Impact of diabetes on the benefits from everolimus-eluting stent as compared to first-generation drug-eluting stent in patients with ST elevation myocardial infarction

Luca, Giuseppe De; Sauro, Rosario; Capasso, Michele; Lanzillo, Tonino; Manganelli, Fiore; Carbone, Giannignazio; Lanni, Francesca; Pagliuca, Maria Rosaria; Palmieri, Vittorio; Serino, Vincenzo; Rosato, Giuseppe; Suryapranata, Harry; Lorenzo, Emilio Di

doi:10.1177/1479164115592252

Cited by 11 publications

(9 citation statements)

References 31 publications

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“…Great improvements have been achieved in the treatment of patients with CAD and especially among those higher risk categories, as patients with an acute myocardial infarction (AMI), where an early invasive management and more potent antithrombotic strategies have provided a significant improvement in clinical outcome. 16 –19…”

Section: Discussionmentioning

confidence: 99%

Impact of Long-Term Dual Antiplatelet Therapy on Immature Platelet Count and Platelet Reactivity

Verdoia¹,

Pergolini²,

Rolla³

et al. 2017

Angiology

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The immature platelet count (IPC) is a potential marker of platelet reactivity. We assessed the relationship between IPC during chronic dual antiplatelet therapy (DAPT) and the response to antiplatelet drugs (acetylsalycilic acid + clopidogrel/ticagrelor). We included 286 patients: 167 (58.4%) patients received ticagrelor and 119 (41.6%) received clopidogrel. At a median follow-up of 46.5 days, the variation in IPC displayed an absolute median (interquartile range [IQR]) of -11.9 × 10/µL (-182.7 to 160.8), corresponding to a median percentage change in IPC ([%ΔIPC] IQR) of -0.3% (-21.9% to 35.5%), with an increase in IPC levels in those on ticagrelor and a decrease in IPC levels in those on clopidogrel. We observed an inverse association of lower platelet reactivity at different tests and a higher increase in IPC ( r = -0.14, P = .04 for arachidonic acid test; r = -0.12, P = .05 for collagen test; and r = -0.13, P = .02 for adenosine diphosphate test [ADP]). The rate of poor effectiveness of ADP antagonists was the only independent predictor of a ΔIPC above the third tertile (odds ratio [95% confidence interval] = 0.55 [0.32-0.99]; P = .048). We showed that in patients treated with chronic DAPT, an increase in IPC is significantly related to lower levels of platelet reactivity.

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Section: Discussionmentioning

confidence: 99%

Impact of Long-Term Dual Antiplatelet Therapy on Immature Platelet Count and Platelet Reactivity

Verdoia¹,

Pergolini²,

Rolla³

et al. 2017

Angiology

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“…Recent advances in the technologies of drug eluting stents (DES) have significantly improved the outcomes of patients with coronary artery disease (CAD), [1][2][3] although not completely overcoming the surgical revascularization in certain more complex settings of patients, [4][5][6] where the need of extensive stenting and "metalization" of the coronary tree has been shown to increase the risk of restenosis, repeated revascularization and loss of the physiological vasomotion properties. 7,8 Bioresorbable vascular scaffolds (BVS) have been proposed as a potential solution to the long-term limitations of permanent metallic stents, 9 offering the benefits of mechanical stabilization of the plaque and drug delivery capability for a shorter period, thereafter allowing a potential restitutio ad integrum of the native coronary wall.…”

Section: Introductionmentioning

confidence: 99%

Poly (l‐lactic acid) bioresorbable scaffolds versus metallic drug‐eluting stents for the treatment of coronary artery disease: A meta‐analysis of 11 randomized trials

