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[PMID]:29390379
[Au] Autor:Choi S; Song M
[Ti] Título:Successful coronary stenting in a patient with factor V deficiency in the absence of fresh frozen plasma transfusion: Case report.
[So] Source:Medicine (Baltimore);96(50):e9274, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Drug-eluting stent (DES) implantation in a patient with factor V deficiency (F5D) is very complex. No antithrombotic therapy study has been reported for F5D patients who undergo a coronary stenting procedure. PATIENT CONCERNS: A 73-year-old woman presented with chest discomfort and exertional dyspnea. Coronary stenting was performed successfully using DES stents. DIAGNOSES: The D-dimer, prothrombin time, and partial thromboplastin time prolongation persisted from admission until 24 hours after coronary stenting. Epistaxis and blood-tinged sputum occurred on day 3. The antiplatelet therapy measured using a Multiplate Analyzer was adequate, and other laboratory findings except factor V activity (14%) were within normal ranges; she was diagnosed with F5D based on low factor V activity. INTERVENTIONS: While taking 90 mg of ticagrelor and 100 mg of aspirin daily, the patient revisited due to recurrent epistaxis, hemoptysis, and coughing on day 26. Epistaxis and hemoptysis stopped after the aspirin was discontinued. Finally, the daily maintenance dose was reduced to 90 mg of ticagrelor once. OUTCOMES: She led healthy life for 9 months without any recurrent symptoms and the test results also were stabilized. LESSONS: We report a case of an F5D patient who underwent coronary stenting in the absence of frozen fresh plasma transfusion who received successful maintenance therapy using a single antiplatelet agent (90 mg of ticagrelor/day) with recurrent multiple mucosal bleeding events after coronary stenting.
[Mh] Termos MeSH primário: Adenosina/análogos & derivados
Estenose Coronária/tratamento farmacológico
Stents Farmacológicos
Deficiência do Fator V/complicações
Antagonistas do Receptor Purinérgico P2Y/uso terapêutico
[Mh] Termos MeSH secundário: Adenosina/uso terapêutico
Idoso
Testes de Coagulação Sanguínea
Estenose Coronária/diagnóstico
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Purinergic P2Y Receptor Antagonists); GLH0314RVC (Ticagrelor); K72T3FS567 (Adenosine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009274


  2 / 8990 MEDLINE  
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[PMID]:28460763
[Au] Autor:Kiatchoosakun S; Pienvichit P; Kuanprasert S; Suraphakdee N; Phromminikul A
[Ad] Endereço:Division of Cardiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Electronic address: sonkia@kku.ac.
[Ti] Título:A clinical evaluation of the XIENCE V everolimus eluting stent in the treatment of patients with coronary artery disease: Result from Thailand Registry - XIENCE V performance evaluation (THRIVE study).
[So] Source:Indian Heart J;69(2):165-169, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the 2-year clinical outcomes of XIENCE V everolimus eluting stent (EES) for the treatment of coronary artery disease. BACKGROUND: Percutaneous coronary intervention with a drug eluting stent has become the preferred treatment in patients with coronary artery disease. Everolimus eluting stent had proven efficacy in randomized control trials but those trials may not represent daily practice of interventional cardiology. METHODS: The THRIVE study was a prospective, multicenter, real-world, single-arm registry. Included in the registry were 400 patients in Thailand with coronary artery disease suitable for treatment with the XIENCE V. RESULTS: At 30 days, 1 year, and 2 years, the respective rate of all-cause mortality, myocardial infarction (MI), and target lesion revascularization (TLR) was 0.7, 1.0, and 0.5 %. 2.1, 2.1, and 1.0 %, and 2.2, 3.0, and 2.1 %. The cumulative rate for stent thrombosis was 1.6 % at 2 years. CONCLUSIONS: The THRIVE study demonstrated that use of EES yielded a rate for 2 years of major adverse cardiac events comparable to the randomized controlled trial of EES in the SPIRIT trials. This result supports the efficacy and safety of XIENCE V everolimus eluting for daily interventional cardiology practice.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/cirurgia
Stents Farmacológicos
