impact of TA on major adverse cardiac events (MACEs) were evaluated. Median clinical follow‐up period was 875 (641–1,052) days. Results All patients were male, mean age was 40 ± 5 years. High thrombus burden (HTB) was evidenced in 100 (54.9%) patients. TA was performed in 62 out 100 (62%) patients with high TB (HTB) during PCI. The prevalence of hypertension was significantly higher in the HTB group than in the low thrombus burden (LTB) group (75 vs. 17%, P < 0.001). The proportion of smoking, alcohol consumption, and family history of premature coronary artery disease were similar between HTB and LTB groups. During follow‐up, 2 patients died and 31 patients underwent repeat PCI. MACE rate was significantly higher in the HTB group than in the LTB group (24.0 vs. 9.8%, P = 0.012) and significantly lower in HTB patients with TA than HTB patients without TA (14.5 vs. 39.5%, P = 0.018). Conclusions Hypertension is an independent determinant of HTB and TA could be considered as an effective therapeutic option in young male STEMI patients with HTB.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

Dong

et al. 2018

Cathet Cardio Intervent

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“…Over the next three months after restoring TIMI III blood flow through culprit artery with PCI, the primary causes inducing adverse cardiac remodelling can be different from the aforementioned. Indeed, other factors that may contribute to cardiac remodelling after successful primary PCI are arterial healing, vessel remodelling, stent restenosis, thrombosis, and incomplete expansion of stent branches (known as malposition), and stent fracture, which require ischemia-driven target vessel revascularization further [23]. Performing of optical coherence tomography (OCT) in STEMI patients presenting with late and very late stent thrombosis has yielded that stent malposition was determined in 55% cases, quarter of which had been found evidence of positive vessel remodelling [24].…”

Section: Contributing Factors Of Adverse Cardiacmentioning

confidence: 99%

Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers

Berezin

2020

Disease Markers

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The prevalence of heart failure (HF) due to cardiac remodelling after acute myocardial infarction (AMI) does not decrease regardless of implementation of new technologies supporting opening culprit coronary artery and solving of ischemia-relating stenosis with primary percutaneous coronary intervention (PCI). Numerous studies have examined the diagnostic and prognostic potencies of circulating cardiac biomarkers in acute coronary syndrome/AMI and heart failure after AMI, and even fewer have depicted the utility of biomarkers in AMI patients undergoing primary PCI. Although complete revascularization at early period of acute coronary syndrome/AMI is an established factor for improved short-term and long-term prognosis and lowered risk of cardiovascular (CV) complications, late adverse cardiac remodelling may be a major risk factor for one-year mortality and postponded heart failure manifestation after PCI with subsequent blood flow resolving in culprit coronary artery. The aim of the review was to focus an attention on circulating biomarker as a promising tool to stratify AMI patients at high risk of poor cardiac recovery and developing HF after successful PCI. The main consideration affects biomarkers of inflammation, biomechanical myocardial stress, cardiac injury and necrosis, fibrosis, endothelial dysfunction, and vascular reparation. Clinical utilities and predictive modalities of natriuretic peptides, cardiac troponins, galectin 3, soluble suppressor tumorogenicity-2, high-sensitive C-reactive protein, growth differential factor-15, midregional proadrenomedullin, noncoding RNAs, and other biomarkers for adverse cardiac remodelling are discussed in the review.

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“…3,4 In the large scale LEADERS-FREE trial, a polymer-free biolimuseluting stent (PF-BES) demonstrated improved outcomes as compared to a bare metal stent in high bleeding risk (HBR) patients, when used with a 1-month DAPT strategy. 5 The favorable clinical profile of the PF-BES was further established across a wide range or real-world patients, with outcomes in the lower range of cardiovascular adverse event rates observed with contemporary new-generation drug-eluting stents (DES) when used in patients with mostly non-HBR features, [6][7][8][9] and overall good safety and efficacy when used in patients with mostly HBR features. 10 The PF-BES peculiar characteristics, including the absence of a polymer-coat along with the fast drug elution, may result in rapid and complete stent endothelialization, blunting the late ST risk observed with polymer-coated DESs.…”

Section: Introductionmentioning

confidence: 99%

“…Results: Following PF-BES-PCI, 328(40.3%) and 485(59.6%) patients were discharged with 1-month and longer DAPT (12 months [6][7][8][9][10][11][12]), respectively. Patients with a previous or index MI were less likely to be discharged on 1-month DAPT.…”

mentioning

confidence: 99%

Real‐world reasons and outcomes for 1‐month versus longer dual antiplatelet therapy strategies with a polymer‐free BIOLIMUS A9‐coated stent

Gallone

D’Ascenzo

Boccuzzi

et al. 2020

Cathet Cardio Intervent

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Background A large trial established the favorable profile of a new polymer‐free biolimus A9‐eluting stent (PF‐BES) with a 1‐month dual antiplatelet therapy (DAPT) in high bleeding risk (HBR) patients. This is the first study comparing outcomes for a 1‐month versus longer DAPT strategies following PF‐BES‐percutaneous coronary intervention (PCI). Methods All patients undergoing PF‐BES‐PCI (January 2016 to July 2018) were included in the multicenter CHANCE registry. Patients were stratified according to DAPT strategy at discharge (planned 1‐month vs. planned >1‐month). Primary outcomes were the 390‐day estimates of a patient‐oriented and of a device‐oriented composite endpoints (POCE: death, myocardial infarction [MI] or target vessel revascularization; DOCE: cardiac death, target vessel‐MI or ischemia‐driven target lesion revascularization). Landmark analyses from 1‐month post‐PCI were carried. Results Following PF‐BES‐PCI, 328(40.3%) and 485(59.6%) patients were discharged with 1‐month and longer DAPT (12 months [6–12]), respectively. Patients with a previous or index MI were less likely to be discharged on 1‐month DAPT. Patients prescribed with 1‐month DAPT were more likely to be at HBR than those with longer DAPT (90.2% vs. 69.9%, p = .001). No between‐groups differences in the primary outcomes (planned 1‐month vs. planned >1‐month DAPT: POCE 11.9% vs. 13.2%, p = .747; DOCE: 4.8% vs. 8.1%, p = .500) were observed, also after adjusting for confoundings (POCE: adjusted‐hazard ratio [adj‐HR] 1.26, 95%CI 0.74–2.13; DOCE: adj‐HR 1.00, 95%CI 0.49–1.99). Landmark analyses showed similar results. Conclusions In a large all‐comers registry of PF‐BES PCI, no interaction of planned DAPT strategy (1‐month vs. >1‐month) with outcomes was found. This observation warrants investigation in adequately powered randomized studies (http://clinicaltrials.gov NCT03622203).

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Angiographic and clinical performance of polymer‐free biolimus‐eluting stent in patients with ST‐segment elevation acute myocardial infarction in a metropolitan public hospital: The BESAMI MUCHO study

Abstract: In real-world setting, implantation of a new-generation polymer-free BES during STEMI is associated with favorable clinical and angiographic results, pointing toward the overall efficacy and safety of the device in complex clinical scenarios.

Cited by 9 publications

References 34 publications

Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

Determinants of angiographic thrombus burden and impact of thrombus aspiration on outcome in young patients with ST‐segment elevation myocardial infarction

Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers

Real‐world reasons and outcomes for 1‐month versus longer dual antiplatelet therapy strategies with a polymer‐free BIOLIMUS A9‐coated stent

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