Very late stent thrombosis in patients with first-generation drug-eluting stents: A systematic review of reported cases

Perrin, Caroline; Eisenberg, Mark J.; Dourian, Tara; Grandi, Sonia M.; Filion, Kristian B.

doi:10.1016/j.ijcard.2014.11.030

Cited by 8 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mainly out of misgivings about VLST and its subsequent cardiovascular complications, some researchers advocate for prolonged use of thienopyridine therapy. Previous studies have shown that VLST, though rare it may be, is associated with high mortality (2). Our study shows extended thienopyridine therapy significantly helps in stent thrombosis or even myocardial infarction but at the cost of increasing bleeding.…”

Section: Discussionsupporting

confidence: 50%

“…Drug-eluting stents (DESs) have been widely used because they were considered to dramatically reduce the rates of in-stent restenosis or target lesion revascularization compared with bare metal stents (1). Nevertheless, researchers have also raised concerns about the risks of late and very late stent thrombosis (VLST) after DES implantation, since those events may be catastrophic (2)(3)(4). Current guidelines recommend that all patients undergoing DES placements should receive dual antiplatelet therapy, usually referred to…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Meta-analysis of randomized controlled trials on efficacy and safety of extended thienopyridine therapy after drug-eluting stent implantation

Tang

Yeh

Chen

et al. 2016

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Meta-analysis of randomized controlled trials on efficacy and safety of extended thienopyridine therapy after drug-eluting stent implantation

Tang

Yeh

Chen

et al. 2016

Cardiovasc. Diagn. Ther.

View full text Add to dashboard Cite

show abstract

“…Studies have also associated first-generation DESs with a high rate of late restenosis in the treatment of patients with acute coronary syndrome and stable coronary artery disease (CAD), even during long-term follow-up after the index procedure. 4 , 5 In contrast, second-generation DESs, which use more advanced stent technology, have shown promise in improving clinical outcomes not only for patients with stable CAD but also for patients with acute myocardial infarction (AMI). 6 - 8 …”

Section: Introductionmentioning

confidence: 99%

Three-Year Clinical Outcomes With the Cilotax Dual Drug-Eluting Stent vs Everolimus-Eluting Stents in Patients With Acute Myocardial Infarction

Yu,

Ahn,

Choi

et al. 2024

Texas Heart Institute Journal

View full text Add to dashboard Cite

Background: This study compared the safety and effectiveness of paclitaxel/cilostazol–eluting Cilotax stents with those of everolimus-eluting stents in patients with acute myocardial infarction. Real-world data from the Korea Acute Myocardial Infarction Registry were examined. Methods: A total of 5,472 patients with acute myocardial infarction underwent percutaneous coronary intervention with Cilotax stents (n = 212) or everolimus-eluting stents (n = 5,260). The primary end point was the 3-year rate of target lesion failure. The other end points were major adverse cardiovascular events (a composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization), target vessel revascularization, and stent thrombosis. A propensity score matching analysis was performed to adjust for potential confounders by using a logistic regression model; propensity score matching generated 2 well-balanced groups (Cilotax group, n = 180; everolimus-eluting stents group, n = 170; N = 350). After propensity score matching, baseline clinical characteristics were similar between the groups. Results: After percutaneous coronary intervention, compared with the everolimus-eluting stents group, the Cilotax group more often had major adverse cardiovascular events (24.1% vs 18.5%; P = .042), myocardial infarction (8.0% vs 3.2%; P < .001), target lesion revascularization (8.0% vs 2.6%; P < .001), target vessel revascularization (11.3% vs 4.5%; P < .001), and stent thrombosis (4.7% vs 0.5%; P < .001) before matching. Even after matching, the Cilotax group had more frequent target lesion revascularization (9.4% vs 2.9%; P = .22) and stent thrombosis (5.6% vs 1.2%; P = .34). Conclusion: In patients with acute myocardial infarction who underwent percutaneous coronary intervention, use of the Cilotax stent was associated with higher rates of target lesion revascularization, target vessel revascularization, and stent thrombosis than were everolimus-eluting stents. Use of the Cilotax dual drugeluting stent should be avoided in the treatment of myocardial infarction.

