Seven-year clinical outcomes in patients undergoing percutaneous coronary intervention with biodegradable polymer coated sirolimus-eluting stent: Results from a single-center real-world experience

Abhyankar, Atul; Kaul, Upendra; Sinha, Santosh Kumar

doi:10.1016/j.ihj.2018.05.014

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…In the present study, we found a prevalence of MACE of 17.39%. This was consistent with the findings of Abhyankar et al 13 who reported a prevalence of 12.5% for MACE during a median follow-up of 7 years based on a single-center study in 2018. In another study looking at prognosis and disease progression in patients under age 50 years who were undergoing PCI, survival was 97.8% after 5 years, and freedom from major adverse cardiac and cerebrovascular events was 74.1%.…”

Section: Discussionsupporting

confidence: 93%

Predictive value of cardiopulmonary fitness parameters in the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

et al. 2020

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Objectives We aimed to determine the predictive value of cardiopulmonary exercise testing (CPX) in the prognosis of patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI). Methods We conducted a retrospective study including patients who underwent CPX within 1 year of PCI between September 2012 and October 2017. Patients were followed-up until the occurrence of a major adverse cardiac event (MACE) or administrative censoring (September 2019). A Cox regression model was used to identify significant predictors of a MACE. Model performance was evaluated in terms of discrimination (C-statistic) and calibration (calibration-in-the-large). Results In total, 184 patients were included and followed-up for a median 51 months (interquartile range: 36–67 months) and 32 events occurred. Multivariable analysis revealed that body mass index and Gensini score were significant predictors of a MACE. Four CPX-related variables were found to be predictive of a MACE: premature CPX termination, peak oxygen uptake, heart rate reserve, and ventilatory equivalent for carbon dioxide slope. The final prediction model had a C-statistic of 0.92 and calibration-in-the-large 0.58%. Conclusion CPX-related parameters may have high predictive value for poor outcomes in patients with ACS who undergo PCI, indicating a need for appropriate treatment and timely management.

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Section: Discussionsupporting

confidence: 93%

Predictive value of cardiopulmonary fitness parameters in the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

et al. 2020

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“…Rapa, as a third-generation novel immunosuppressant, has the properties of anti-proliferation, anti-inflammation, low toxicity and high cell membrane penetration (Xu et al, 2022). Moreover, the effectiveness and biocompatibility of Rapa-eluting stents have been confirmed in some clinical trials (Abhyankar et al, 2018;Nathani et al, 2020;Pamidimukkala et al, 2020). Based on these data, the Rapa-laden IOL for PCO therapy has been designed and fabricated (Liu et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Two-dimensional ultrathin Ti3C2 MXene nanosheets coated intraocular lens for synergistic photothermal and NIR-controllable rapamycin releasing therapy against posterior capsule opacification

Huang

et al. 2022

Front. Bioeng. Biotechnol.

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Posterior capsule opacification (PCO) is one of the most frequent late-onset complications after cataract surgery. Several kinds of drug-eluting intraocular lenses (IOL) were designed for sustainable drug release to suppress ocular inflammation, the proliferation of lens epithelial cells (LECs) and the development of PCO after cataract surgery. Despite previous advances in this field, the drug-loaded IOLs were limited in ocular toxicity, insufficient drug-loading capacity, and short release time. To prevent PCO and to address these drawbacks, a novel drug-loaded IOL (Rapa@Ti3C2-IOL), prepared from two-dimensional ultrathin Ti3C2 MXene nanosheets and rapamycin (Rapa), was fabricated with a two-step spin coating method in this study. Rapa@Ti3C2 was prepared via electrostatic self-assembly of Ti3C2 and Rapa, with a loading capacity of Rapa at 92%. Ti3C2 was used as a drug delivery reservoir of Rapa. Rapa@Ti3C2-IOL was designed to have the synergistic photothermal and near infrared (NIR)-controllable drug release property. As a result, Rapa@Ti3C2-IOL exhibited the advantages of simple preparation, high light transmittance, excellent photothermal conversion capacity, and NIR-controllable drug release behavior. The Rapa@Ti3C2 coating effectively eliminated the LECs around Rapa@Ti3C2-IOL under a mild 808-nm NIR laser irradiation (1.0 W/cm−2). Moreover, NIR-controllable Rapa release inhibited the migration of LECs and suppressed the inflammatory response after photothermal therapy in vitro. Then, Rapa@Ti3C2-IOL was implanted into chinchilla rabbit eyes, and the effectiveness and biocompatibility to prevent PCO were evaluated for 4 weeks. The Rapa@Ti3C2-IOL implant exhibited excellent PCO prevention ability with the assistance of NIR irradiation and no obvious pathological damage was observed in surrounding healthy tissues. In summary, the present study offers a promising strategy for preventing PCO via ultrathin Ti3C2 MXene nanosheet-based IOLs with synergistic photothermal and NIR-controllable Rapa release properties.

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Evolution of Drug-Eluting Stent Drug Elution Profile: Is a Crystalline Drug Form the Ideal Solution?

Sangiorgi

Colantonio²,

Luca³

2016

EMJ Int Cardiol

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Since its introduction into clinical practice, coronary angioplasty has seen game-changing advances incomparable to any other medical technology. In particular, the progression from balloon angioplasty to stent technology has not only seen significant advances in technology but, more importantly, improved patient outcomes. The introduction of the drug-eluting stent (DES) has further pushed the technology to a new standard of care. However, even in the current day, top performing DESs still have several limitations. Their safety has been limited by suboptimal polymer biocompatibility, delayed stent re-endothelialisation, and local drug toxicity, leading to adverse clinical outcomes such as very late stent thrombosis, allergic reactions, and chronic inflammation. In addition, current DESs have a consistent yearly increase in late restenosis and revascularisations. Furthermore, durable polymer coatings used in first-generation DESs have been associated with mechanical complications and non-uniform coating, resulting in drug loss and poor distribution. As a consequence, in recent years, the focus of research has been on the development of novel drug carrier systems including absorbable (or biodegradable) polymer coatings and non-polymeric stent surfaces. Additional improvements have included the development of more modern stent platforms. Optimised drug delivery requires a combination of refined stent designs and drug delivery technology. The combination of highly-refined bare-metal stent designs and polymer coating materials have been two areas of focus for the development and improvement of next-generation DESs. Despite all the changes in stent design and polymer materials, there has been little done in the past 15 years to improve drug elution profiles. The need for new advancements in DES design to overcome late event occurrence, and possibly even improve on the clinical outcomes of current DESs, has led to interest in moving away from the standard drug elution profile to explore alternatives. A new manufacturing technique that may have overcome traditional limitations has led to the development of a novel stent platform. This review will explore the principles, device technology, and clinical data to date on a crystalline form of the anti-restenotic drug for stent implantation. This approach could truly be game changing due to an improved elution pharmacokinetic profile, as well as reduced local toxicity and improved long-term biologic arterial wall response.

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Seven-year clinical outcomes in patients undergoing percutaneous coronary intervention with biodegradable polymer coated sirolimus-eluting stent: Results from a single-center real-world experience

Cited by 5 publications

References 35 publications

Predictive value of cardiopulmonary fitness parameters in the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

Predictive value of cardiopulmonary fitness parameters in the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

Two-dimensional ultrathin Ti3C2 MXene nanosheets coated intraocular lens for synergistic photothermal and NIR-controllable rapamycin releasing therapy against posterior capsule opacification

Evolution of Drug-Eluting Stent Drug Elution Profile: Is a Crystalline Drug Form the Ideal Solution?

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