Early vascular healing of ultra-thin strut polymer-free sirolimus-eluting stents in acute coronary syndrome: USUI-ACS study

Matsuhiro, Yutaka; Egami, Yasuyuki; Okamoto, Naotaka; Kusuda, Masaya; Sakio, Takashige; Nohara, Hiroaki; Sugae, Hiroki; Kawanami, Shodai; Kawamura, Akito; Ukita, Kohei; Nakamura, Hitoshi; Yasumoto, Koji; Tsuda, Masaki; Matsunaga‐Lee, Yasuharu; Yano, Masamichi; Nishino, Masami; Tanouchi, Jun

doi:10.1007/s12928-022-00862-2

Cited by 7 publications

(1 citation statement)

References 32 publications

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“…This offers the possibility of releasing the drug in a controlled manner and then dissolving the polymer material. This, at least theoretically, might decrease the stimulus for a persistent inflammatory state predisposing one to future ischemic events such as in-stent thrombosis [24]. In the HATTRICK-OCT trial, BP-SES enabled slightly better stent strut coverage at 3 months compared to a durable polymer (DP) zotarolimus-eluting stent (ZES) [25].…”

Section: Discussionmentioning

confidence: 99%

48-Month Clinical Outcomes and Prognostic Factors in an All-Comers Population with Acute Coronary Syndrome and Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention with a Sirolimus-Eluting Stent

Tyczynski,

Kern,

Buller

et al. 2023

JPM

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We characterized the performance as well as safety of a second-generation thin-strut sirolimus-eluting stent with a biodegradable polymer, Alex Plus (Balton, Poland), deployed in the acute coronary syndrome (ACS) setting. We enrolled patients who were subjected to percutaneous coronary intervention (PCI) between July 2015 and March 2016 and took into consideration demographics, clinical and laboratory data, and clinical outcomes. We defined the primary endpoint as the 48-month rate of major cardiovascular adverse events (MACE), including cardiac death, myocardial infarction (MI), or target lesion revascularization (TLR). The secondary endpoints were all-cause death, cardiac death, MI, and TLR rates at 12-, 24-, 36-, and 48 months. We enrolled 232 patients in whom 282 stents were implanted, including 88 ACS and 144 chronic coronary syndrome (CCS) patients. The mean age of the ACS population was 67 ± 13 years old, and 32% of it consisted of females. Patients with ACS were characterized by lower rates of arterial hypertension (85.2% vs. 95.8%, p = 0.004), dyslipidemia (67% vs. 81.9%, p = 0.01), prior MI (34.1% vs. 57.6%, p < 0.001), and prior PCI (35.2% vs. 68.8%, p < 0.001). At 48 months, among the ACS patients, the rates of MACE, death, cardiac death, MI, and TLR were 23.9%, 11.4%, 7.9%, 9.1%, and 10.2%, respectively. No stent thrombosis cases were reported. Multivariable Cox regression revealed that the statistically significant MACE predictors were massive calcifications in coronary arteries (HR 9.0, 95% CI 1.75–46.3, p = 0.009), post-dilatation (HR 3.78, 95% CI 1.28–11.2, p = 0.016), prior CABG (HR 6.64, 95% CI 1.62–27.1, p = 0.008), vitamin K antagonist use (HR 5.99, 95% CI 1.29–27.8, p = 0.022), and rivaroxaban use (HR 51.7, 95% CI 4.48–596, p = 0.002). The study findings show that Alex Plus was effective and safe in a contemporary cohort of real-world ACS patients undergoing primary PCI. The outcomes were comparable between the ACS and chronic coronary syndrome patients, with a trend of lower TLR in ACS patients at 4 years.

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Section: Discussionmentioning

confidence: 99%

48-Month Clinical Outcomes and Prognostic Factors in an All-Comers Population with Acute Coronary Syndrome and Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention with a Sirolimus-Eluting Stent

Tyczynski,

Kern,

Buller

et al. 2023

JPM

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Antithrombotic management in atrial fibrillation patients following percutaneous coronary intervention: A clinical review

Saito,

Kobayashi

2024

Journal of Arrhythmia

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Patients with atrial fibrillation (AF) often develop acute coronary syndrome and undergo percutaneous coronary intervention (PCI), and vice versa. Acute coronary syndrome and PCI mandate the use of dual antiplatelet therapy, while oral anticoagulation is recommended in patients with AF to mitigate thromboembolic risks. Clinical evidence concerning antithrombotic treatment in patients with AF and PCI has been accumulated, but when combined, the therapeutic strategy becomes complex. Although triple therapy, a combination of oral anticoagulation with dual antiplatelet therapy, has been used for patients with AF undergoing PCI as an initial antithrombotic strategy, less intensive regimens may be associated with a lower rate of bleeding without an increased risk in thrombotic events. This narrative review article summarizes currently available evidence of antithrombotic therapy in patients with AF undergoing PCI.

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Current situation and overview of resorbable magnesium scaffolds: a perspective for overcoming the remaining issues of polymeric bioresorbable scaffold

Seguchi,

Sakakura,

Taniguchi

et al. 2024

Cardiovasc Interv and Ther

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Early vascular healing of ultra-thin strut polymer-free sirolimus-eluting stents in acute coronary syndrome: USUI-ACS study

Cited by 7 publications

References 32 publications

48-Month Clinical Outcomes and Prognostic Factors in an All-Comers Population with Acute Coronary Syndrome and Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention with a Sirolimus-Eluting Stent

48-Month Clinical Outcomes and Prognostic Factors in an All-Comers Population with Acute Coronary Syndrome and Chronic Coronary Syndrome Undergoing Percutaneous Coronary Intervention with a Sirolimus-Eluting Stent

Antithrombotic management in atrial fibrillation patients following percutaneous coronary intervention: A clinical review

Current situation and overview of resorbable magnesium scaffolds: a perspective for overcoming the remaining issues of polymeric bioresorbable scaffold

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