A comparative study of restenosis rates in bare metal and drug-eluting stents

Mohan, Sanjay; Dhall, Anil

doi:10.1055/s-0031-1278368

Cited by 42 publications

(37 citation statements)

References 40 publications

(33 reference statements)

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“…It is estimated that the rate of restenosis occurrence in patients who have undergone an angioplasty and stent procedure in randomized trials ranges between 30–40% [56], [57]. Other studies, however, have reported incidence rates as high as 48.8% [58] or even 60% [5]. This natural variation in restenosis rates as described in the literature was recreated by the model on both the tissue and organ scales.…”

Section: Discussionmentioning

confidence: 94%

An Agent-Based Model of the Response to Angioplasty and Bare-Metal Stent Deployment in an Atherosclerotic Blood Vessel

Curtin

Zhou

2014

PLoS ONE

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PurposeWhile animal models are widely used to investigate the development of restenosis in blood vessels following an intervention, computational models offer another means for investigating this phenomenon. A computational model of the response of a treated vessel would allow investigators to assess the effects of altering certain vessel- and stent-related variables. The authors aimed to develop a novel computational model of restenosis development following an angioplasty and bare-metal stent implantation in an atherosclerotic vessel using agent-based modeling techniques. The presented model is intended to demonstrate the body’s response to the intervention and to explore how different vessel geometries or stent arrangements may affect restenosis development.MethodsThe model was created on a two-dimensional grid space. It utilizes the post-procedural vessel lumen diameter and stent information as its input parameters. The simulation starting point of the model is an atherosclerotic vessel after an angioplasty and stent implantation procedure. The model subsequently generates the final lumen diameter, percent change in lumen cross-sectional area, time to lumen diameter stabilization, and local concentrations of inflammatory cytokines upon simulation completion. Simulation results were directly compared with the results from serial imaging studies and cytokine levels studies in atherosclerotic patients from the relevant literature.ResultsThe final lumen diameter results were all within one standard deviation of the mean lumen diameters reported in the comparison studies. The overlapping-stent simulations yielded results that matched published trends. The cytokine levels remained within the range of physiological levels throughout the simulations.ConclusionWe developed a novel computational model that successfully simulated the development of restenosis in a blood vessel following an angioplasty and bare-metal stent deployment based on the characteristics of the vessel cross-section and stent. A further development of this model could ultimately be used as a predictive tool to depict patient outcomes and inform treatment options.

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Section: Discussionmentioning

confidence: 94%

An Agent-Based Model of the Response to Angioplasty and Bare-Metal Stent Deployment in an Atherosclerotic Blood Vessel

Curtin

Zhou

2014

PLoS ONE

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“…22 The present study showed that restenosis was shown in 10 patients (4.3%) it can be compared with the M-heart trial and also reported that LAD lesion were more prone to restenosis than lesions in LCX and RCA. 23,24 A greater number of patients and a longer follow-up period could allow the observation of long-term changes in clinical outcomes of DES and BMS groups. After PCI with DES or BMS the patients will have long-term favourable outcomes, unless there was occurrence of ST or peri-procedural complications.…”

Section: Discussionmentioning

confidence: 99%

Drug eluting stents versus bare metal stents in coronary artery disease patients: outcomes and complications

Kalburgi

2018

Int J Res Med Sci

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Background: To date, data regarding the long-term safety and efficacy of BMS and DES implantation in a real-world population are limited. Thus, this study was designed to study the complications, early and late outcomes of drug-eluting stents (DES) versus bare metal stents (BMS) after implantation in coronary artery disease (CAD) patients up to 6months follow-up period.Methods: This was a single-center, hospital-based, prospective study conducted at a tertiary care center in India. Records of 250 patients who underwent percutaneous coronary intervention (PCI) in the period of January to December 2007 were included in the study. Early outcomes were indications of coronary angioplasty, length of hospital stay, Killip’s classification at presentation, type of coronary lesions, cath-lab outcomes and acute stent thrombosis (ST). Patients were clinically followed-up till hospital discharge, 30days and in 6months.Results: Total 250 patients with an age range of 30-39years underwent PCI. Of the study population who underwent PCI 111 patients (44.4%) received DES, 104 patients (8%) received BMS, 20 patients received both DES and BMS and 15 patients underwent POBA, respectively. Complications like stroke and major bleeding were observed in 2 patients (0.8%) and 12 patients (4.8%) respectively. TIMI III flow and ST was observed in 215 patients (91.5%) and 6 patients (2.6%), respectively. Death was observed in 3 patients (1.2%) due to cardiogenic shock.Conclusions: DES and BMS have good procedural success in achieving early revascularization with PCI. The incidence of ST was almost equal in DES compared to BMS.

