Nobori Biolimus-Eluting Stent vs. Permanent Polymer Drug-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention

Danzi, Gian Battista; Piccolo, Raffaele; Galasso, Gennaro; Piscione, Federico

doi:10.1253/circj.cj-13-1558

Cited by 11 publications

(9 citation statements)

References 39 publications

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“…3,4) However, BES did not exhibit angiographic efficacy compared to SES in 2 previous randomized studies. 7,8) Compared to the results of the Nobori-Japan trial (0.14 mm), 7) the mean LLL in the SES group (0.28-0.36 mm; Tables III and IV) was larger, suggesting that the present cohort included complex lesions with a higher propensity for ISR, reflecting the daily practice environment as described above. Although the platform of BES was relatively thick (120 µm), a 2-link based 3.5 mm-sized BES could dilate the most as compared to other second generation DESs.…”

Section: Discussionmentioning

confidence: 60%

“…1,2) The biolimus-eluting stent (BES; Nobori) also showed a better midterm intravascular response compared to SES, owing to its properties such as being a biodegradable polymer and the highest lipophilicity among the limus analogues. 3,4) However, despite these advanced aspects of EES and BES compared with the former evidence-based first generation "-limus" DES, that is, SES, prospective randomized trials have not demonstrated significantly better midterm angiographic outcomes for either EES 5,6) or BES 7,8) in terms of binary in-stent restenosis, TLR, or mean magnitude of in-stent late luminal loss compared to those of SES.In the present study, we conducted a retrospective comparison to examine the impact of the advances in coronary stent technology, represented by improved intravascular and pathological findings of either EES or BES over SES 1-4) on the overall midterm angiographic outcomes. For this purpose, 3420 lesions angiographically followed-up within 550 days after successful placement of either SES, EES, or BES by elective procedure were identified from the unified database of 6 institutes.…”

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Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for <i>De Novo</i> Coronary Stenosis

et al. 2017

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SummaryWe conducted propensity-score matched comparisons of midterm angiographic outcomes of sirolimus (SES) versus either everolimus-(EES) or biolimus-(BES) eluting stents after placements for coronary stenosis in a daily practice environment since previous randomized trials did not demonstrate the superiority of EES and BES over SES in terms of midterm angiographic outcomes.The present study was a non-randomized, retrospective, and lesion-based study, recruiting angiographically followed-up lesions within 550 days after successful and elective SES (n = 1793), EES (n = 1303), or BES (n = 324) placement for de novo native coronary stenosis during the period from August 2004 to January 2014 at 6 institutes. The endpoint, as an angiographic surrogate marker of clinical efficacy, was the distribution of in-stent follow-up percent diameter stenosis (%DS) which comprised the percentages of 1) follow-up %DS < 20 and 2) follow-up %DS > 50. Propensityscore matched analyses were conducted to adjust 21 baselines.In 1215 baseline adjusted lesions, the endpoints in the EES group [1) 74.1%, and 2) 4.6%] were significantly different from those in the SES group [57.9%; P < 0.001, 7.2%; P = 0.006, respectively). In 307 baseline adjusted lesions, the endpoints in the BES group [1) 80.5%, 2) 2.0%] were significantly different from those in the SES group [59.3%; P < 0.001, 2) 8.1%; P = 0.001, respectively].The present study is the first to confirm the superiority of midterm angiographic outcomes after the placement of EES and BES over SES for de novo coronary stenosis in a clinical setting. (Int Heart J 2017; 58: 320-327) Key words: Follow-up result, Angioplasty, Binary restenosis, Target lesion revascularization, Late luminal loss E verolimus-eluting stents (EES; Xience and Promus) have exhibited benefits associated with a favorable vascular response compared to sirolimus-eluting stents (SES; Cypher BxV and Select+), owing to their advanced drug-eluting stent (DES) technology that consists of the revised thin and flexible stent platform, anti-thrombogenic fluoropolymer, and drug. 1,2) The biolimus-eluting stent (BES; Nobori) also showed a better midterm intravascular response compared to SES, owing to its properties such as being a biodegradable polymer and the highest lipophilicity among the limus analogues. 3,4) However, despite these advanced aspects of EES and BES compared with the former evidence-based first generation "-limus" DES, that is, SES, prospective randomized trials have not demonstrated significantly better midterm angiographic outcomes for either EES 5,6) or BES 7,8) in terms of binary in-stent restenosis, TLR, or mean magnitude of in-stent late luminal loss compared to those of SES.In the present study, we conducted a retrospective comparison to examine the impact of the advances in coronary stent technology, represented by improved intravascular and pathological findings of either EES or BES over SES 1-4) on the overall midterm angiographic outcomes. For this purpose, 3420 lesions angiographically followed-up ...

