Second generation drug‐eluting stents <i>versus</i> bare‐metal stents for percutaneous coronary intervention of the proximal left anterior descending artery: An analysis of the BASKET‐PROVE I and II trials

Mangione, Fernanda Marinho; Nochioka, Kotaro; Jatene, Tannas; Silvestre, Odílson Marcos; Hansen, Kim Wadt; Sørensen, Rikke; Jensen, Jan Skov; Jørgensen, Peter Godsk; Jeger, Raban; Kaiser, Christoph; Pfisterer, Matthias; Galatius, Søren

doi:10.1002/ccd.27200

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…Furthermore, the intravascular imaging included in our study includes IVUS and OCT. Meanwhile, our study included all types of DES, new-generation of DES may lead to better clinical outcomes [ 32 , 33 ]. However, the subgroup analysis of the first or second-generation and new-generation DES in this study did not get a positive result, which may be related to insufficient sample size and different trials have been associated with different definitions of clinical outcomes.…”

Section: Limitationmentioning

confidence: 99%

Efficacy of intravascular imaging-guided drug-eluting stent implantation: a systematic review and meta-analysis of randomized clinical trials

Niu

Bai

et al. 2022

BMC Cardiovasc Disord

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Background Traditional angiography only displays two-dimensional images of the coronary arteries during stent implantation. However, intravascular imaging can show the structure of the vascular wall, plaque characteristics. This article aims to evaluate the efficacy of intravascular imaging-guided drug-eluting stent (DES) implantation. Method We conducted a systematic review and meta-analysis of randomized controlled trials of intravascular imaging-guided, including patients with DES implantation guided by intravascular ultrasound or optical coherence tomography and traditional angiography. The databases of PubMed, EMBASE, web of science, and Cochrane Library were searched. The primary outcome was target lesion revascularization (TLR). The secondary outcomes included the target vessel revascularization (TVR), myocardial infarction (MI), stent thrombosis (ST), cardiac death, all-cause death, and the major adverse cardiac events (MACE) during the 6–24 months follow-up. The fixed-effects model was used to calculate the relative risk (RR) and 95% confidence interval of the outcome event. Meanwhile, the trial sequence analysis was employed to evaluate the results. Result This meta-analysis included fourteen randomized controlled trials with 7307 patients. Compared with angiography-guided, intravascular imaging-guided DES implantation can significantly reduce the risk of TLR (RR 0.63, 0.49–0.82, P = 0.0004), TVR (RR 0.66, 0.52–0.85, P = 0.001), cardiac death (RR 0.58; 0.38–0.89; P = 0.01), MACE (RR 0.67, 0.57–0.79; P < 0.00001) and ST (RR 0.43, 0.24–0.78; P = 0.005). While there was no significant difference regarding MI (RR 0.77, 0.57–1.05, P = 0.10) and all-cause death (RR 0.87, 0.58–1.30, P = 0.50). Conclusions Compared with angiography, intravascular imaging-guided DES implantation is associated with better clinical outcomes in patients with coronary artery disease, especially complex lesions (Registered by PROSPERO, CRD 42021289205).

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Section: Limitationmentioning

confidence: 99%

Efficacy of intravascular imaging-guided drug-eluting stent implantation: a systematic review and meta-analysis of randomized clinical trials

Niu

Bai

et al. 2022

BMC Cardiovasc Disord

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“…[2][3][4] The development of DES was considered as another pronounced leap in the field of interventional cardiology and various clinical trials demonstrated the superiority of DES over BMS with significant decrease in the target lesion revascularisation (TLR) and ISR rates. [6][7][8][9][10][11] However, with the incidence of late stent thrombosis, the usage of earlier generation DES with durable polymers and thick strut reduced significantly. This led to another breakthrough in the development of newer generation DES with thinner struts that were coated with biodegradable polymers and newer antiproliferative agents.…”

