5However, optical coherence tomography (OCT) with a higher resolution (12-18 μm) may detect stent malapposition with greater accuracy. There are limited data on detection of acute and late stent malapposition by OCT in small sample sizes. Therefore, we investigated the incidences, predictors, and clinical outcomes of acute and late stent malapposition detected by OCT in a large number of patients who received DESs. Editorial see p 6 Methods Study PopulationPatients who received implantation of DESs for de novo coronary lesions between January 2009 and December 2011 with poststent and follow-up OCT were identified from the OCT registry database of our institute. Exclusion criteria included the following (1) the DES was implanted for left main coronary disease, (2) there were overlapping DESs implanted in the lesion, (3) the clinical follow-up period after DES implantation was <1 year, (4) follow-up OCT was performed >1 year after DES implantation, and (5) the OCT image had poor quality.Background-We investigated the incidences, predictors, and clinical outcomes of acute and late stent malapposition detected by optical coherence tomography (OCT) after drug-eluting stent implantation. Methods and Results-We analyzed the OCT images from 351 patients with 356 lesions who received poststent and followup OCT examinations. Acute stent malapposition was observed in 62% of lesions. Approximately half of the acute stent malappositions were located within the edges of the stents. Severe diameter stenosis, calcified lesions, and long stents were independent predictors of acute stent malapposition. Follow-up OCT examinations were performed 175±60 days after drug-eluting stent implantation. Thirty-one percent of lesions with acute stent malapposition remained malapposed (late-persistent stent malapposition) and were typically (72%) located within the edges of the stent. The location within the stent edges and the volume of acute stent malapposition were independent predictors of late-persistent stent malapposition. Acute stent malapposition with a volume >2.56 mm 3 differentiated late-persistent stent malapposition from resolved acute stent malapposition. Late-acquired stent malapposition was detected in 15% of all lesions and was usually (61%) located within the stent body. Late-acquired stent malapposition was more frequently associated with plaque/thrombus prolapse on poststent OCT images (70% versus 42%; P<0.001). Clinical events, including cardiovascular death, nonfatal myocardial infarction, and stent thrombosis, did not occur in patients with late stent malapposition during the follow-up period of 28.6±10.3 months after drug-eluting stent implantation. Conclusions-Acute, late-persistent, and late-acquired stent malapposition had relatively high incidences but different predictors. The clinical outcome of stent malapposition was favorable. (Circ Cardiovasc Interv. 2014;7:88-96.)
Cytosine bases can be deaminated spontaneously to uracil, causing DNA damage. Uracil-DNA glycosylase (UDG), a ubiquitous uracil-excising enzyme found in bacteria and eukaryotes, is one of the enzymes that repair this kind of DNA damage. To date, no UDG-coding gene has been identified in Methanococcus jannaschii, although its entire genome was deciphered. Here, we have identified and characterized a novel UDG from M.jannaschii designated as MjUDG. It efficiently removed uracil from both single- and double-stranded DNA. MjUDG also catalyzes the excision of 8-oxoguanine from DNA. MjUDG has a helix-hairpin-helix motif and a [4Fe-4S]-binding cluster that is considered to be important for the DNA binding and catalytic activity. Although MjUDG shares these features with other structural families such as endonuclease III and mismatch-specific DNA glycosylase (MIG), unique conserved amino acids and substrate specificity distinguish MjUDG from other families. Also, a homologous member of MjUDG was identified in Aquifex aeolicus. We report that MjUDG belongs to a novel UDG family that has not been described to date.
Although first-generation drug-eluting stents (DES) have significantly reduced the risk of in-stent restenosis, they have also increased the long-term risk of stent thrombosis. This safety concern directly triggered the development of new generation DES, with innovations in stent platforms, polymers, and anti-proliferative drugs. Stent platform materials have evolved from stainless steel to cobalt or platinum-chromium alloys with an improved strut design. Drug-carrying polymers have become biocompatible or biodegradable and even polymer-free DES were introduced. New limus-family drugs (such as everolimus, zotarolimus or biolimus) were adopted to enhance stent performances. As a result, these new DES demonstrated superior vascular healing responses on intracoronary imaging studies and lower stent thrombotic events in actual patients. Recently, fully-bioresorbable stents (scaffolds) have been introduced, and expanding their applications. In this article, the important concepts and clinical results of new generation DES and bioresorbable scaffolds are described.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.