One-year clinical outcomes of different coronary drug eluting stents—Data from a prospective registry

Sastry, B.K.S.; Nallamalla, Krishna Reddy; Kumar, Nirmal; Deepti, K.; Menon, Rajeev

doi:10.1016/j.ihj.2018.05.012

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Some studies have suggested that, compared to first-generation DES, second-generation DES are associated with better vascular healing, lower prevalence of neoatherosclerosis and reduction in the incidence of unstable features such as disrupted neointima, thin-cap fibroatheroma, thrombus and fibrin deposition [27, 28]. In our setting, a plethora of stent types with various combinations of anti-proliferative drugs and polymers are available which makes it difficult to analyse the results stratified by stent types [29]. Mechanisms underlying ACS presentations with various stent types need further studies.…”

Section: Discussionmentioning

confidence: 99%

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In-stent restenosis of drug-eluting stents: clinical presentation and outcomes in a real-world scenario

et al. 2019

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BackgroundDrug-eluting stents (DES) have substantially reduced the incidence of coronary in-stent restenosis (ISR), but the problem persists. Clinical presentation and outcomes of DES-ISR in a real-world scenario remains underreported.ResultsIn this retrospective study, we examined medical records of 191 consecutive patients with DES-ISR (210 ISR lesions) hospitalized between January 2013 and December 2017. ISR clinical presentation was classified as acute coronary syndrome (ACS) or non-ACS. Clinical, angiographic features and 1-year outcomes [composite of death, myocardial infarction (MI) and repeat-target lesion revascularization] for these two groups were compared.The mean age of study population was 61 ± 10 years and 81.2% were males. ACS was the dominant clinical presentation mode occurring in 118 (61.8%) patients. MI was seen in 66 (34.6%) patients. Female gender (odds ratio, 2.71; 95% confidence interval [CI], 1.13–6.52; P = 0.026) and chronic kidney disease (odds ratio, 3.85; 95% CI, 1.05–14.20; P = 0.043) correlated significantly with ACS ISR presentation. A majority [104 (54.5%)] of patients underwent percutaneous coronary intervention (PCI), of whom 72 (69.2%) received a new DES. The rest either underwent CABG (26.2%) or received medical therapy (19.4%). Patients presenting with ACS had a significantly worse clinical outcome at 1-year follow-up (ACS versus non-ACS presentation: hazard ratio [HR], 2.66; 95% CI, 1.09–6.50; P = 0.032).ConclusionsDES-ISR presents most commonly as ACS. Female gender and chronic kidney disease seem to be associated with ACS presentation. ACS presentation of ISR is associated with worse 1-year outcomes. Early identification of those with ACS risk and closer follow-up may improve outcomes.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, the impact of the type of DES on clinical presentation could not be compared. However, in developing countries like ours, a variety of stent types with various combinations of anti-proliferative drugs and polymers are available which makes it difficult to segregate them into two or three groups for study purposes [29].…”

Section: Discussionmentioning

confidence: 99%

In-stent restenosis of drug-eluting stents: clinical presentation and outcomes in a real-world scenario

et al. 2019

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“…1,2 Although restenosis still develops after modern DES in 5 to 10% patients, 3,4 and this has become a common clinical problem despite widespread use of 3rd generation DES. 5,6 however, if we compare it with BMS stent restenosis, DES restenosis treatment is associated with poor long-term outcomes; present data suggest that after repeat stenting, 10-20% of these patients go on to develop recurrent restenosis. 7,8 Coronary intervention with stenting is best treatment modality for both acute coronary syndrome and stable ischemic heart disease.…”

Section: Introductionmentioning

confidence: 80%

Frequency of In-Stent Restenosis among Different 2nd/3rd Drug Eluting Stents in Patients Presenting with ACS/Angina at Trtiary Cradiac Care Centre

