The death knell of bare metal stents: The Cobra stent's encouraging results with short‐term antiplatelet therapy

2021 ◽  
Vol 98 (1) ◽  
pp. 55-56
Author(s):  
Nachiket J. Patel ◽  
Richard R. Heuser
Keyword(s):  
Antiplatelet Therapy ◽  
Bare Metal Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Short Term ◽  
Death Knell

Short-term clinical analysis of the use of Endeavor stent vs bare metal stents in primary PCI

2009 ◽  
Vol 18 ◽  
pp. S233-S234
Author(s):  
Wally Ahmar ◽  
Yuvaraj Malaiapan ◽  
Pei Lee See ◽  
Prashanth Puspanathan ◽  
Maro Baldi ◽  
...  
Keyword(s):  
Bare Metal Stents ◽  
Clinical Analysis ◽  
Metal Stents ◽  
Bare Metal ◽  
Primary Pci ◽  
Short Term

scholarly journals Impact of medication adherence to dual antiplatelet therapy on the long-term outcome of drug-eluting or bare-metal stents

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244062
Author(s):  
Jung Min Choi ◽  
Seung-Hwa Lee ◽  
Mira Kang ◽  
Jin-Ho Choi
Keyword(s):  
Medication Adherence ◽  
Clinical Outcome ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Bare Metal Stents ◽  
Clinical Event ◽  
Metal Stents ◽  
Bare Metal ◽  
Long Term Outcome ◽  
Drug Eluting

Background In percutaneous coronary intervention, drug-eluting stent (DES) showed better clinical outcome compared to bare-metal stent (BMS) but mostly with different DAPT durations. Hypothesis The clinical superiority of DES over BMS may depend on the medication adherence to dual antiplatelet therapy (DAPT). Methods We retrospectively enrolled all Koreans PCI patients in year 2011 (n = 47,291). Medication adherence to DAPT was assessed by proportion of days covered (PDC) per 6 months. Analysis adjusted with the clinical propensity for receiving DES or BMS and DAPT PDC of the first 6 month was performed. Primary outcome was the 5-year major adverse clinical event (MACE) risk consisting all-cause death, revascularization, shock, or stroke. Results Patients with DES (n = 46,356) showed higher PDC (78% versus 60%, p<0.001) and lower MACE risk (39% versus 56%, p<0.001) compared to patients with BMS (n = 935). In the propensity-matched 1,868 patients, MACE risk was lower with DES than BMS (46% versus 54%, HR = 0.80, 95% CI = 0.70–0.91, p<0.001). In both DES and BMS, patients with good medication adherence (PDC ≥80%) showed much lower MACE risk compared to patients with PDC <80% (HR = 0.36, 95% CI = 0.30–0.44; HR = 0.40, 95%CI = 0.33–0.48, p<0.001, all). Patients with DES and PDC <80% showed higher MACE risk compared to BMS with and PDC ≥80% (HR = 1.30, 95%CI = 1.03–1.64, p = 0.027). Conclusions Good medication adherence to DAPT in the first 6 month was prerequisite for better clinical outcome in both DES and BMS. DES with poor adherence to DAPT showed worse outcome compared with BMS with good adherence.

scholarly journals Percutaneous coronary interventions in patient with hemophilia A, partial gastrectomy and recurrent myocardial infarction

2020 ◽  
Vol 1 (2) ◽  
pp. 15-18
Author(s):  
Miodrag Vučić ◽  
Nebojša Vacić
Keyword(s):  
Coronary Angiography ◽  
Antiplatelet Therapy ◽  
Stent Implantation ◽  
Bare Metal Stents ◽  
Partial Gastrectomy ◽  
Drug Eluting Stent ◽  
Metal Stents ◽  
Bare Metal ◽  
Coronary Syndrome ◽  
Stent Type

Acute coronary syndrome is not rare in patients with haemophilia. We report a case of 55-year-old male patient with haemophilia A and gastric resection with Billroth II anastomosis with repeated STEMI and NSTEMI who was successfully treated by PTCA with stent implantation. Patient was admitted to the emergency department (April 2010). Coronary angiography revealed occlusion of mid-RCA, suboclusion of proximal LAD and also of medial Diagonal (Dg) brunch. Bare metal stent was implanted into the RCA. Two-years after (March 2012) patient was readmitted due to chest pain. Coronary angiography showed occluded posterior descendent artery from right coronary artery, subocluded proximal and medial LAD and first Diagonal brunch. Two Carbostents were implanted. There are no reports on the use of drug-eluting stent implantation in patients with hemophilia; however, with concerns about bleeding diathesis, bare-metal stents are regarded as safe. Our choice was new stent type, allowing more rapid reendothelialization, and minimizing the risk of stent thrombosis in the situation when the discontinuation of dual antiplatelet therapy. Antiplatelet therapy is important for preventing thrombus formation in the implanted stent even in patients with abnormal coagulation and high bleeding risk. New rapid-reendothelization stents may be the better choice in this group of patients.