Everolimo/farmacologia
Intervenção Coronária Percutânea/métodos
Sistema de Registros
[Mh] Termos MeSH secundário: Causas de Morte/tendências
Doença da Artéria Coronariana/diagnóstico
Doença da Artéria Coronariana/epidemiologia
Feminino
Seguimentos
Seres Humanos
Imunossupressores/farmacologia
Incidência
Índia
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Prognóstico
Estudos Prospectivos
Taxa de Sobrevida/tendências
Tailândia/epidemiologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Immunosuppressive Agents); 9HW64Q8G6G (Everolimus)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  3 / 8990 MEDLINE  
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[PMID]:28468954
[Au] Autor:Mahmoud AN; Barakat AF; Elgendy AY; Schneibel E; Mentias A; Abuzaid A; Elgendy IY
[Ad] Endereço:From the Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville (A.N.M., A.Y.E., E.S., I.Y.E.); Department of Medicine, Cleveland Clinic Foundation, OH (A.F.B.); Division of Cardiovascular Medicine, Department of Medicine, University of Iowa Carver College of
[Ti] Título:Long-Term Efficacy and Safety of Everolimus-Eluting Bioresorbable Vascular Scaffolds Versus Everolimus-Eluting Metallic Stents: A Meta-Analysis of Randomized Trials.
[So] Source:Circ Cardiovasc Interv;10(5), 2017 May.
[Is] ISSN:1941-7632
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Data regarding the long-term efficacy and safety of everolimus-eluting bioresorbable vascular scaffolds (BVS) compared with everolimus-eluting stents are limited. This meta-analysis aimed to compare the long-term outcomes with both devices. METHODS AND RESULTS: Randomized trials reporting clinical outcomes beyond 1 year and comparing BVS with everolimus-eluting stents were included. Summary estimates risk ratios (RRs) were constructed. The primary efficacy outcome was target lesion failure, defined as cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization, and the primary safety outcome was definite or probable stent/scaffold thrombosis. Six trials with 5392 patients were included (mean follow-up, 25 months). BVS had a higher rate of target lesion failure (RR, 1.33; 95% confidence interval [CI], 1.11-1.58) driven by the higher rates of target vessel myocardial infarction (RR, 1.65; 95% CI, 1.26-2.17) and target lesion revascularization (RR, 1.39; 95% CI, 1.08-1.78). The risk of definite or probable stent/scaffold thrombosis (RR, 3.22; 95% CI, 1.89-5.49) and very late stent/scaffold thrombosis (>1 year; RR, 4.78; 95% CI, 1.66-13.8) was higher with BVS. The risk of cardiac and all-cause mortality was similar in both groups. CONCLUSIONS: Compared with everolimus-eluting stents, BVS is associated with increased risk of target lesion failure driven by the increased rates of target vessel myocardial infarction and ischemia-driven target lesion revascularization in these studies (mean follow-up, 25 months). The risk of definite or probable stent/scaffold thrombosis and very late stent/scaffold thrombosis seems to be higher with BVS. Further information from randomized trials is critical to evaluate clinical outcomes with BVS on complete resolution of the scaffold.
[Mh] Termos MeSH primário: Implantes Absorvíveis
Fármacos Cardiovasculares/administração & dosagem
Materiais Revestidos Biocompatíveis
Doença da Artéria Coronariana/terapia
Stents Farmacológicos
Everolimo/administração & dosagem
Metais
Intervenção Coronária Percutânea/instrumentação
[Mh] Termos MeSH secundário: Idoso
Fármacos Cardiovasculares/efeitos adversos
Doença da Artéria Coronariana/diagnóstico por imagem
Doença da Artéria Coronariana/mortalidade
Trombose Coronária/etiologia
Everolimo/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio/etiologia
Razão de Chances
Intervenção Coronária Percutânea/efeitos adversos
Intervenção Coronária Percutânea/mortalidade
Desenho de Prótese
Ensaios Clínicos Controlados Aleatórios como Assunto
Medição de Risco
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Cardiovascular Agents); 0 (Coated Materials, Biocompatible); 0 (Metals); 9HW64Q8G6G (Everolimus)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:29443766
[Au] Autor:Ali WE; Vaidya SR; Ejeh SU; Okoroafor KU
[Ad] Endereço:Department of Internal Medicine, Cape Fear Valley Medical Center, affiliated with Campbell University School of Osteopathic Medicine.