Ghaffar

Rehman²,

Khan³

et al. 2022

PAFMJ

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Objective: Primary objective was to determine the frequency of in-stent restenosis (ISR) among second/third generation drug eluting stents (DES), diagnosed angiographically in cardiac catheterization laboratory either in emergency settings or elective stage procedure and to determine the risk factors precipitating ISR. Study Design: Analytical Cross-sectional study. Place and Duration of the study: Tertiary Cardiac Care Center of Rawalpindi Pakistan, from Nov 2021 to Apr 2022. Methodology: After hospital ethical committee approval, medical data of consecutive patients were analyzed. Clinical and bio data were obtained followed by admission. Risk factors for atherosclerosis obtained along with baseline investigations and echocardiogram obtained to calculate ejection fraction. Classified interventional cardiologists analyzed angiographic images and confirmed the presence of ISR. Details of previous angioplasty and type of stent were documented. Results: Out of total 137 patients, 98(72%) were males and 39(28%) females. 94(68%) patients were diabetic, 102(72%) were hypertensive, 72(52%) had dyslipidemia, 56(40%) were smokers, and 32(23.35%) strong family history of CHD. After coronary angiography we found that frequency of ISR was 32(23%) in patients who had Xlimus sirolimus stent, 34(24.8%) patients had Xience (everolimus eluting stent), 33(24%) had Ultimaster (sirolimus eluting stent), 38(27%) had Biomatrix stent with p-value=0.25. Conclusion: The clinical presentation of ISR is usually with angina in all new generation DES. There was no statistically significant difference in terms of ISR among second/3rd generation DES. DES ISR not only depends upon the type of DES used but also depends upon multiple patient ...

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“…Although there is no scientific difference between indigenously developed DES vs those developed and marketed by global manufacturers, cost effectiveness remains a key factor in the decision-making process for patients and health care providers in India[21]. The most promising results of this retrospective study are 100% procedural success rate and low rates of MACE (4.87%).…”

Section: Discussionmentioning

confidence: 96%

One-year outcomes of a NeoHexa sirolimus-eluting coronary stent system with a biodegradable polymer in all-comers coronary artery disease patients: Results from NeoRegistry in India

Jambunathan¹,

Basavanna²,

Vani³

et al. 2019

WJC

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BACKGROUND Biodegradable polymer drug-eluting stents (BP-DES) have shown to reduce restenosis rates and have low rates of stent thrombosis. The present postmarketing surveillance assessed 1-year clinical outcomes of patients who had received NeoHexa DES in real practice. AIM To investigate 1-year clinical outcomes of Neohexa DES in real practice. METHODS Data obtained from a single-center cohort of patients who had received NeoHexa stents as part of routine treatment of coronary artery disease (CAD) were retrospectively investigated. The primary study endpoint was the rate of major adverse cardiac events (MACEs) defined as the composite of death, myocardial infarction (MI), and target lesion revascularization (TLR) during the follow-up at 1 mo, 6 mo, and 1 year after the index procedure. RESULTS A total of 129 patients with 172 lesions were enrolled. The most common comorbid conditions were hypertension (49.61%) and diabetes mellitus (39.53%). Procedural success was achieved in all patients, and no in-hospital MACE was reported. The incidence of composite MACE at 30 d, 6 mo, and 1 year was 0.78%, 3.94%, and 4.87%, respectively. The rate of possible and probable late stent thrombosis was 0.78%. The cumulative incidences of death, MI, and TLR at 1 year were 2.44%, 0.81%, and 1.63%, respectively. CONCLUSION The relatively low rates of MACE and stent thrombosis in this study support safety and performance of NeoHexa stents, suggesting it to be an effective alternative to other contemporary stents for the treatment of de novo lesions in native coronary arteries.

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One-year clinical outcomes of different coronary drug eluting stents—Data from a prospective registry

Cited by 6 publications

References 13 publications

In-stent restenosis of drug-eluting stents: clinical presentation and outcomes in a real-world scenario

In-stent restenosis of drug-eluting stents: clinical presentation and outcomes in a real-world scenario

Frequency of In-Stent Restenosis among Different 2nd/3rd Drug Eluting Stents in Patients Presenting with ACS/Angina at Trtiary Cradiac Care Centre

One-year outcomes of a NeoHexa sirolimus-eluting coronary stent system with a biodegradable polymer in all-comers coronary artery disease patients: Results from NeoRegistry in India

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