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“…In addition, In-Stent Restenosis (ISR) is one of the important complications after PCI, which depends on CV risk factors (6,7), such as inflammation (8), hyperlipidemia (9), and lesion features (10). A prior study indicated that Copyright ISR was common in patients undergoing PCI (6,11). Therefore, the improvement of CV risk factors by safe adjuvant therapy, proper diet, and dietary supplementation seems to be required for improving secondary prevention in post MI patients undergoing PCI.…”

Section: Introductionmentioning

confidence: 99%

“…The new generation of drug-eluting stents (DESs) has been shown to be superior to Bare Metal Stents (BMS) due to reducing the risk of inflammation and ISR (6,7). However, DESs are not immune to restenosis in the long run (6), and ISR is also common in DES generation (12% -23.5%) (6,11). In spite of heterogeneity across studies, evidence has indicated that plasma high-sensitivity C-reactive protein (hs-CRP) level, as an inflammatory biomarker, could predict coronary ISR after stenting at both admission and follow-up in patients (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Effects of Therapeutic Lifestyle Change Diet and Q10 Plus L-Carnitine Supplementation on Inflammatory Biomarkers of In-Stent Restenosis, Lipid Profile, and Left Ventricular Ejection Fraction in Myocardial Infarction: A Randomized Clinical Trial

Sharifi

Eftekhari

Ostovan

et al. 2017

Iran Red Crescent Med J

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Background: Following Myocardial Infarction (MI) and percutaneous coronary intervention (PCI), the modification of cardiovascular risk factors and inflammation can improve MI progression and PCI outcomes. Up to now, no certain conclusions have been drawn regarding the effect of therapeutic lifestyle change (TLC) diet and a combination of Q10 plus L-carnitine (LC) supplementation on inflammatory biomarkers of In-Stent Restenosis (ISR), lipid profile, and Left ventricular ejection fraction (LVEF).Objectives: This study aimed to evaluate the effects of TLC diet and Q10 plus LC supplementation on inflammatory biomarkers of ISR, lipid profile, and LVEF following MI and PCI.Methods: This single-blind randomized controlled trial was conducted on 128 subjects. After randomization for treatment allocation, the subjects were divided into the study groups through block randomization. The MI patients were admitted to 2 hospitals, namely Al-Zahra and Kowsar (Shiraz, Iran), between April 2015 and May 2016. The patients were divided into 4 groups receiving TLC diet (A), oral Q10 150 mg/d and LC 1200 mg/d (B), a combination of LC plus Q10 and TLC diet (C), and the routine care (D). This study evaluated Interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP) as inflammatory biomarkers of ISR, lipid profile, and LVEF in 128 patients with MI undergoing PCI before and 3 months after the intervention. Results:The results showed a significant decrease in hs-CRP in groups B (11.8 ± 4.3 to 2.0 ± 1 mg/L) and C (11.7±3.9 to 1.3±1.1 mg/L) (P < 0.0001 and P < 0.0001, respectively), but not in group A. Also, a significant reduction was found in IL-6 in groups A (38.0 ± 15 to 9.4 ± 2 pg/mL), B (34.6 ± 12 to 5.1 ± 2.4 pg/mL), and C (33.7 ± 12 to 4.8 ± 2.1 pg/mL) (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). Additionally, LDL and total cholesterol, but not TG, levels significantly decreased in groups A (150 ± 17 to 80 ± 13 mg/dL), B (148 ± 15 to 77.2 ± 14 mg/dL), and C (142 ± 11 to 64.8 ± 10 mg/dL) (P < 0.0001, P < 0.001, and P < 0.0001, respectively). Nevertheless, only group C showed a significant improvement in LVEF (45.1 ± 8 to 53.6 ± 8) (P < 0.027).Conclusions: An adjuvant therapy with TLC diet and supplementation with Q10 and LC seems to be required for secondary prevention following MI and PCI. TLC diet and Q10 plus LC appeared to be effective in inflammatory biomarkers of ISR as well as LDL reduction.

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A comparative study of restenosis rates in bare metal and drug-eluting stents

Cited by 42 publications

References 40 publications

An Agent-Based Model of the Response to Angioplasty and Bare-Metal Stent Deployment in an Atherosclerotic Blood Vessel

An Agent-Based Model of the Response to Angioplasty and Bare-Metal Stent Deployment in an Atherosclerotic Blood Vessel

Drug eluting stents versus bare metal stents in coronary artery disease patients: outcomes and complications

Effects of Therapeutic Lifestyle Change Diet and Q10 Plus L-Carnitine Supplementation on Inflammatory Biomarkers of In-Stent Restenosis, Lipid Profile, and Left Ventricular Ejection Fraction in Myocardial Infarction: A Randomized Clinical Trial

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