Everolimus eluting stent vs first generation drug-eluting stent in primary angioplasty: A pooled patient-level meta-analysis of randomized trials

Luca, Giuseppe De; Smits, Peter; Hofma, Sjoerd H.; Lorenzo, Emilio Di; Vlachojannis, Georgios J.; Hof, Arnoud W.J. van’t; Boven, Ad J. van; Kedhi, Elvin; Stone, Gregg W.; Suryapranata, Harry

doi:10.1016/j.ijcard.2017.06.022

Cited by 59 publications

(32 citation statements)

References 35 publications

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“…In addition to mechanical devices and stent technology [23][24][25], large improvement have been achieved in antithrombotic strategies that allow to prevent a large quote of ischemic complications, especially in-stent thrombosis [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Immature platelet fraction and high-on treatment platelet reactivity with ticagrelor in patients with acute coronary syndromes

Verdoia¹,

Sartori²,

Pergolini³

et al. 2015

J Thromb Thrombolysis

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Residual high-on treatment platelet reactivity (HRPR) has been associated with a 2-9 fold increased risk of acute ischemic events in patients with acute coronary syndromes or coronary stenting. However, the mechanism of suboptimal platelet inhibition are still poorly understood. Aim of present study was to evaluate the role of the percentage of reticulated platelets on HRPR with ticagrelor. In patients treated with ASA (100-160 mg) and ticagrelor (90 mg twice a day) platelet reactivity and the reticulated platelets fraction (immature platelets fraction, IPF) were assessed at 30-90 days after acute coronary syndrome. Aggregation was assessed by multiple-electrode aggregometry. HRPR was defined as ADP test >417 AU*min. Our population is represented by 190 patients, divided according to tertiles values of IPF (<2.5; 2.5-3.99; ≥4 %). Higher IPF was associated to a larger platelet volume and lower platelets count (p < 0.001), and inversely related with a history of previous coronary revascularization (p = 0.03). Twenty-one out of 190 (11.0 %) patients displayed HRPR. No difference in the levels of circulating IPF was found in patients with or without HRPR (p = 0.25), with no correlation between the rate of reticulated platelets and platelet reactivity at ADP test (r = -0.084, p = 0.26). In fact no association was observed between high levels of IPF and the occurrence of HRPR (adjusted OR[95 % CI] = 0.69[0.34-1,37], p = 0.28), even after correction for baseline differences. In patients treated with ticagrelor, the levels of circulating reticulated platelets assessed at 30-90 days post-ACS are not associated with platelet reactivity or the occurrence of HRPR.

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Section: Discussionmentioning

confidence: 99%

Immature platelet fraction and high-on treatment platelet reactivity with ticagrelor in patients with acute coronary syndromes

Verdoia¹,

Sartori²,

Pergolini³

et al. 2015

J Thromb Thrombolysis

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“…In the 3‐year results of XAMI trial, the primary endpoint (CD, non‐fatal MI, or any TVR) between EES and SES was similar (8.9% vs. 10.5%, p = .30). De Luca et al reported EES was associated with a lower TVR than 1G‐DES. Kim et al showed 2G‐DES was better for TLR, TVR, and any repeat revascularization than the 1G‐DES.…”

Section: Discussionmentioning

confidence: 97%

Impact of stent generation on 2‐year clinical outcomes in ST‐segment elevation myocardial infarction patients with multivessel disease who underwent culprit‐only or multivessel percutaneous coronary intervention

Kim

Her

Cho

et al. 2019

Cathet Cardio Intervent

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AbstractsBackground: Data concerning the impact of stent generation on long-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) who underwent primary percutaneous coronary intervention (PCI) with culprit-only PCI (C-PCI) or multivessel PCI (M-PCI) are limited.Methods: A total of 7,266 patients were separated into the two groups, a C-PCI (n = 4,901) or M-PCI group (n = 2,365). The primary endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction, and any repeat revascularization. The secondary endpoint was the cumulative incidence of stent thrombosis (ST) at 2 years.Results: The cumulative incidence of MACE was significantly higher in the bare-metal stents (BMS) group than the first-generation (1G)-drug-eluting stents (DES) (C-PCI: adjusted hazard ratio [aHR], 1.940; 95% confidence interval [CI], 1.389-2.709; p < .001; M-PCI: aHR, 1.544; 95% CI, 1.099-2.074; p = .038), and the secondgeneration (2G)-DES group (C-PCI: aHR, 2.271; 95% CI, 1.657-3.114; p < .001; M-PCI: aHR, 2.999; 95% CI, 1.899-4.704; p < .001). In the M-PCI group, 1G-DES showed a higher incidence of MACE compared with 2G-DES (aHR, 1.639; 95% CI, 1.028-2.614; p = .004). The cumulative incidences of ST in the both groups were similar. Conclusion: The cumulative incidence of MACE was the lowest for 2G-DES, the highest for BMS, and intermediate for 1G-DES in the STEMI patients with MVD after Yong Hoon Kim and Ae-Young Her contributed equally to this study as first authors.