Section: Introductionmentioning

confidence: 99%

Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice

Chandwani¹,

Meel²,

Singhal³

et al. 2019

Ann Acad Med Singap

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Introduction: Although drug-eluting stents (DES) have outclassed the use of bare metal stents, the safety and efficacy of DES at long-term follow-up has still been conflicting because of increased occurrence of late or very late restenosis and stent thrombosis after DES implantation. Hence, the present study was aimed to evaluate the 3-year safety and clinical performance of biodegradable polymer-coated ultra-thin (60 μm) sirolimus-eluting stent (SES) in real-world patients with coronary artery disease (CAD). Materials and Methods: This was a physician-initiated, retrospective, single-centre, observational study that included 237 consecutive patients who had previously undergone implantation of only Supraflex SES (Sahajanand Medical Technologies Pvt Ltd, Surat, India) for the treatment of CAD. Follow-up was received after 1 year and 3 years of stent implantation. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR). Stent thrombosis was considered as a safety endpoint. Results: The mean age of patients was 64.1 ± 10.2 years, and 192 (81.0%) patients were male. The average stent length and diameter were 24.4 ± 9.0 mm and 3.1 ± 0.4 mm, respectively. The cumulative MACE rate at 3 years follow-up was 6.5% which included 4 (1.8%) cardiac deaths, 6 (2.8%) MI, and 4 (1.8%) TLR. There were 2 (0.9%) cases of stent thrombosis. Conclusion: Treatment of patients with CAD in real-world clinical practice was associated with sustained clinical safety and low rates of restenosis, stent thrombosis and MACE up to 3 years after Supraflex SES implantation. Key words: Coronary artery disease, Percutaneous coronary intervention

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“…Имплантация ГМС, представляющих собой металлический каркас, была сопряжена с повышенной тромбогенностью и вероятностью рестеноза ранее стентированного сегмента. Нанесение на стент лекарственного покрытия подавляет избыточную пролиферацию неоинтимы и снижает вероятность рестеноза по сравнению с таковыми при использовании непокрытых (голометаллических) стентов [2][3][4].…”

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The Incidence and Possible Predictors of Coronary Restenosis

et al. 2020

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Objective. Assess time and possible predictors of restenosis after the implantation of first- and second-generation coronary stents and bare metal stents (BMSs) in patients with stable coronary artery disease after elective coronary stenting.Materials and Methods. From 2010 to 2014, 3,732 (2,897 males, 60 [53; 68] years old) patients with stable exertional angina of functional class I–III underwent coronary stenting. From 2014 to 2017, 1,487 (1,173 males and 314 females) patients returned. Repeat coronary angiography was performed in 699 patients.Results. A total of 644 first-generation stents, 5,321 second-generation stents, and 473 BMSs were implanted. During the control coronary angiography, contrasting was repeated for 193 first-generation stents, 899 second-generation stents, and 77 BMSs. Restenosis (stenosis of 50 % or more in the previously stented segment) was detected in 28 (14 % of angiographic control) first-generation drug-eluting stents, 94 (10 %) second-generation drug-eluting stents, and 21 (27 %) BMSs. Patients with BMS restenosis returned significantly earlier than patients with restenosis of the first- and second-generation drug-eluting stents (11 [6, 27] months vs. 32 [11; 48]) months and 24 [12; 42] months, respectively; p<0.05). The initial and repeat levels of high-sensitivity C-reactive protein (hs-CRP) were higher in patients with restenosis (2.2 [1.2, 5.0] mg / L vs. 2.1 [1.0, 4.6] mg / L, respectively; p> 0.05) than in patients without restenosis (2.0 [0.9, 4.2] mg / L vs. 1.9 [0.7, 3.5] mg / L respectively, p>0.05). Blood levels of hs-CRP ≥2 mg / L according to receiver operating characteristic curve (ROC) analysis at return visit were used as a predictor to identify restenosis of stents with a diameter <3 mm and a length >25 mm – area under the curve (AUC) 0.67 (95 % confidence interval (CI) 0.51–0.84), p <0.05, odds ratio 3.7 (95 % CI 1.1–12.1), p<0.05. Stent type had a significant effect on the time to restenosis in the survival analysis (p<0.0005).Conclusion. The time from coronary stenting to the return visit of patients presenting with restenosis after the implantation of first- and second-generation drug-eluting stents is consistent; median time of the return visit of patients with restenosis of the first-generation stents was 2–3 years after coronary stenting. Blood levels of hs-CRP ≥2 mg / L at the return visit is a predictor of restenosis of stents with a diameter <3 mm and a length >25 mm.

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Second generation drug‐eluting stents versus bare‐metal stents for percutaneous coronary intervention of the proximal left anterior descending artery: An analysis of the BASKET‐PROVE I and II trials

Abstract: In patients with proximal LAD stenosis, treatment with second-generation DES was associated with reduced 2-year rates of adverse cardiac events and TVR compared to BMS, with reintervention rates similar to those earlier reported from bypass surgery.

Cited by 4 publications

References 28 publications

Efficacy of intravascular imaging-guided drug-eluting stent implantation: a systematic review and meta-analysis of randomized clinical trials

Efficacy of intravascular imaging-guided drug-eluting stent implantation: a systematic review and meta-analysis of randomized clinical trials

Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice

The Incidence and Possible Predictors of Coronary Restenosis

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