Abstract 14766: Short-Term Dual Antiplatelet Therapy Following Bare Metal Stent Increases the Risk of Ischemic Events- A Meta-Analysis of Randomized Clinical Trials

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Georges El-Hayek ◽  
Abel Casso Dominguez ◽  
Jacqueline Tamis-Holland ◽  
Eyal Herzog ◽  
Alexandre Benjo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Major Bleeding ◽  
Cardiac Death ◽  
Randomized Clinical Trials ◽  
Bare Metal Stents ◽  
Prolonged Treatment ◽  
Metal Stents ◽  
Bare Metal ◽  
Short Term ◽  
Increased Risk

Background: Bare metal stents (BMS) are a reasonable option even in the modern era of superior outcomes with 2nd generation drug eluting stents mainly because of the need for short term dual antiplatelet platelet therapy (DAPT). Current guidelines recommend a minimum of 1 month of DAPT following BMS use. The safety of limiting DAPT to one month has not been clearly established. Methods: We searched PubMed, Scopus and ClinicalTrials.gov databases till May 2014 for randomized clinical trials (RCTs) that compared short (<6 months) versus long DAPT duration (> 6 months) after BMS. Risks ratios (RRs) with 95% confidence interval (CI) for the composite outcome of cardiac death or myocardial infarction (MI) and for major bleeding were calculated using random-effects model. Results: We included 3 RCTs in this analysis. A total of 2654 patients received short term DAPT and 2612 patients received long term DAPT (9 to 24 months). The rates of cardiac death or MI were significantly higher in the short-term DAPT group (9.1%) compared to the prolonged DAPT group (7.0%)which corresponds to a 30% increase in the risk of cardiac death or MI (RR: 1.30, 95% CI: 1.08 to 1.57; p=0.005, figure). On the other hand, short-term DAPT was associated with numerically lower major bleeding events (4.0% vs 5.0%) when compared with prolonged DAPT but this did not reach statistical significance (p=0.06). Conclusion: Short-term DAPT as compared with prolonged treatment is associated with an increased risk of cardiac death or MI.

scholarly journals Impact of medication adherence to dual antiplatelet therapy on the long-term outcome of drug-eluting or bare-metal stents

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.H Choi ◽  
J.M Choi ◽  
S.H Lee ◽  
Y.J Jang ◽  
M Kang ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Clinical Outcome ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Bare Metal Stents ◽  
Clinical Event ◽  
Metal Stents ◽  
Bare Metal ◽  
Long Term Outcome ◽  
Drug Eluting

Abstract Objective In percutaneous coronary intervention, drug-eluting stent (DES) showed better clinical outcome compared to bare-metal stent (BMS) but mostly with different DAPT durations. This study investigated the clinical superiority of DES over BMS with regard to the medication adherence to dual antiplatelet therapy (DAPT). Methods We retrospectively enrolled all Koreans PCI patients in year 2011 (n=47,291). Medication adherence to DAPT was assessed by proportion of days covered (PDC) per 6 months. Analysis adjusted with the clinical propensity for receiving DES or BMS and DAPT PDC of the first 6 month was performed. Primary outcome was the 5-year major adverse clinical event (MACE) risk consisting all-cause death, revascularization, shock, or stroke. Results Patients with DES (n=46,356) showed higher PDC (78% versus 60%, p&lt;0.001) and lower MACE risk (39% versus 56%, p&lt;0.001) compared to patients with BMS (n=935). In the propensity-matched 1,868 patients, MACE risk was lower with DES than BMS (46% versus 54%, HR=0.80, 95% CI: 0.70–0.91, p&lt;0.001). Patients with good medication adherence (PDC ≥80%) showed much lower MACE risk compared to patients with PDC &lt;80% regardless of DES or BMS (HR=0.36, 95% CI: 0.30–0.44; HR=0.40, 95% CI: 0.33–0.48, p&lt;0.001, all). Patients with DES and PDC &lt;80% showed higher MACE risk compared to BMS with and PDC ≥80% (HR=1.30, 95% CI: 1.03–1.64, p=0.027). Conclusions Good medication adherence to DAPT in the first 6 month was prerequisite for better clinical outcome in both DES and BMS. DES with poor adherence to DAPT showed worse outcome compared with BMS with good adherence. Impact of medication adherence to dual antiplatelet therapy. Funding Acknowledgement Type of funding source: None

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