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Section: Discussionmentioning

confidence: 60%

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confidence: 99%

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confidence: 99%

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Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for <i>De Novo</i> Coronary Stenosis

et al. 2017

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“…Noteworthy, these studies assessed other biodegradable-polymer coronary stents than the BP-BES used in the Nobori 2 registry. In contrast, pairwise meta-analyses showed that the BP-BES is associated with a similar safety and efficacy compared with permanent polymer DES at 1-year follow-up and a lower risk of TLR in comparison with the early-generation, paclitaxel-eluting stents 5 6…”

Section: Discussionmentioning

confidence: 98%

Five-year clinical performance of a biodegradable polymer-coated biolimus-eluting stent in unselected patients

Danzi

Piccolo

Chevalier

et al. 2016

Heart

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“…12 Meta-analysis has demonstrated that the use of the Nobori biolimus-eluting stent is associated with a similar safety and efficacy as permanent polymer DES at 1-year follow-up, albeit it is superior to paclitaxel-eluting stents in terms of target lesion revascularization rates. 13 In addition, of the next generation DES, the Nobori biolimus-eluting stent demonstrated a lower inflammatory response in the stented segment compared with the SES in a porcine coronary artery model. 14 Therefore, it is unknown whether IR will be a predictor of the late catch-up phenomenon after implantation of next-generation DES, and further prospective studies using these DES are needed.…”

Section: Disclosuresmentioning

confidence: 98%

Impact of Insulin Resistance on Clinical Outcomes After Implantation of Drug-Eluting Stents

Miyata

2016

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp or failed cellular response to insulin receptor-activated signaling in insulin-sensitive tissues such as the liver, skeletal muscle, adipose, and brain, which results in reduced glucose uptake by these tissues and concomitant increase in hepatic glucose output, both leading to elevated plasma glucose concentrations. The subsequent change in glucose homeostasis places an increased burden on pancreatic β-cells to produce and secrete more insulin in order to restore normal blood carbohydrate levels. 4 The hyperinsulinemia upregulates glucose transport, glycogen synthesis, gluconeogenesis, lipolysis, protein synthesis, proliferation, differentiation, and inflammation. 5 Uetani et al have reported the effect of IR on post-procedural myocardial injury and clinical outcomes after elective PCI with DES deployment. 6 The incidence of late and very late stent thrombosis increases after implantation of 1st-generation DES, in which delayed arterial healing and poor re-endothelialization may play a major role. 7 In addition, late incomplete stent apposition was observed in 8.7% of patients after implantation of a sirolimuseluting stent (SES), a 1st-generation DES. 8 An autopsy case ercutaneous coronary intervention (PCI) using drugeluting stents (DES) is a widespread and efficacious treatment for coronary artery disease, and has dramatically reduced the incidence of restenosis after PCI compared with bare-metal stents or balloon angioplasty. However, stent thrombosis and the late catch-up phenomenon are major problems of DES implantation. In this issue of the Journal, Komatsu et al analyze 109 patients who underwent elective PCI and implantation of 1st-generation DES and demonstrated that insulin resistance (IR) was associated with the late catchup phenomenon after DES implantation. 1 These findings are clinically interesting and evaluation of IR may provide useful information for predicting clinical outcomes after DES implantation. Article p 657IR is a key pathological factor of the metabolic syndrome, and associated with the risk of diabetes mellitus, microalbuminuria, 2 and cardiovascular events. 3 IR refers to an impaired Impact of Insulin Resistance on Clinical Outcomes After Implantation of Drug-Eluting StentsMasaaki Miyata, MD, PhD Figure. Insulin resistance, inflammation, and late catch-up phenomenon after drug-eluting stent (DES) implantation. Insulin resistance progresses the inflammation at the DES site and increases the incidence of the late catch-up phenomenon.

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Nobori Biolimus-Eluting Stent vs. Permanent Polymer Drug-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention

Cited by 11 publications

References 39 publications

Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for <i>De Novo</i> Coronary Stenosis

Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for <i>De Novo</i> Coronary Stenosis

Five-year clinical performance of a biodegradable polymer-coated biolimus-eluting stent in unselected patients

Impact of Insulin Resistance on Clinical Outcomes After Implantation of Drug-Eluting Stents

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