Predictive Factors of Restenosis After Coronary Stent Placement

Kastrati, Adnan; Schömig, Albert; Elezi, Shpend; Schühlen, Helmut; Dirschinger, Josef; Hadamitzky, Martin; Wehinger, Anne; Hausleiter, Jörg; Walter, Hanna; Neumann, Franz‐Josef

doi:10.1016/s0735-1097(97)00334-3

Cited by 633 publications

(336 citation statements)

References 35 publications

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“…Diabetes mellitus has been identified as an independent risk factor for the development of atherosclerosis and is considered a coronary-heart-disease risk equivalent. It is also a recognized independent risk factor for poor outcome after percutaneous transluminal coronary angioplasty for symptomatic coronary disease (Kip et al, 1996;Holmes et al, 1997;Kastrati et al, 1997;Mathew et al, 2004). TNF-is increased in arterial smooth muscle cells following injury and has multiple biological effects, such as promoting the migration of VSMCs and inflammatory cells by a mechanism dependent on the activation of NF-B (Wang et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

α-Lipoic acid inhibits matrix metalloproteinase-9 expression by inhibiting NF-κB transcriptional activity

Kim

Kim²,

Park³

et al. 2007

Exp Mol Med

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Abbreviations: ALA, α-lipoic acid; AP-1, activator protein-1; MMP-9, matrix metalloproteinase-9; VSMC, vascular smooth muscle cell AbstractThe migration of vascular smooth muscle cells (VSMCs) into the intima, an important step in injury-induced neointimal hyperplasia, requires the activation of nuclear factor-κB (NF-κB) and the consequent up-regulation of matrix metalloproteinase-9 (MMP-9). This study was undertaken to test for a possible effect of α-lipoic acid (ALA), a potent inhibitor of NF-κB, on MMP-9 expression. ALA inhibited high-glucose-and TNF-α-stimulated VSMC migrations in vitro. It also inhibited high-glucoseand TNF-α-induced increases in MMP-9 expression. The activity of MMP-9-promoter constructs with mutations in the NF-κB binding site was not inhibited by ALA, indicating an involvement of the NF-κB signaling pathway in the ALA-specific inhibition of MMP-9. These data suggest the possibility that ALA may be useful for the prevention of neointimal hyperplasia after angioplasty, by inhibiting the NF-κB/ MMP-9 pathway, especially with hyperglycemia.

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Section: Discussionmentioning

confidence: 99%

α-Lipoic acid inhibits matrix metalloproteinase-9 expression by inhibiting NF-κB transcriptional activity

Kim

Kim²,

Park³

et al. 2007

Exp Mol Med

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“…In addition, predictors of clinical outcomes in both BMS- (16) and DES-treated (17) patients have been identified; although, for the large part, these studies were again limited to reporting restenosis at six months in patients enrolled in RCTs. With recent concerns raised regarding very late outcomes in patients enrolled in clinical trials, particularly in the context of DES use (18), it is important to examine the long-term outcomes of 'all-comers' who undergo PCI.…”

mentioning

confidence: 99%

Late outcomes following percutaneous coronary interventions: Results from a large, observational registry

Appleby¹,

Mackie²,

Džavík³

et al. 2010

Canadian Journal of Cardiology

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T he introduction of coronary stent implantation heralded a major advance in percutaneous coronary intervention (PCI), with dramatically improved in-hospital mortality and morbidity compared with plain old balloon angioplasty for the treatment of coronary artery disease. Several randomized controlled trials (RCTs) have established the superior long-term safety and efficacy of bare-metal stenting (BMS) compared with plain old balloon angioplasty (1-3). The introduction of drug-eluting stents (DES) resulted in a further significant reduction in restenosis, and has been associated with improved procedural outcomes in a more complex subset of patients and lesions (4-7). Thus, coronary stenting using bare-metal or drug-eluting platforms has become the cornerstone of PCI, and the indications for PCI have vastly expanded beyond those originally proposed.Pooled data from randomized DES trials have shown acceptable rates of all-cause mortality, myocardial infarction (MI) and revascularization in extended follow-up, up to four years (8). Although RCTs have excellent internal validity, direct extrapolation of their findings to the general population has been problematic due to their restrictive inclusion and exclusion criteria. Early data (9,10) regarding clinical outcomes in real-world patient reports from registries had limitations in both the follow-up period and the patient cohort size; the large New York State registry (11) comparing three-year outcomes in patients undergoing coronary stenting versus coronary artery bypass graft (CABG) surgery excluded all those with previous revascularization, left main stem (LMS) disease or MI within 24 h of the index procedure (11). More recently, several registries have compared two-(6,12-14) or three-year (15) outcomes in patients undergoing BMSonly versus DES-only PCI, and confirmed higher rates of subsequent revascularization in BMS-treated patients with either lower (12-14) or equivalent (6) rates of mortality or MI in DES-treated patients, or a HeaLtH outcomes/pubLic poLicy ©2010 Pulsus Group Inc. All rights reserved BACKgRounD: Randomized controlled trials report short-and medium-term outcomes following percutaneous coronary intervention (PCI), but their applicability to the general population is not known. Data regarding the long-term clinical outcomes of patients undergoing PCI are lacking. oBJECTIVE: To determine the long-term outcomes of 'all-comers' undergoing PCI at a large-volume tertiary cardiac referral centre. METhoDs: A total of 12,662 consecutive patients undergoing an index procedure and entered into the University Health Network's (Toronto, Ontario) prospective registry between April 2000 and September 2007 were identified. In-hospital outcomes were assessed. Follow-up data were obtained through linkage to a provincial registry. Kaplan-Meier analysis was performed to calculate unadjusted survival rates, and Cox multiple regression analysis identified independent predictors of late mortality, major adverse cardiac events and all cardiovascular events. REsuLTs: T...

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“…Even sirolimus-eluting stents could not completely prevent these recurrences. (4,5 (11,12), but these stents are not without problems including in-stent restenosis. In the RESEARCH study (13) …”

Section: Discussionmentioning

confidence: 99%

Successive, Rapid Recurrences of In-stent Restenoses in a Woman with Angina Pectoris

Teragawa

Ueda

et al. 2006

Intern. Med.

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Predictive Factors of Restenosis After Coronary Stent Placement

Cited by 633 publications

References 35 publications

α-Lipoic acid inhibits matrix metalloproteinase-9 expression by inhibiting NF-κB transcriptional activity

α-Lipoic acid inhibits matrix metalloproteinase-9 expression by inhibiting NF-κB transcriptional activity

Late outcomes following percutaneous coronary interventions: Results from a large, observational registry

Successive, Rapid Recurrences of In-stent Restenoses in a Woman with Angina Pectoris

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