[Ti] Título:Meta-analysis study comparing percutaneous coronary intervention/drug eluting stent versus coronary artery bypass surgery of unprotected left main coronary artery disease: Clinical outcomes during short-term versus long-term (> 1 year) follow-up.
[So] Source:Medicine (Baltimore);97(7):e9909, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Results on the safety and long-term efficacy of drug-eluting stent placement in unprotected left main coronary artery disease (ULMCAD) compared with those of coronary artery bypass surgery (CABG) remain inconsistent across randomized clinical trials and recent meta-analysis studies. We aimed to compare the clinical outcomes and safety over short- and long-term follow-ups by conducting a meta-analysis of large pooled data from randomized controlled trials and up-to-date observational studies. METHODS: A systematic review of PubMed, Google Scholar, Medline, and reference lists of related articles was performed for studies conducted in the drug-eluting stent era, to compare percutaneous coronary intervention (PCI) with CABG in ULMCAD. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction (MI), stroke, all-cause mortality, and revascularization after at least 1-year follow-up. In-hospital and 30-day clinical outcomes were considered secondary outcomes. Furthermore, a subgroup analysis of studies with ≥5 years follow-up was performed to test the sustainability of clinical outcomes. RESULTS: A total of 29 studies were extracted with 21,832 patients (10,424 in PCI vs 11,408 in CABG). Pooled analysis demonstrated remarkable differences in long-term follow-up (≥1 year) MACCE (odds ratio [OR] 1.42, 95% CI 1.27-1.59), P < .00001), repeat revascularization (OR 3.00, 95% CI 2.41-3.73, P < .00001), and MI (OR 1.32, 95% CI 1.14-1.53, P = .0002), favoring CABG over PCI. However, stroke risk was significantly lower in the PCI group. Subgroup analysis of studies with ≥5 years follow-up showed similar outcomes except for the noninferiority outcome of MACCE in the PCI arm. However, the PCI group proved good safety profile after a minimum of 30-day follow-up with lower MACCE outcome. CONCLUSION: PCI for ULMCAD can be applied with attentiveness in carefully selected patients. MI and the need for revascularization remain drawbacks and areas of concern among previous studies. Nonetheless, it has been proven safe during short-term follow-up.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária
Doença da Artéria Coronariana/cirurgia
Stents Farmacológicos
Intervenção Coronária Percutânea
[Mh] Termos MeSH secundário: Ponte de Artéria Coronária/efeitos adversos
Ponte de Artéria Coronária/métodos
Doença da Artéria Coronariana/diagnóstico
Vasos Coronários/patologia
Vasos Coronários/cirurgia
Seres Humanos
Efeitos Adversos de Longa Duração/epidemiologia
Efeitos Adversos de Longa Duração/etiologia
Seleção de Pacientes
Intervenção Coronária Percutânea/efeitos adversos
Intervenção Coronária Percutânea/instrumentação
Intervenção Coronária Percutânea/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009909


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[PMID]:29208251
[Au] Autor:Gobic D; Tomulic V; Lulic D; Zidan D; Brusich S; Jakljevic T; Zaputovic L
[Ad] Endereço:Department of Cardiovascular Disease, University Hospital Rijeka, Rijeka, Croatia. Electronic address: dgobic@gmail.com.
[Ti] Título:Drug-Coated Balloon Versus Drug-Eluting Stent in Primary Percutaneous Coronary Intervention: A Feasibility Study.
