New Frontiers in Cardiology

Sousa, J. Eduardo; Serruys, Patrick W.; Costa, Marco A.

doi:10.1161/01.cir.0000069331.67148.2f

Cited by 145 publications

(53 citation statements)

References 33 publications

(29 reference statements)

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“…Defining the most appropriate study end point has also been a dilemma. The classical binary restenosis rate has limited value [7]. Angiographic late lumen loss and neointimal hyperplasia (NIH) volume detected by intravascular ultrasonography are considered important parameters to evaluate the performance of drug-eluting stents [7].…”

Section: Discussionmentioning

confidence: 99%

“…The classical binary restenosis rate has limited value [7]. Angiographic late lumen loss and neointimal hyperplasia (NIH) volume detected by intravascular ultrasonography are considered important parameters to evaluate the performance of drug-eluting stents [7]. The late-loss of luminal diameter was also shown to have significantly reduced in the combined analysis of drug eluting stents.…”

Section: Discussionmentioning

confidence: 99%

“…Several categories of pharmaceutical agents have been utilized for coating the stents. Paclitaxel-and sirolimus-eluting stents act by their immunosuppressive and antiproliferative properties and have been studied most often in clinical trials [5][6][7]. The outcomes of these studies include loss of arterial lumen diameter (the difference between neo-intimal diameter immediately after the procedure and that at follow up), neointimal hyperplasia, restenosis rates and major adverse cardiac events.…”

Section: Introductionmentioning

confidence: 99%

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A meta‐analysis of clinical trials of paclitaxel‐ and sirolimus‐eluting stents in patients with obstructive coronary artery disease

Shafiq¹,

Malhotra²,

Pandhi³

et al. 2004

Brit J Clinical Pharma

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Br J Clin PharmacolAim This meta-analysis was conducted to compare the effects of drug (paclita xel and sirolimus)-eluting stents with bare metal stents on major adverse cardiac events, restenosis rates and late loss of arterial lumen diameter in patients with obstructive coronary artery disease. MethodsRandomized, controlled clinical trials comparing sirolimus-and paclita xel-eluting stents with bare metal stents were identified through electronic and manual search. Fixed effects method of Mantel-Haenszel and random effects method of DerSimonian and Laird were used for computing the pooled odds ratio (OR) and 95% confidence intervals (CI) for major adverse cardiac events and restenosis rates. Standardized mean difference with 95% CI was calculated for late-loss of ar terial lumen diameter. ResultsA total of 13 studies were included in the meta-analysis. As compared with bare metal stents, the use of sirolimus-and paclitaxel-eluting stents significantly reduced the major adverse cardiac events (pooled OR 0.35; 95% CI 0.24-0.50), restenosis rates (pooled OR 0.27; 95% CI 0.15-0.47), and late loss of arterial lumen diameter (mean difference 0.57 mm, 95% CI 0.49-0.68). ConclusionPaclitaxel-and sirolimus-eluting stents significantly reduced the incidence of major adverse cardiac events, restenosis rates, and late loss of ar terial lumen diameter as compared with bare metal stents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A meta‐analysis of clinical trials of paclitaxel‐ and sirolimus‐eluting stents in patients with obstructive coronary artery disease

Shafiq¹,

Malhotra²,

Pandhi³

et al. 2004

Brit J Clinical Pharma

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“…Coronary angiography after six months revealed that the biphasic polymer managed delivery of low levels of paclitaxel produced substantial decreases in neointimal proliferation as compared to controls (Colombo et al 2003). However, other studies measuring the effects of paclitaxel delivery using different dosing and delivery systems revealed that the ability to deliver large quantities of paclitaxel through acrylate polymer coatings were correlated with high incidences of acute, subacute, and late in-stent thrombosis (SCORE Trial; Sousa et al 2003). In addition, paclitaxel release from stents with nonpolymer-based delivery systems did not translate into patient clinical benefit (Park et al 2003).…”

