6,963 publications from this institution
At present, 90 to 95 percent of percutaneous coronary interventions involve the implantation of a stent, often a drug-eluting stent, though most published data originated in the era of bare-metal stents. This article reviews the indications for and biology of coronary-artery stents, focusing on recent advances in drug-eluting stents.
Bioresorbable scaffolds (BRS) were designed more than 30 years ago to overcome the disadvantages related to the permanent implantation of a metallic stent and, at present, a number of these devices have obtained a CE mark on the basis of midterm follow-up studies. However, although BRS have already been introduced into clinical practice, intensive research is ongoing worldwide to clarify their long-term safety and effectiveness. This type of research has captivated the interest of the cardiovascular community after the recent publication of long-term follow-up data from randomised trials demonstrating increased late scaffold thrombosis in the Absorb™ BRS (Abbott Vascular, Santa Clara, CA, USA). In this regard, any long-term follow-up data for BRS are of particular importance, especially when they originate from real-world patients, challenging lesions and scaffolds other than the Absorb GT1™, which is the only available BRS that has been evaluated in a controlled fashion so far versus the current standard, new-generation drug-eluting stents. The session "Long-term data of BRS" on the last day of EuroPCR 2017 (Paris, France) offered some very interesting data on what the global picture for the future of BRS could be.
AimsTo report the 4-month angiographic and 6-month clinical follow-up in first-in-man study using the tacrolimus-eluting bioabsorbable polymer-coated cobalt–chromium MAHOROBA™ stent.
Down through the ages Calvin has at times received a brutal press, especially in the last half of the nineteenth century and the first half of the twentieth century. Adolf von Harnack is supposed to have begun his lecture on Calvin with the words, 'We now come to a man who never smiled.' More severely, Stefan Zweig in 1936 portrayed him as a dictator, a kind of Hitler before his time, who inspired his followers to be 'hostile to beauty, happiness, life itself '. However, Zweig said nothing about Calvin and the Jewish question - which must be of some significance.
Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is expressed abundantly in the necrotic core of coronary lesions, and products of its enzymatic activity may contribute to inflammation and cell death, rendering plaque vulnerable to rupture.This study compared the effects of 12 months of treatment with darapladib (an oral Lp-PLA(2) inhibitor, 160 mg daily) or placebo on coronary atheroma deformability (intravascular ultrasound palpography) and plasma high-sensitivity C-reactive protein in 330 patients with angiographically documented coronary disease. Secondary end points included changes in necrotic core size (intravascular ultrasound radiofrequency), atheroma size (intravascular ultrasound gray scale), and blood biomarkers.=0.37). In contrast, Lp-PLA(2) activity was inhibited by 59% with darapladib (P<0.001 versus placebo). After 12 months, there were no significant differences between groups in plaque deformability (P=0.22) or plasma high-sensitivity C-reactive protein (P=0.35). In the placebo-treated group, however, necrotic core volume increased significantly (4.5+/-17.9 mm(3); P=0.009), whereas darapladib halted this increase (-0.5+/-13.9 mm(3); P=0.71), resulting in a significant treatment difference of -5.2 mm(3) (P=0.012). These intraplaque compositional changes occurred without a significant treatment difference in total atheroma volume (P=0.95).Despite adherence to a high level of standard-of-care treatment, the necrotic core continued to expand among patients receiving placebo. In contrast, Lp-PLA(2) inhibition with darapladib prevented necrotic core expansion, a key determinant of plaque vulnerability. These findings suggest that Lp-PLA(2) inhibition may represent a novel therapeutic approach.
The aim of this study was to investigate the impact on 10-year survival of patient-reported anginal status at 1 year following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in patients with left main coronary artery disease (LMCAD) and/or three-vessel CAD (3VD).