[So] Source:Am J Med Sci;354(6):553-560, 2017 12.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Drug-eluting stents (DES) represent a significant evolution in the treatment of patients with acute myocardial infarction with ST elevation. However, stent-related adverse events have led to an introduction of drug-coated balloons (DCB) applied particularly to bifurcation lesions, in-stent restenosis and small vessel disease. The aim of this study was to determine whether a DCB-only strategy has a similar safety profile and equal angiographic and clinical outcomes to DES implantation in primary percutaneous coronary intervention (pPCI). MATERIALS AND METHODS: Seventy-five patients with acute myocardial infarction with ST elevation were randomized into DES and DCB groups of 37 and 38 patients, respectively. The study end-points were major adverse cardiac events and late lumen loss during the 6 months following the pPCI. RESULTS: Reinfarction occurred in 5.4% of patients in the DES and 5.3% of patients in the DCB group after 1 month (risk ratio = 1.03, 95% CI [0.15-6.91], P = 0.98). After 6 months, major adverse cardiac events were reported in 5.4% of patients in the DES group and none in the DCB group (risk ratio = 5.13, 95% CI [0.25-103.42], P = 0.29). Late lumen loss in the DES group was 0.10 ± 0.19mm and -0.09 ± 0.09mm in the DCB group (P < 0.05). CONCLUSIONS: A DCB-only strategy is safe and feasible in the pPCI setting and showed good clinical and angiographic outcomes in a 6-month follow-up period.
[Mh] Termos MeSH primário: Angioplastia Coronária com Balão/métodos
Stents Farmacológicos
Intervenção Coronária Percutânea/métodos
Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia
[Mh] Termos MeSH secundário: Angioplastia Coronária com Balão/efeitos adversos
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29384957
[Au] Autor:Wu S; Liu W; Guo Y; Zeng Y; Zhou Z; Zhao Y; Liu Y; Shi D; Wang Z; Ge H; Wang J; Jin P; Zhou Y
[Ad] Endereço:Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing.
[Ti] Título:The impact of acute coronary syndrome on late drug-eluting stents restenosis: Insights from optical coherence tomography.
[So] Source:Medicine (Baltimore);96(52):e9515, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the study was to investigate the optical coherence tomography (OCT)-identified difference of in-stent restenosis (ISR) tissue characteristics between patients with and without acute coronary syndrome (ACS) at index intervention.The retrospective study included 80 patients with 85 drug-eluting stent (DES) restenosis lesions. Subjects were classified according to clinical presentation at the time of de-novo lesion intervention, namely ACS and non-ACS. OCT was performed at 5 years follow-up. The frequency of malapposition, neointimal characteristics, thrombus, and minimal stent area (MSA) were evaluated.ACS group consisted of 48 (60%) patients. The mean duration from initial intervention to OCT study was 66.15 months. Malapposition was more frequent in the ACS group (25.5% vs 2.9%, P = .006), as well as a higher prevalence of thrombus in the ACS group (21.6% vs 0%, P = .015). MSA of ACS group was significantly less than that of non-ACS group (4.99 ±â€Š1.80 vs 5.62 ±â€Š2.08 mm, P = .018). Compared with non-ACS group, only MI group was related to smaller MSA (4.37 ±â€Š1.39 vs 5.62 ±â€Š2.08 mm, P = .048); The unstable angina (UA) group was not associated with a decreased MSA. The occurrence of neoatherosclerosis tended to be higher in ACS group (60.8% vs 41.2%, P = .076).In DES restenosis, an ACS presentation at initial intervention is associated with a higher incidence of malapposition, thrombus, and smaller MSA.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/patologia
Stents Farmacológicos
[Mh] Termos MeSH secundário: Síndrome Coronariana Aguda/diagnóstico por imagem
Idoso
Angina Estável/diagnóstico por imagem
Angina Estável/patologia
Constrição Patológica
Feminino
Seres Humanos
Masculino
Meia-Idade
Neointima/patologia
Estudos Retrospectivos
Trombose/patologia
Tomografia de Coerência Óptica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009515


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[PMID]:29211222
[Au] Autor:Sá MPBO; Soares AF; Miranda RGA; Araújo ML; Menezes AM; Silva FPV; Lima RC
[Ad] Endereço:Division of Cardiovascular Surgery, Pronto-Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE, Brazil.
