A Polymer-Based, Paclitaxel-Eluting Stent in Patients with Coronary Artery Disease

Stone, Gregg W.; Ellis, Stephen G.; Cox, David A.; Hermiller, James; O’Shaughnessy, Charles; Mann, James Tift; Turco, Mark; Caputo, Ronald P.; Bergin, Patrick; Greenberg, Josh; Popma, Jeffrey J.; Russell, Mary E.

doi:10.1056/nejmoa032441

Cited by 2,522 publications

(857 citation statements)

References 29 publications

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“…35 In contemporary emergency, urgent, or elective stent and drug-eluting stent (DES) clinical trials and registries, adjustments for these factors largely eradicate any sex differences, dispelling the notion of a sex-specific mortality risk. 28,32,36,37 In the majority of studies, adjusted longterm mortality rates after PCI (1 year and beyond) are similar for men and women (Figures 1 and 2). 23,28,38 -40 Historically, restenosis and revascularization rates have not been well defined for women, partly because of the small sample of women in prospective trials with systematic angiographic follow-up, as well as the paucity of published sex-subset analyses.…”

Section: Sex Differences In Outcomes Of Pcimentioning

confidence: 92%

Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women

Lansky¹,

Hochman²,

Ward³

et al. 2005

Circulation

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212

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Abstract-More than 1.2 million percutaneous coronary interventions are performed annually in the United States, with only an estimated 33% performed in women, despite the established benefits of percutaneous coronary intervention and adjunctive pharmacotherapy in reducing fatal and nonfatal ischemic complications in acute myocardial infarction and high-risk acute coronary syndromes. This statement reviews sex-specific data on the safety and efficacy of contemporary interventional therapies in women. 1 Despite the fact that more women than men die from cardiovascular disease in the United States, and despite the established benefits of PCI in reducing fatal and nonfatal ischemic complications in patients with acute myocardial infarction and high-risk acute coronary syndromes, only an estimated 33% of annual PCIs are performed in women. [1][2][3][4] In addition, women experience greater delays 5 to intervention and are referred for diagnostic catheterization less frequently than are men. 6 -8 Although suggested reasons for referral differences have included women's older age at presentation, greater risk profile, and increased risk for an adverse procedural outcome, as well as differences in symptoms and pain perception between men and women and lower predictive accuracy of noninvasive testing in women, some evidence suggests a potential sex and race bias. 9 In contrast, once women are referred for cardiac catheterization, revascularization rates and practices are similar to those in men. 10 -12 Recent advances in angioplasty equipment and technique have improved options for patients with smaller coronary and peripheral (access) arteries. In addition, the increased use of stents and adjunctive pharmacotherapy has improved outcomes in both women and men. Nevertheless, women continue to represent 15% to 38% of the population in studies of PCI, and still relatively few sex-or race-specific data exist.The purpose of this statement is to review what is known and not known about PCI in women and to put published data in context with contemporary coronary intervention. It is not the intention of the writing group to give specific treatment recommendations but rather to compile and collate the available sex-specific data on the safety and efficacy of interventional therapies in women. Tables 1 and 3 provide summaries of the findings in women drawn from this literature review, as well as recommendations from previously published American College of Cardiology/American Heart Association (ACC/AHA) guidelines. MethodsThe information in this statement was compiled by systematic literature review. By searching MEDLINE from JanuaryThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perc...

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Section: Sex Differences In Outcomes Of Pcimentioning

confidence: 92%

Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women

Lansky¹,

Hochman²,

Ward³

et al. 2005

Circulation

Self Cite

212

View full text Add to dashboard Cite

show abstract

“…Drug‐eluting stents (DESs) have reduced restenosis by inhibiting neointimal growth,1, 2 but there are still certain indications of late stent failure such as late stent thrombosis and restenosis. Although incomplete endothelialization was reported as the primary substrate of late stent thrombosis in an initial pathological study,3, 4 recent reports revealed that abnormal vascular responses are also responsible for the occurrence of late stent failure 5, 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Vascular Responses Following New‐Generation Biodegradable and Durable Polymer‐Based Drug‐Eluting Stent Implantation in an Atherosclerotic Rabbit Iliac Artery Model

Nakazawa

Torii

Ijichi

et al. 2016

JAHA

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BackgroundIncomplete endothelialization is the primary substrate of late stent thrombosis; however, recent reports have revealed that abnormal vascular responses are also responsible for the occurrence of late stent failure. The aim of the current study was to assess vascular response following deployment of biodegradable polymer‐based Synergy (Boston Scientific) and Nobori (Terumo) drug‐eluting stents and the durable polymer‐based Resolute Integrity stent (Medtronic) in an atherosclerotic rabbit iliac artery model.Methods and ResultsA total of 24 rabbits were fed an atherogenic diet, and then a balloon injury was used to induce atheroma formation. Synergy, Nobori, and Resolute Integrity stents were randomly implanted in iliac arteries. Animals were euthanized at 28 days for scanning electron microscopic evaluation and at 90 days for histological analysis. The percentage of uncovered strut area at 28 days was lowest with Synergy, followed by Resolute Integrity, and was significantly higher with Nobori stents (Synergy 1.1±2.2%, Resolute Integrity 2.0±3.9%, Nobori 4.6±3.0%; P<0.001). At 90 days, inflammation score was lowest for Synergy (0.27±0.45), followed by Nobori (0.62±0.59), and was highest for Resolute Integrity (0.89±0.46, P<0.001). Foamy macrophage infiltration within neointima (ie, neoatherosclerosis) was significantly less with Synergy (0.62±0.82) compared with Nobori (0.85±0.74) and Resolute Integrity (1.39±1.32; P=0.034).ConclusionsThe biodegradable polymer‐coated thin‐strut Synergy drug‐eluting stent showed the fastest stent strut neointimal coverage and the lowest incidence of neoatherosclerosis in the current animal model.

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“…Although the advantage of drug-eluting stents (DESs) versus bare metal stents (BMSs) has been well documented for native coronary artery disease, [1][2][3] data are limited for the systematic evaluation of DESs and BMSs in saphenous vein graft (SVG) disease. The clinical studies undertaken to evaluate DESs in SVG were underpowered, and the results of these studies were inconsistent with respect to the rates of major adverse cardiac events, death, myocardial infarction (MI), and target vessel revascularization (TVR).…”

mentioning

confidence: 99%

Comparison by Meta-Analysis of Drug-Eluting Stents and Bare Metal Stents for Saphenous Vein Graft Intervention

Lee

Yang

Kandzari

et al. 2010

The American Journal of Cardiology

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A Polymer-Based, Paclitaxel-Eluting Stent in Patients with Coronary Artery Disease

Abstract: As compared with bare-metal stents, the slow-release, polymer-based, paclitaxel-eluting stent is safe and markedly reduces the rates of clinical and angiographic restenosis at nine months.

Cited by 2,522 publications

References 29 publications

Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women

Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women

Comparison of Vascular Responses Following New‐Generation Biodegradable and Durable Polymer‐Based Drug‐Eluting Stent Implantation in an Atherosclerotic Rabbit Iliac Artery Model

Comparison by Meta-Analysis of Drug-Eluting Stents and Bare Metal Stents for Saphenous Vein Graft Intervention

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