Section: Drug Eluting Stents Paclitaxel Drug Eluting Stentsmentioning

confidence: 99%

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

et al. 2006

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Restenosis is one of the major adverse outcomes of Percutaneous CoronaryIntervention (PCI). Previous studies have shown conflicting reports for homocysteine as a predictor of restenosis following PCI. The conflicting reports may be due to oxidative factors (stimulation of polymorphonuclear leukocyte [PMNL]-induced reactive oxygen species generation, xanthine-xanthine oxidase, and arachidonic acid metabolism) other than homocysteine which could cause endothelial cell dysfunction leading to restenosis.Malondialdehyde (MDA), a lipid peroxidation product, is a marker for oxidative stress and is related to all oxidative factors. Therefore, it is possible that serum MDA may be a better predictor of restenosis than plasma homocysteine. The purpose of this study is to determine whether or not the pre-procedural serum MDA and plasma homocysteine levels are elevated in patients who develop restenosis post PCI.The study included fifty-one patients undergoing elective PCI who consented to participate in a protocol that was approved by the Ethics Committee of the University of Saskatchewan. Homocysteine and malondialdehyde were measured in the plasma and serum respectively. Blood samples were collected pre-procedural, 0 time, 8 hours, 24 hours, and 6 months post-procedure. Exercise tolerance tests were performed at two weeks, and six months post-procedure to determine if there was any evidence of restenosis.The results of the study showed that pre-procedural values of plasma homocysteine in the restenosis and non-restenosis groups were 10.37 ± 0.46 and 10.73 ± 0.49 respectively. These values were not significantly different (p=0.60) between the groups. The pre-procedural levels of plasma homocysteine were not significantly ii different (p=0.08) from the post-PCI values of those patients who did not develop restenosis at the 6-month time interval. However, the pre-procedural levels of plasma homocysteine were significantly different from the post-PCI values of those patients in the restenosis group at the 24hr (p=0.04) and 6-month (p=0.002) time intervals. In the restenosis group there was a significant increase (24%) after six months in the values of homocysteine from the pre-procedural levels. Thus, this indicates that restenosis is associated with higher post-PCI levels of homocysteine.The pre-procedural levels of serum MDA in the restenosis and non-restenosis groups were 0.124± 0.16 and 0.147± 0.02 respectively. There was no significant difference (p=0.60) between the two groups. There was also no significant difference The results suggest that pre-procedural levels of plasma homocysteine and serum MDA were not predictors of restenosis following PCI. However, the post-PCI sixmonth levels of both homocysteine and MDA are predictors of restenosis. Moreover, the post-PCI levels of MDA were better predictors of restenosis than the post-PCI levels of homocysteine because the increase in MDA levels were greater at six months than the rise in homocysteine levels at the same time interval.iii ACKNOWLEDGEMENTS

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“…Particularly, the poly(styrene-b-isobutylene-b-styrene) triblock copolymer is currently used as the drug carrier matrix for the TAXUS Express Paclitaxel-Eluting Coronary Stent system (Boston Scientific Corporation, Natick, MA, USA). [14][15][16] PIB-based TPEs are relatively hydrophobic. Hydrophilic drugs, such as paclitaxel, are incompatible with PIB-based TPEs.…”

Section: Introductionmentioning

confidence: 99%

Living cationic sequential block copolymerization: synthesis and characterization of poly(4-(2-hydroxyethyl)styrene-b-isobutylene-b-4-(2-hydroxyethyl)styrene) triblock copolymers

Ren

Guo

et al. 2010

Polym J

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New Frontiers in Cardiology

Cited by 145 publications

References 33 publications

A meta‐analysis of clinical trials of paclitaxel‐ and sirolimus‐eluting stents in patients with obstructive coronary artery disease

A meta‐analysis of clinical trials of paclitaxel‐ and sirolimus‐eluting stents in patients with obstructive coronary artery disease

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

Living cationic sequential block copolymerization: synthesis and characterization of poly(4-(2-hydroxyethyl)styrene-b-isobutylene-b-4-(2-hydroxyethyl)styrene) triblock copolymers

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