Second-generation versus first-generation drug-eluting stents in saphenous vein graftdisease: A meta-analysis of randomized controlled trials

Shi, Hongtao; Chu, Hongxia; Gu, Weijun; Cai, Xinyong; Guo, Junjie; Ding, Zhuo; Gao, Wei; Ma, Liang; Zhu, Jiaan; Liu, Hai-Bo; Huang, Zheyong; Wang, Qibing; Ge, Junbo; Wen, Shaojun

doi:10.1016/j.ijcard.2016.03.228

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…The cDES had been proved to be superior to eDES in many studies 19,20 . The cDES has many advantages compared to eDES, such as platinum or cobalt–chrome platforms, durable polymer coatings, thinner struts and better biocompatibility 34,35 . In our study, cDES shows a significant improvement in TLR of LCXos.…”

Section: Discussionmentioning

confidence: 51%

Clinical outcomes of double stent strategy for unprotected left main distal bifurcation lesions using current generation drug eluting stent comparing to early generation drug eluting stent; The Milan and New Tokyo (MITO) registry

Watanabe

Mitomo

Naganuma

et al. 2020

Cathet Cardio Intervent

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Background There are only little data available on the comparison of clinical outcomes between a early generation drug eluting stent (eDES) and a current generation drug eluting stent (cDES) for percutaneous coronary intervention (PCI) with double stent strategy (DSS) for unprotected distal left main disease (ULMD). Methods Between April 2005 and December 2015, we recruited 452 consecutive ULMD patients treated with DSS (eDES, 236 patients; cDES, 216 patients). In this study, eDES included Cipher, Taxus, and Endeavor and cDES included Ultimaster, Resolute family, Xience family, Promus family, Synergy, and Nobori. The primary endpoint was target lesion failure (TLF) defined as a composite of cardiac death, target lesion revascularization (TLR) and myocardial infarction (MI) during the median follow‐up period of 1,809(IQR: 1,190–2,510) days. Results In entire population, the rate of overall TLR was significantly lower in cDES group than that in eDES group (adjusted HR 0.62, 95% CI 0.40–0.96, p = .032). The rate of TLR for the ostium of LCX was significantly lower in cDES group than that in eDES group (adjusted HR 0.63, 95% CI 0.39–0.99, p = .047). Cardiac mortality, the rate of TLR for LM‐LAD, MI and definite/probable ST did not significantly differ between both groups. The results were preserved in the propensity adjusted population. Conclusions cDES significantly improved the clinical outcomes in population treated with DSS mainly driven by the reduction of TLR for the ostium of LCX.

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Section: Discussionmentioning

confidence: 51%

Clinical outcomes of double stent strategy for unprotected left main distal bifurcation lesions using current generation drug eluting stent comparing to early generation drug eluting stent; The Milan and New Tokyo (MITO) registry

Watanabe

Mitomo

Naganuma

et al. 2020

Cathet Cardio Intervent

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“…Fourth, use of EPDs was low in most studies (<5% in ISAR‐CABG); EPDs have been shown to reduce the risk for periprocedural MI and could affect subsequent clinical outcomes. Fifth, 3 trials only included first‐generation DES; second‐generation DES have been shown to improve outcomes in de novo coronary lesions, although the results of retrospective SVG studies have been less consistent . Finally, prior CABG participants often have multiple comorbidities that may confound assessment of various treatment strategies, including stents…”

Section: Discussionmentioning

confidence: 99%

“…6,7,[9][10][11]27 30 although the results of retrospective SVG studies have been less consistent. [31][32][33][34] Finally, prior CABG participants often have multiple comorbidities that may confound assessment of various treatment strategies, including stents. 35 The DIVA trial will address many of these limitations.…”

Section: Discussionmentioning

confidence: 99%

Rationale and design of the Drug‐Eluting Stents vs Bare‐Metal Stents in Saphenous Vein Graft Angioplasty (DIVA) Trial

Brilakis

Banerjee

Edson

et al. 2017

Clinical Cardiology

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VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drugeluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site.At sites that did not routinely administer 12-months of dual antiplatelet therapy after SVG stenting participants without acute coronary syndromes received 1 month of open-label clopidogrel, followed by 11 months of clopidogrel for those assigned to DES and 11 months of placebo for those assigned to BMS. The primary endpoint was the 12-month incidence of targetvessel failure (defined as the composite of cardiac death, target-vessel myocardial infarction, or target-vessel revascularization). Secondary endpoints included the incidence of other clinical endpoints and the incremental cost-effectiveness of DES relative to BMS. Due to lower-thananticipated target-vessel failure rates, target enrollment was increased from 519 to 762. The study had randomized 599 participants when recruitment ended in December 2015. The DIVA trial will provide clarity on the appropriate stent type for de novo SVG lesions.

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“…A tecnologia aplicada no stent tem evoluído rapidamente, buscando dispositivos mais seguros a longo prazo, com uso de substâncias antiproliferativas menos tóxicas e a utilização de novos revestimentos de polímeros melhor biocompatíveis, proporcionando a elaboração de diversas gerações de dispositivos percutâneos (Shi et al, 2016).…”

Section: Gerações De Stents Farmacológicosunclassified

Gerações de stents no tratamento da cardiopatia isquêmica

Ferreira¹,

Gusmão²,

Duarte³

et al. 2020

RSD

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A Doença Arterial Coronariana predispõe o desenvolvimento de doenças isquêmicas cardíacas, sendo uma das principais causas de morbimortalidade em todo mundo. As intervenções coronarianas percutâneas revascularizam o miocárdio por meio da implantação de stents a fim de restabelecer o fluxo sanguíneo nas artérias afetadas. Devido à alta no uso desses dispositivos nos procedimentos percutâneos, bem como as limitações atualmente encontradas, como trombose de stent, reestenose e eventos cardíacos adversos, o objetivo do presente estudo foi analisar as publicações que tratam das diversas gerações de stents no tratamento da doença arterial coronariana, através de uma revisão literária, com busca nas bases Scielo, Pubmed e Sciencedirect. Os stents farmacológicos surgiram como uma alternativa mais segura e eficaz que os stents convencionais, reduzindo episódios de reestenose e eventos cardíacos adversos maiores. No entanto, um maior risco de trombose ligada ao seu uso foi observado. Assim, por meio de um aperfeiçoamento no design, bem como dos materiais utilizados na sua fabricação, diversas gerações de stents farmacológicos foram desenvolvidas, ampliando o acervo terapêutico. Apesar disso, novos estudos ainda são necessários para comprovar sua segurança a longo prazo.

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Second-generation versus first-generation drug-eluting stents in saphenous vein graftdisease: A meta-analysis of randomized controlled trials

Cited by 8 publications

References 28 publications

Clinical outcomes of double stent strategy for unprotected left main distal bifurcation lesions using current generation drug eluting stent comparing to early generation drug eluting stent; The Milan and New Tokyo (MITO) registry

Clinical outcomes of double stent strategy for unprotected left main distal bifurcation lesions using current generation drug eluting stent comparing to early generation drug eluting stent; The Milan and New Tokyo (MITO) registry

Rationale and design of the Drug‐Eluting Stents vs Bare‐Metal Stents in Saphenous Vein Graft Angioplasty (DIVA) Trial

Gerações de stents no tratamento da cardiopatia isquêmica

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