show abstract

“…[ 1 ] The first-generation DESs (G1-DESs) adopted sirolimus or paclitaxel as the coated antiproliferative medications, which effectively eliminated coronary arterial neointimal hyperplasia and thus, in-stent restenosis, mitigating the risks of TVR/TLR events. [ 2 3 ] However, safety concerns arose because of late- and very-late stent thrombosis associated with G1-DES,[ 4 5 ] prompting the development of second-generation DESs (G2-DESs). Based on a novel platform design, more biocompatible polymers, and/or lipophilic antiproliferative medications, G2-DESs were demonstrated to have favorable efficacy and safety in patients undergoing PCI.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Safety between First- and Second-Generation Drug-Eluting Stents in Patients with Acute Coronary Syndrome

Tang

Yao

et al. 2018

Chinese Medical Journal

View full text Add to dashboard Cite

Background:It remains undetermined whether second-generation drug-eluting stents (G2-DESs) outperform first-generation DESs (G1-DESs) in patients with acute coronary syndrome (ACS). We aimed to compare the efficacy and safety of G1-DES and G2-DES in ACS patients in a high-volume cardiovascular center.Methods:In 2013, 10,724 consecutive patients underwent percutaneous coronary intervention in our institution. We included 4037 patients with ACS who underwent exclusively G1-DES or G2-DES implantation (n = 364 and n = 3673, respectively). We used propensity score matching to minimize the imbalance between the G1-DES and G2-DES groups and followed patients for 2 years. The efficacy endpoints were major adverse cardiac events (MACEs) and its components including target vessel-related myocardial infarction (TV-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), and cardiac death. The safety endpoint was stent thrombosis. Continuous variables were compared by Mann-Whitney U-test, and categorical variables were compared using Pearson's Chi-square or Fisher's exact test. Kaplan-Meier curves were constructed to compare the event-free survival rates, and multivariate Cox proportional hazards regression analysis was used to assess whether stent type was an independent risk factor for the efficacy and safety endpoints.Results:At the 2-year follow-up, the results for MACE and it components, as well as stent thrombosis, were similar for G1-DES and G2-DES (MACE, 5.2% vs. 4.3%, χ2 = 0.514, P = 0.474; TV-MI, 0.8% vs. 0.4%, P = 0.407; TVR, 4.9% vs. 3.7%, χ2 = 0.939, P = 0.333; TLR, 3.8% vs. 2.5%, χ2 = 1.610, P = 0.205; cardiac death, 0.3% vs. 0.5%, P = 0.670; and stent thrombosis, 0.5% vs. 0.4%, P > 0.999). Kaplan-Meier analysis indicated similar event-free survival rates between G1-DES and G2-DES after propensity score matching (all: log-rank P > 0.05). Multivariate analysis demonstrated that stent type was not an independent risk factor for the efficacy and safety endpoints (MACE, hazard ratio [HR] = 0.805, 95% confidence interval [CI]: 0.455–1.424, P = 0.456; TV-MI, HR = 0.500, 95% CI: 0.101–2.475, P = 0.395; TVR, HR = 0.732, 95% CI: 0.403–1.330, P = 0.306; TLR, HR = 0.629, 95% CI: 0.313–1.264, P = 0.193; cardiac death, HR = 1.991, 95% CI: 0.223–17.814, P = 0.538; and stent thrombosis, HR = 0.746, 95% CI: 0.125–4.467, P = 0.749).Conclusion:G1-DES and G2-DES have similar efficacy and safety profiles in ACS patients at the 2-year follow-up.

show abstract

Very late stent thrombosis in patients with first-generation drug-eluting stents: A systematic review of reported cases

Cited by 8 publications

References 10 publications

Meta-analysis of randomized controlled trials on efficacy and safety of extended thienopyridine therapy after drug-eluting stent implantation

Meta-analysis of randomized controlled trials on efficacy and safety of extended thienopyridine therapy after drug-eluting stent implantation

Three-Year Clinical Outcomes With the Cilotax Dual Drug-Eluting Stent vs Everolimus-Eluting Stents in Patients With Acute Myocardial Infarction

Comparison of Efficacy and Safety between First- and Second-Generation Drug-Eluting Stents in Patients with Acute Coronary Syndrome

Contact Info

Product

Resources

About