Original Title: Mechanisms of Very Late Drug-Eluting Stent Thrombosis Assessed by Optical Coherence Tomography. Reference: Masanori Taniwaki et al. Circulation. 2016 Feb 16;133(7):650-60. The physiopathological mechanisms behind DES thrombosis have not been fully described yet. The potential causes behind this adverse event were assessed using optical computed tomography (OCT). Between August 2010 and December 2014,…
High bleeding risk: is BMS still justifiable?
Original Title: Is Bare-Metal Stent Implantation Still Justifiable in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention? A Pre-Specified Analysis From the ZEUS Trial. Reference: Sara Ariotti et al. J Am Coll Cardiol Intv. 2016;9(5):426-436. This work studied ischemic and bleeding events in high bleeding risk patients randomized to the zotarolimus eluting stent (ZEZ) Endeavor…
Diabetes has higher impact on DES outcomes than disease complexity
Original Title: Impact of diabetic status on outcomes after revascularization with drug-eluting stents in relation to coronary artery disease complexity. Reference: Koskinas KC et al. Circ Cardiovasc Intv. 2016; Epub ahead of print Diabetic patients ongoing PCI with drug eluting stents (DES) are at higher risk of repeat revascularization than non-diabetic patients. According to this…
SORT OUT IV at 5 years: second generation DES efficacy confirmed
Original Title: Safety and efficacy of everolimus-versus sirolimus-eluting stents: 5-Year results from SORT OUT IV. Reference: Jensen LO et al. J Am Coll Cardiol. 2016;67:751-762. Reassuring long term outcomes from SORT OUT IV confirm the safety and efficacy of second generation everolimus eluting stents (EES) over first generation DES. The difference at 5-year follow up…
In saphenous vein graft lesions, 1st and 2nd generation DES have similar outcomes
Long-Term Outcomes with First vs. Second-Generation Drug-Eluting Stents in Saphenous Vein Graft Lesions. Nagendra R. Pokala. Catheterization and cardiovascular Intervention 2016;87:34-40 Courtesy of del Dr. Carlos Fava. Second generation DES have been proved superior to first generation DES in native arteries, but there is limited information on DES in saphenous vein grafts (SVG), from a…
Definite/Probable Thrombosis with Bioresorbable Scaffolds
Original Title: Scaffold Thrombosis After Percutaneous Coronary Intervention With ABSORB Bioresorbable Vascular Scaffold. A Systematic Review and Meta-Analysis. Reference: Michael J. Lipinski et al. J Am Coll Cardiol Intv. 2016;9(1):12-24. The authors of this study carried out a systematic review and a meta-analysis to determine the thrombosis risk of the bioresorbable everolimus eluting scaffold ABSORB (Abbott…
Polymer-Free Biolimus Coated Stent: 5 Year Outcomes
Original Title: Polymer-Free Biolimus A9-Coated Stents in the Treatment of De Novo Coronary Lesions4- and 12-Month Angiographic Follow-Up and Final 5-Year Clinical Outcomes of the Prospective, Multicenter BioFreedom FIM Clinical Trial CME. Reference: Ricardo A. Costa et al. J Am Coll Cardiol Intv. 2016;9(1):51-64. The purpose of this study was to assess the efficacy and long…
Dual Antiplatelet Therapy after Everolimus Eluting Stenting
Original Title: Benefits and Risks of Extended Dual Antiplatelet Therapy after Everolimus-Eluting Stents. For the Dual Antiplatelet Therapy (DAPT) Study Investigators. Reference: James B. Hermiller et al. JACC: Cardiovascular Interventions 2015, online before print. The DAPT study had shown that continued aspirin plus thienopyridine beyond a year reduces ischemic events. Given the fairly low rate of thrombosis…
ADAPT-DES: Proton Pump Inhibitors and Clopidogrel in Patients with DES
Original Title: Proton Pump Inhibitors, Platelet Reactivity, and Cardiovascular Outcomes After Drug-Eluting Stents in Clopidogrel-Treated Patients. The ADAPT-DES Study. Some proton pump inhibitors interfere with clopidogrel metabolism and could attenuate P2Y12 reception. Prior observational and randomized studies have reported contradicting results on the clinical significance of this drug interaction. The aim of this trial was…
ABSORB III: Everolimus Eluting Bioresorbable Scaffolds for Coronary Artery Disease
Original Title: Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease. Reference: Stone, M.D. for the ABSORB III Investigators. N Engl J Med 2015;373:1905-1915. The ABSORB III is part of a series of randomized studies that test bioresorbable scaffolds in the clinical practice (ABSORB II, EVERBIO II, ABSORB Japan, and ABSORB IV). 2008 patients were randomized; 60% had…
OPTIDUAL: Dual Antiaggregation Not Beneficial after 12 Months.
Extending dual antiaggregation therapy (DAT) from 12 to 48 months appears not to offer extra protection after DES implantation in patients with no adverse ischemic events during the first year, neither does it increase the risk of severe bleeding. The OPTIDUAL study was carried out in 58 centers and included 1.385 patients one year after…