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“…[12][13][14][15][16] Despite recent advances, still consistent percentage of patients displays higher mortality and morbidity due to CAD, especially in acute coronary syndromes. Our main findings are consistent with a significant, independent role of active smoking to predict higher immature platelet fraction (IPF) among patients undergoing percutaneous coronary intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Undoubtedly in last years, many improvements have been obtained in relation to cardiovascular diseases, especially in the treatment of coronary artery disease. [12][13][14][15][16] Despite recent advances, still consistent percentage of patients displays higher mortality and morbidity due to CAD, especially in acute coronary syndromes. [17][18][19] Understanding the underlying processes involved in pathogenesis of CAD is essential to detect potential site of intervention to improve patients' outcome.…”

Section: Discussionmentioning

confidence: 99%

Impact of active smoking on the immature platelet fraction and its relationship with the extent of coronary artery disease

Nardin

Verdoia

Negro³

et al. 2020

Eur J Clin Investigation

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Introduction:Smoking represents a major cardiovascular risk factor, due to the induction of oxidative stress and low-grade, continuous, inflammation that contribute to promote atherothrombosis. However, the mechanisms leading to increased platelet aggregability associated with smoking are only partially defined. A potential role has been hypothesized for immature platelets, a younger and potentially more reactive fraction, previously associated with the main determinants of coronary artery disease (CAD). Therefore, the aim of our study was to define the impact of smoking on the immature platelet fraction (IPF) and its relationship with prevalence and extent of coronary artery disease. Methods: We enrolled a cohort of consecutive patients undergoing coronary angiography in a single centre. Significant CAD was defined as at least 1 vessel stenosis >50%, while severe CAD was defined as left main and/or three-vessel disease. IPF was measured at admission by routine blood cell count (Sysmex XE-2100). Results: We included in our study 2553 patients who were divided according to smoking status (active smokers: 512; nonactive smokers: 2041). Smokers were younger, more frequent males, with lower rate of diabetes mellitus, previous PCI and previous CABG (P < .001, respectively) and were in treatment less often with ARB, BB, nitrates, statins, ASA, clopidogrel, CCB and diuretics (P < .001, respectively) as compared to nonactive smokers. Higher percentage of smokers was observed in patients with higher IPF values, and at multivariate analysis, active smoking resulted as an independent predictor of higher IPF (adjusted OR [95% CI] = 1.59[1.03-2.45], P = .035). Among smokers, higher IPF was associated with lower ejection fraction (P = .034), percentage of acute coronary syndrome (P = .002) and platelet count (P < .001) compared to ones with lower IPF. However, the IPF (according to quartiles values) was not associated with the prevalence and extent of CAD (82.5%, 80.4%, 86.1% and 80.9%, from 1st to 4th quartile, respectively, adjusted OR[95% CI] = 0.98[0.79-1.23], P = .89) and severe CAD (31%, 31.1%, 39.1% and 35.2%, from 1st to 4th quartile, respectively, adjusted OR[95% CI] = 1.03[0.86-1.23], P = .76).

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Everolimus eluting stent vs first generation drug-eluting stent in primary angioplasty: A pooled patient-level meta-analysis of randomized trials

Cited by 59 publications

References 35 publications

Immature platelet fraction and high-on treatment platelet reactivity with ticagrelor in patients with acute coronary syndromes

Immature platelet fraction and high-on treatment platelet reactivity with ticagrelor in patients with acute coronary syndromes

Impact of stent generation on 2‐year clinical outcomes in ST‐segment elevation myocardial infarction patients with multivessel disease who underwent culprit‐only or multivessel percutaneous coronary intervention

Impact of active smoking on the immature platelet fraction and its relationship with the extent of coronary artery disease

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