Impact of stent length and diameter on short term clinical outcomes of drug eluting stents in patients with stable coronary artery disease

Adnan, Yasir; Noor, Lubna; Dar, Muhammad Habeel; Ali, Umair; Hafizullah, Mohammad

doi:10.12669/pjms.334.13068

Cited by 13 publications

(13 citation statements)

References 20 publications

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“…This study also confirmed a linear relationship between abnormal flow and stent length, and longer stenting would result in a larger area of low WSS, high OSI, and RRT than the shorter one. This was in agreement with clinical conclusions, which showed that risk of in-stent recurrent stenosis and thrombosis increased with a longer stent [17,28].…”

Section: Rrt Distributionsupporting

confidence: 92%

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role in the Stented Segment and External Carotid Artery

Fan

Liu

Zhang

et al. 2021

Preprint

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Carotid stenting near the bifurcation carina is associated with adverse events, especially in-stent restenosis, in-stent thrombosis, and side branch occlusion in clinical data. This study aims to determine the potential biomechanical mechanisms for these adverse events after carotid stenting. The patient-specific carotid models were constructed with different stenting scenarios to study the flow distribution and hemodynamic parameters, such as wall shear stress (WSS), flow velocity, relative residence time (RRT), and oscillating shear index (OSI) in the carotid bifurcation. The results suggested that existing stent obviously reduced blood flow to external carotid artery (ECA) but enhanced local flow disturbance both in ECA and stented internal carotid artery (ICA), and the inner-posterior wall of stented ICA and the outer-posterior wall of ECA might endure a relatively low level of WSS and remarkably elevated OSI and RRT. In addition, the implanted stent leads to more ECA adverse flow than stented ICA. While disturbed flow in the vicinity of strut increased as stent length increased, blood flow and areas of local flow disturbance in ECA slightly decreased as stent length increased. In conclusion, the results revealed that ECA might be in relatively high levels of abnormal local hemodynamics after stenting, followed by stented ICA, leading to potential adverse events after interventions.

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Section: Rrt Distributionsupporting

confidence: 92%

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role in the Stented Segment and External Carotid Artery

Fan

Liu

Zhang

et al. 2021

Preprint

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“…For instance, the results from a meta-analysis found that females with smaller SDstreated with PCI had ahigher risk of definite stent thrombosis and target lesion revascularization, consistent with earlyand newgenerations of DES (18). However, in a prospective study, Adnan et al (19) reported that the length and diameter of stent did not have any impact on the short-term clinical outcomes of DES inpatients in stable CAD status.In addition, results from another meta-analysis observed mean stent length was longer in those patients suffering stent thrombosis, indicating that the risk of stent thrombosis after DES implantation is related to stent length (20). Although we observed that MACE incidence was increased with SSA, no statistically significant association between SSA and the risk of MACE development was detected in this study.…”

Section: Discussionmentioning

confidence: 93%

Joint effect of platelet distribution width and stent surface area on major adverse cardiovascular events after percutaneous coronary intervention