Verdoia¹,

Kedhi

Suryapranata³

et al. 2019

Cathet Cardio Intervent

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Background: Bioresorbable vascular scaffolds (BVS) have been proposed for overcoming the long-term limitations of permanent metallic stents, while theoretically warranting similar advantages in plaque stabilization and anti-restenotic drug delivery in the early postrevascularization phase. However, increased rates of malapposition, restenosis, or thrombosis have emerged from initial trials with BVS, that were nevertheless underpowered for the evaluation of the real outcome benefits of these coronary devices. The recent completion of newer randomized clinical trials paves the way to the present meta-analysis, aiming at the comparison of Poly (L-Lactic acid) BVS (PLLA-BVS) versus metallic drug-eluting stents (DES) in the treatment of coronary stenoses. Methods: Literature and main scientific session abstracts were searched for randomized clinical trials (RCTs) comparing drug-eluting BVS versus metallic DES for the treatment of coronary artery disease (CAD). The primary efficacy endpoint was mortality, secondary endpoints were cardiovascular death, myocardial infarction, target lesion revascularization (TLR), stent thrombosis and the composite of device-oriented target lesion failure (TLF). Results: We included 11 randomized trials, for a total population of 10,707 patients, 54.5% treated with BVS. The major indication for PCI was stable CAD, whereas acute coronary syndrome represented 30% of the patients. At a mean follow-up of 2.64 years (1-5 years), mortality occurred in 2.71% of the patients, with no difference according to the type of implanted stent (OR[95%CI] = 0.94 [0.74, 1.20], p = .62). No interaction was observed according to patients' risk profile or the rate of diabetes and ACS. However, a significant increase in myocardial infarction, stent thrombosis, TLR and TLF was observed with BVS as compared to DES. Conclusions: The present meta-analysis provides the most updated data on the use of PLLA-BVS for the treatment of CAD. We documented a poorer performance of these new coronary devices, as compared to new generation metallic DES, being associated with an increased rate of recurrent cardiovascular events. However, such ischemic complications did not impact on mortality, with a comparable survival independently from the type of stent.

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“…Our finding that diabetic subjects with acute MI have low levels of SPA could be important because diabetics have a disproportionately higher rate of acute MI: 33% of acute MI occurs in diabetics, and diabetes is associated with a >2-fold increase in recurrent major adverse cardiac events after index MI compared with non-diabetic counterparts ( 17 – 19 ). Furthermore, diabetics are known to have generalized defects in connective tissue metabolism.…”

Section: Discussionmentioning

confidence: 89%

“…The MI type was determined using novel criteria specifically developed for this study and incorporated historical, biochemical, electrocardiographic, histological and core lab read coronary angiographic data. Additionally, because diabetics have higher rates of MI in general ( 17 – 19 ), we determined whether prolidase activity was associated with diabetes status in a small number of diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

Circulating Prolidase Activity in Patients with Myocardial Infarction

Sultan

Zheng

Trainor

et al. 2017

Front. Cardiovasc. Med.

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BackgroundCollagen is a major determinant of atherosclerotic plaque stability. Thus, identification of differences in enzymes that regulate collagen integrity could be useful for predicting susceptibility to atherothrombosis or for diagnosing plaque rupture. In this study, we sought to determine whether prolidase, the rate-limiting enzyme of collagen turnover, differs in human subjects with acute myocardial infarction (MI) versus those with stable coronary artery disease (CAD).MethodsWe measured serum prolidase activity in 15 patients with stable CAD and 49 patients with acute MI, of which a subset had clearly defined thrombotic MI (n = 22) or non-thrombotic MI (n = 12). Prolidase activity was compared across study time points (at cardiac catheterization, T0; 6 h after presentation, T6; and at a quiescent follow-up, Tf/u) in acute MI and stable CAD subjects. We performed subgroup analyses to evaluate prolidase activity in subjects presenting with acute thrombotic versus non-thrombotic MI.ResultsAlthough prolidase activity was lower at T0 and T6 versus the quiescent phase in acute MI and stable CAD subjects (p < 0.0001), it was not significantly different between acute MI and stable CAD subjects at any time point (T0, T6, and Tf/u) or between thrombotic and non-thrombotic MI groups. Preliminary data from stratified analyses of a small number of diabetic subjects (n = 8) suggested lower prolidase activity in diabetic acute MI subjects compared with non-diabetic acute MI subjects (p = 0.02).ConclusionCirculating prolidase is not significantly different between patients with acute MI and stable CAD or between patients with thrombotic and non-thrombotic MI. Further studies are required to determine if diabetes significantly affects prolidase activity and how this might relate to the risk of MI.

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Impact of diabetes on the benefits from everolimus-eluting stent as compared to first-generation drug-eluting stent in patients with ST elevation myocardial infarction

Cited by 11 publications

References 31 publications

Impact of Long-Term Dual Antiplatelet Therapy on Immature Platelet Count and Platelet Reactivity

Impact of Long-Term Dual Antiplatelet Therapy on Immature Platelet Count and Platelet Reactivity

Poly (l‐lactic acid) bioresorbable scaffolds versus metallic drug‐eluting stents for the treatment of coronary artery disease: A meta‐analysis of 11 randomized trials

Circulating Prolidase Activity in Patients with Myocardial Infarction

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