[Ti] Título:CABG Surgery Remains the best Option for Patients with Left Main Coronary Disease in Comparison with PCI-DES: Meta-Analysis of Randomized Controlled Trials.
[So] Source:Braz J Cardiovasc Surg;32(5):408-416, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis. Five studies fulfilled our eligibility criteria and they included a total of 4.595 patients (2.298 for CABG and 2.297 for PCI with DES). RESULTS: At 1-year follow-up, there was no significant difference between CABG and DES groups concerning the risk for death (risk ratio [RR] 0.973, P=0.830), myocardial infarction (RR 0.694, P=0.148), stroke (RR 1.224, P=0.598), and major adverse cerebrovascular and cardiovascular events (RR 0.948, P=0.680). The risk for target vessel revascularization (TVR) was significantly lower in the CABG group compared to the DES group (RR 0.583, P<0.001). It was observed no publication bias regarding the outcomes, but only the outcome TVR was free from substantial statistical heterogeneity of the effects. In the meta-regression, there was evidence that the factor "female gender" modulated the effect regarding myocardial infarction rates, favoring the CABG strategy. CONCLUSION: CABG surgery remains the best option of treatment for patients with ULMCA disease, with lower TVR rates.
[Mh] Termos MeSH primário: Ponte de Artéria Coronária
Doença da Artéria Coronariana/cirurgia
Stents Farmacológicos
[Mh] Termos MeSH secundário: Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29374937
[Au] Autor:Liu ZJ; Shi B; Deng CC; Xu GX; Zhao RZ; Shen CY; Wang ZL; Liu HL
[Ad] Endereço:Department of Cardiology, First Affiliated Hospital, Zunyi Medical College, Zunyi 563003, China.
[Ti] Título:[Optical coherence tomographic analysis of in-stent neoatherosclerosis in lesions with restenosis after drug-eluting stent implantation].
[So] Source:Zhonghua Xin Xue Guan Bing Za Zhi;46(1):44-49, 2018 Jan 24.
[Is] ISSN:0253-3758
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the imaging characteristics and related influencing factors of in-stent neoatherosclerosis (ISNA) in patients with restenosis after drug-eluting stent(DES) implantation with optical coherence tomography(OCT). A total of 25 cases of coronary heart disease patients(DES placement time ≥8 months) with coronary artery angiography showing DES in-stent restenosis (ISR) in Zunyi medical college affiliated hospital from July 2013 to December 2015 were included in this study and patient's data were retrospectively analyzed.In these patients with ISR, OCT images were acquired before percutaneous coronary intervention. Patients were divided into the ISNA group (12 patients and 12 lesions) and non-ISNA group(13 patients and 13 lesions) according to the result of OCT. ISNA on OCT was defined as neointima formation with the presence of lipids or calcification. (1) The incidence of chronic kidney disease and increased low-density lipoprotein cholesterol level in ISNA group were significant higher than that in non-ISNA group(all 0.05). The stent implantation time in ISNA group was longer than that in the non-ISNA group(53.0(14.0, 81.0) months vs. 15.0(8.5, 32.5) months, 0.01). In addition, clinical manifestation of acute coronary syndrome was present in 8 out of 12 patientsin ISNA group, and stable angina pectoris was found in 10 out of 13 casesin non-ISNA group( 0.01). (2) Quantitative analysis of OCT showed that the lumen area was less in ISNA group than in non-ISNA group((3.45±1.82)mm(2) vs. (4.17±1.68)mm(2), 0.01), and neointimal area(3.89(2.26, 5.52)mm(2) vs. 2.96(1.99, 4.22)mm(2), 0.01), neointimal load (53.15(40.18, 67.30)% vs. 41.54(32.08, 56.91)%, 0.01), neointimal thickness(0.98(0.63, 1.36)µm vs. 0.72(0.51, 1.03)µm, 0.01) were higher in ISNA group than in non-ISNA group.(3)Qualitative analysis of OCT showed that the prevalence of homogeneous intima was less in the ISNA group than in the non-ISNA group ((41.42±22.56)% vs.(72.06±18.68)%, 0.05), on the contrary, the heterogeneous intima was more common in the ISNA group ((58.57±22.56)% vs. (27.94±18.68)%, 0.05). There was no significant difference between two groups in the peri-stentmicrovessels (9/12 vs. 5/13, 0.05), and prevalence of intraintimalmicrovessels was higher in the ISNA group than in non-ISNA group (7/12 vs. 2/13, 0.05). In addition, thin cap fibrous plaque(7/12 vs. 0, 0.01), disrupted intima with visible cavity (7/12 vs. 1/13, 0.05),andintraluminal red thrombus(7/12 vs. 1/13, 0.05) were significantly higher in ISNA group than in non-ISNA group. Results of OCT show that ISNA occurs frequently in patients with ISR after DES implantation. The stent implantation time, incidence of chronic kidney disease and higher low-density lipoprotein cholesterol level are associated with the formation of ISNA in these patients.