Zhang

Gong

et al. 2021

Ann Palliat Med

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Background: This study was conducted to analyze the influences of stent surface area (SSA), platelet distribution width (PDW), and the joint effect of these 2 risk factors on major adverse cardiovascular events (MACEs) in patients treated with percutaneous coronary intervention (PCI) together with drug-eluting stent (DES) implantation.Methods: Based on a cross-sectional survey conducted between 2011 and 2012, a prospective cohort study was enrolled consiting of 442 patients who had undergone PCI with DES implantation. We categorized the participants into 4 subgroups according to PDW and SSA. Cox proportional hazards models were applied to explore the correlation of PDW and SSA with MACE incidence.Results: During the 12 months of follow-up time, 87 patients experienced MACEs, which included 4 deaths (4.6%), 5 nonfatal myocardial infarctions (MIs) (5.75%), 9 ischemic strokes (10.34%), and 73 clinically relevant bleeding episodes (83.91%). The risks of MACEs were decreased by SSA and increased by PDW. However, the association of PDW or SSA with MACE was not statistically significant. Compared with the patients with PDW ≥13.5% and SSA <358.14 mm 2 , the multivariable adjusted hazard ratios [HRs; 95% confience interval (CI)] of the total MACEs for the patients with PDW <13.5% and SSA ≥358.14 mm 2 , and with PDW ≥13.5% and SSA ≥358.14 mm 2 were 0.94 (95% CI: 0.55-1.64) and 0.37 (95% CI: 0.18-0.76), respectively. Additionally, the patients in the group of PDW <13.5% and SSA <358.14 mm 2 , and PDW ≥13.5% and SSA ≥358.14 mm 2 had respective HRs of 0.47 (95% CI: 0.24-0.91) and 0.28 (95% CI: 0.13-0.63) for 12-month bleeding events when PDW ≥13.5% and SSA <358.14 mm 2 was used as a group reference.Conclusions: Our present results suggest that the joint effect of PDW and SSA was significantly correlated to MACE development in the patients treated with PCI (with DES implantation).

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“…14 Adnan et al suggested the role of cardiac troponin I 99th percentile URL of cardiac Troponin I elevation in the MI diagnosis. 15 Several studies have shown the manufacture's 99 th percentile URL does not match values seen in large community-based cohort studies and may result in major differences in the determination of the 99 th percentile URL. Kimenai et al compared the manufacturers hs-cTnT (Roche) and hs-cTnI (Abbott) threshold with the single sex-specific and age-specific 99th percentile URL reference local cohort.…”

Section: Discussionmentioning

confidence: 99%

Determination of high sensitive cardiac troponin I 99th percentile upper reference limits in a healthy Pakistani population

Bahadur¹,

Ijaz²,

Salahuddin³

et al. 2020

Pak J Med Sci

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Objective: This study aims to establish the 99th percentile upper reference limits of high sensitive cardiac troponin I in a healthy Pakistani population. Methods: It was an Observational cohort study carried out in Department of Chemical Pathology and Endocrinology Rehman Medical Institute Peshawar, over the period of one year (January 2019- December 2019). Total 299 cardio-healthy males and females were interviewed and taken past medical history. Based on history, clinical examination, echocardiogram and laboratory data including results of estimated glomerular filtration rate (eGFR) and N-terminal pro-B-type natriureteric peptide (NT-proBNP), subjects with possible subclinical diseases were excluded. High Sensitive Cardiac Troponin I (hs-cTtrop I) was analysed on Abbot ARCHITECT STAT ci8200 using chemiluminescent immunoassay technique. The 99th percentile upper reference limit (URL) of hs-cTtrop I was determined using a non-parametric statistic, while gender specific results were compared. Results: In this study, 178 males (59.5%) and 121 females (40.5%) were included. The median Interquartile ranges (IQR) of age was 57 (11.6) for males and 56 (13) for females. The 99th percentile URL hs-cTtrop I was found to be 33.9 ng/L, while gender specific values were 38.41ng/L and 15.73ng/L for males and females, respectively (p= 0.0045). Conclusion: High sensitivity cardiac troponin I 99th percentile URL in our study population was found to be 33.9 ng/L with gender specific values being 38.41 ng/L and 15.73ng/L for males and females respectively. Troponin I in males was substantially high in comparison with females. doi: https://doi.org/10.12669/pjms.36.6.2328 How to cite this:Bahadur K, Ijaz A, Salahuddin M, Alam A. Determination of high sensitive cardiac troponin I 99th percentile upper reference limits in a healthy Pakistani population. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2328 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Impact of stent length and diameter on short term clinical outcomes of drug eluting stents in patients with stable coronary artery disease

Cited by 13 publications

References 20 publications

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role in the Stented Segment and External Carotid Artery

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role in the Stented Segment and External Carotid Artery

Joint effect of platelet distribution width and stent surface area on major adverse cardiovascular events after percutaneous coronary intervention

Determination of high sensitive cardiac troponin I 99th percentile upper reference limits in a healthy Pakistani population

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