جستجوی مقالات مرتبط با کلیدواژه "drug eluting stent" در نشریات گروه "پزشکی"

In-stent restenosis (ISR) is an inevitable complication of percutaneous coronary intervention, with genetic factors thought to play a role in its pathogenesis. The VEGF gene can have an inhibitory effect on ISR development. Accordingly, in the present study, we investigated the role of −2549 VEGF (insertion/deletion [I/D]) variants in ISR formation.

Patients with ISR (ISR+) (n=53) and patients without ISR (ISR-) (n=67) were enrolled in this case-control study based on follow-up angiography 1 year after percutaneous coronary intervention between 2019 and 2020. The clinical characteristics of the patients were evaluated, and the frequencies of the alleles and genotypes of −2549 VEGF (I/D) variants were determined using polymerase chain reaction. The χ2 test was performed for the calculation of genotypes and alleles. A P value of less than 0.05 was considered the level of significance.

This study recruited 120 individuals at a mean age of 61.43±8.91 years in the ISR+ group and 62.09±7.94 years in the ISR- group. Women and men, respectively, comprised 26.4% and 73.6% of the ISR+ group and 43.3% and 56.7% of the ISR- group. A significant association was observed between the VEGF −2549 genotype frequency and ISR. The frequency of the insertion/insertion (I/I) allele was significantly higher in the ISR+ group than in the ISR- group, while the frequency of the D/D allele was higher in the latter group.

Regarding ISR development, the I/I allele may be a risk allele and the D/D allele a protective allele.

Context: 

The optimal treatment strategy for in-stent restenosis (ISR) still remains under debate. Moreover, there have been scarce data on Indian patients relating to ISR treatment.

The aim of this study was to determine the clinical profile and angiographic pattern of patients with ISR and to evaluate the outcome of these patients being treated for ISR. Settings and Design: This was a cross-sectional study which consisted of patients who had coronary angiographic characteristic of ISR.

Patients were divided into subgroups as per presentation, acute coronary syndrome (ACS), and non-ACS. After the ISR event and treatment, the patients were followed up for a minimum period of 6 months for any adverse events. The primary outcome of the study was occurrence of a major adverse cardiac event. Statistical Analysis: Chi-square test, Fisher’s exact test, Student’s t-test, or Mann–Whitney test was applied according to type and distribution of variable (SPSS software).

One hundred patients with 109 culprit lesions of ISR were included in the study. The ACS was dominant clinical presentation mode, occurring in 62 patients. Fifty-four percent of the patients were treated with percutaneous coronary intervention, 26% were managed with coronary artery bypass grafting, and 19% were treated with optimized medical therapy. Majority of the adverse events (12 out of 15 patients) occurred in the ACS group, with a statistically significant difference at 6‑month follow‑up (P = 0.021).

Patients with ISR have ACS as the most common mode of presentation. Patients with ISR presenting with ACS are at high risk and must be closely monitored. The treatment of ISR with drug‑eluting stent or drug‑coated balloon is most effective

Evermine 50™ (Meril Life Sciences Pvt. Ltd., India) everolimus-eluting stent system (EES) is a novel ultrathin strut (50 μm) cobalt-chromium coronary drug-eluting stent (DES) platform with biodegradable polymer coating. The Evermine 50 EES-KLES study aimed to evaluate the Evermine 50 EES in terms of 24-month clinical safety and performance in patients with coronary artery disease (CAD).

This retrospective study consisted of 171 patients (258 lesions) implanted with Evermine 50 EES for managing CAD. We analyzed the major adverse cardiac events (MACE) incidence, defined as a composite of cardiac death, myocardial infarction, and ischemia-driven target lesion revascularization (ID-TLR) at 6-, 12-, and 24-month follow-ups.

A total of 171 patients were included with a mean age of 57.85 ± 10.05 years, of which, 139 (81.29%) were men, 69 (40.35%) were hypertensive, and 70 (40.94%) were diabetic. The incidence of MACE was 1 (0.58%), 3 (1.81%), and 4 (2.42%) at 6-, 12-, and 24-month follow-ups, respectively. There were three cases (1.82%) of cardiac death and one case (0.61%) of ID-TLR up to 24 months. None of the patients was presented with definite or probable stent thrombosis (ST).

This study demonstrated that implantation of ultrathin strut Evermine 50 EES resulted in a low rate of incidence of MACE, indicating a favourable clinical safety and performance profile of Evermine 50 EES in patients with CAD [Clinical Trials Registry-India (CTRI) Number: CTRI/2017/09/009939)].

 The assessment of potential benefits and harms of a medical procedure is essential for both physicians and patients to make an informed choice among treatment options. There is a paucity of studies on the role of creatine kinase-MB  (CKMB) in the prediction of patient outcome after elective percutaneous intervention

 The current study aimed to assess the association of CKMB level with demographic characteristics and major adverse cardiac events (MACES) after percutaneous coronary intervention (PCI) with drug-eluting stent implantation.

 The study was conducted based on the data concerning the consecutive patients hospitalized for PCI and followed for 12 months. We examined the association between CKMB levels at 12 h post-PCI in patients with drug-eluting stent implantation and demographic characteristics. MACEs were defined as death, myocardial infarction, the need for re-revascularization in the first 48 h after the procedure and during a 1-year follow-up in 2898 patients who underwent PCI in Tehran Heart Center within 2015-2016.

 In multivariate logistic regression, after adjustment for differences, no relationship was observed between CKMB level at 12 h post-PCI and 12-month MACEs; nonetheless, in-hospital MACEs were higher in patients who had CKMB> 3 times the upper limit of normal. Furthermore, thrombus, angulated segment, and coronary perforation during the procedure were more prevalent in patients with higher CKMB levels.

 The obtained results demonstrated that in patients with elective drug-eluting stent implantation, the moderate elevation of post-procedural CKMB>3 times was associated with in-hospital MACEs. Moreover, no association was found between 1-year adverse events and >3 times the elevation of CKMB.