[Mh] Termos MeSH primário: Reestenose Coronária/terapia
Stents Farmacológicos
Tomografia de Coerência Óptica
[Mh] Termos MeSH secundário: Constrição Patológica
Angiografia Coronária
Vasos Coronários
Doenças das Valvas Cardíacas
Seres Humanos
Neointima
Intervenção Coronária Percutânea
Placa Aterosclerótica
Estudos Retrospectivos
Stents
Fatores de Tempo
Túnica Íntima
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3758.2018.01.008


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[PMID]:29374936
[Au] Autor:Ni ZH; Huang WH; Liu Y; Chen ZJ; Li J; Yang JQ; He PC; Zhou YL; Chen JY; Luo JF
[Ad] Endereço:Department of Cardiology, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangzhou 510080, China.
[Ti] Título:[Feasibility and safety of paclitaxel-eluting balloon for the treatment of de novo coronary lesions].
[So] Source:Zhonghua Xin Xue Guan Bing Za Zhi;46(1):39-43, 2018 Jan 24.
[Is] ISSN:0253-3758
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed. The primary endpoint was the composite of cardiac death, recurrent myocardial infarction and target lesion revascularization. (1)The age was (63.3±10.3) years. There were 68.4%(52/76) acute coronary syndrome patients, prevalence of type 2 diabetes was 36.8%(28/76), and 64.5%(49/76)patients with at least one high bleeding risk. (2)The lesion length was (17.4±7.6)mm, and the stenosis was (88.1±8.2)%.The reference vessel diameter≥2.75 mm accounted for 51.2% (41/80), and bifurcation stenosis accounted for 67.5%(54/80). (3)53.7%(43/80) lesions were pretreated with scoring balloon to optimize plaque modification. The paclitaxel-eluting balloon length and diameter were (22.3±5.5)mm and (2.74±0.52)mm.The residual stenosis was (12.3±10.3)%. Procedural success was 88.8%(71/80).Bail-out stenting rate was 5.0%(4/80). (4)The median follow-up duration was 12(6, 25) months. Primary endpoint occurred in 3 cases (3.9%), including 2 cardiac deaths(1 patient died of recurrent myocardial infarction, and 1 patient died of acute heart failure induced by severe mitral insufficiency), and one patient receivedtarget lesion revascularization. In case of no more than 30% residual stenosis and no blood flow limited dissection after lesion pretreatment,it is safe and feasible to treat de novo coronary lesionsusing paclitaxel-eluting balloon.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/terapia
Angioplastia Coronária com Balão
Stents Farmacológicos
Paclitaxel/administração & dosagem
Moduladores de Tubulina/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Angiografia Coronária
Diabetes Mellitus Tipo 2
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Estudos Retrospectivos
Stents
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Tubulin Modulators); P88XT4IS4D (Paclitaxel)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3758.2018.01.007


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[PMID]:29374935
[Au] Autor:Yu X; Ji FS; Xu F; Zhang WD; Wang XY; Lu D; Xu T
[Ad] Endereço:National Center of Gerontology, Department of Cardiology, Beijing Hospital, Beijing 100730, China.
[Ti] Título:[Therapeutic efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters larger than 2.8 mm].
[So] Source:Zhonghua Xin Xue Guan Bing Za Zhi;46(1):32-38, 2018 Jan 24.
[Is] ISSN:0253-3758
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters ≥ 2.8 mm. This prospective study included 215 consecutive patients with 238 de novo lesions, who received paclitaxel-coated balloon angioplasty in Beijing Hospital from May 2014 to June 2016. According to the reference vessel diameter, the patients were divided into large vessel disease (LVD) group (reference vessel diameter≥2.8 mm, 85 patients and 90 lesions) and small vessel disease (SVD) group (reference vessel diamete 2.8 mm, 130 patients and 148 lesions). Clinical characteristics, interventional procedures and major adverse cardiovascular events (includingall-cause mortality, non-fatal myocardial infarction and target lesion revascularization) after procedure were compared between the 2 groups. (1)Patients in LVD group were younger than SVD group ((60.1±11.1) years old vs. (65.0±10.6) years old, 0.01), and less patients had diabetes (24.7% (21/85) vs. 43.1%(56/130), 0.01).(2)Prevalence of three-vessel disease (35.5%(30/85) vs. 53.6%(67/130), 0.05) and complex lesions (type B2/C,34.4% (31/90) vs. 50.0%(74/148), 0.05) were significantly lower in LVD group than in SVD group.(3) During pre-dilation, the rate with plain balloons use was significantly higher in SVD group than in LVD group(76.4%(113/148) vs. 58.9%(53/90), 0.01), while the proportion of additional use of non-compliant balloons was significantly higher in LVD groupthan in SVD group(20.0% (18/90) vs. 3.4% (5/148) , 0.01). The ratio of paclitaxel-coated balloon diameter/RVD was significantly lower (0.87±0.12 vs. 0.96±0.15, 0.01) and the duration of dilationwas significantly shorter ((41.5±9.5) seconds vs. (45.1±9.1) seconds, 0.01) in LVD group than those in SVD group. Each group had 1 failure case that was bailout stented with drug-eluting stents. The success rate of paclitaxel-coated balloon treatment was similar in LVD group and SVD group (98.9% (89/90) vs. 99.3%(147/148), 0.05).(4) At the fourth day of procedure, there was 1 acute myocardial infarction requiring emergent target lesion revascularization in SVD group. No major adverse cardiovascular event was observed in LVD group during hospitalization. Forty-two patients with 53 lesions, including 27 LVD lesions and 26 SVD lesions,underwent coronary angiography at (9.4±4.6) months after paclitaxel-coated balloon intervention. The quantitative coronary angiography analysis showed that minimal lumen diameter significantlyincreased during follow-up than that of post-procedurein SVD group ((1.71±0.36)mm vs. (1.52±0.30)mm, 0.05) , while in LVD group the minimal lumen diameter was similar between during follow-up and post-procedure ((2.35±0.48)mm vs. (2.19±0.34)mm, 0.05). Major adverse cardiovascular event rate was 0 in LVD group and 2.3%(3/130) in SVD group ( 0.05) during follow up. No death was observed in this patient cohort. Treatment with paclitaxel-coated balloon for de novo coronary lesions with diameters≥2.8 mm is safe and effective.
[Mh] Termos MeSH primário: Angioplastia Coronária com Balão
Doença da Artéria Coronariana/terapia
Stents Farmacológicos
[Mh] Termos MeSH secundário: Idoso
Angiografia Coronária
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio
Paclitaxel
Estudos Prospectivos
Stents
Resultado do Tratamento
Doenças Vasculares
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
P88XT4IS4D (Paclitaxel)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3758.2018.01.006



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