Background Current studies,including randomized trials and meta-analyses evaluating clinical Results of bioresorbable scaffold(BRS),have raised concerns about the first-generation device with thicker struts and limite...Background Current studies,including randomized trials and meta-analyses evaluating clinical Results of bioresorbable scaffold(BRS),have raised concerns about the first-generation device with thicker struts and limited expansion capability.Newer BRS with thinner struts and improved deliverability are expected to enhance safety and efficacy profile.Bioheart(Bio-Heart,Shanghai,China)BRS is constructed from a PLLA backbone coated with a PDLLA layer eluting sirolimus.Sixmonth Results have proved preliminary safety and effectiveness of the Bioheart BRS in patients with single de novo coronary artery lesions.We sought to report serial intracoronary imaging findings at 1 year.展开更多
Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet re...Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet reactivity(HRPR)during DAPT therapy.Therefore,we performed a large prospective observational study to evaluate the platelet reactivity and related clinical outcomes in real-world patients with different renal insufficiency stage after PCI,and to examine whether HRPR is associated with higher incidence of adverse cardiovascular events in a 2-year follow up.展开更多
Objective The SYNTAX score(Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery,SS)is now broadly accepted to guide and predict mortality of complex coronary artery disease(CAD)patients un...Objective The SYNTAX score(Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery,SS)is now broadly accepted to guide and predict mortality of complex coronary artery disease(CAD)patients undergoing PCI or CABG.Recently,the clinical SYNTAX score which is a combination of age,ejection fraction,decrease in creatinine clearance and classic SYNTAX score,has been found to be superior in predicting adverse outcomes compared with the SYNTAX scores.Whether the clinical SS could help to determine which patients could be managed medically has never been explored.We sought to investigate the prognostic impact of the SS on long-term clinical outcomes in patients with three vessels disease undergoing medical therapy only.展开更多
Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-elutin...Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-eluting stents(DP-DES).The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up.Methods:Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence.CPCI included at least one of the following features:unprotected left main lesion,≥2 lesions treated,≥2 stents implanted,total stent length>40 mm,moderate-to-severe calcified lesion,chronic total occlusion,or bifurcated target lesion.The primary endpoint was major adverse cardiac events(MACE)including all-cause death,recurrent myocardial infarction,and total coronary revascularization(target lesion revascularization,target vessel revascularization[TVR],and non-TVR)during the 5-year follow-up.The secondary endpoint was total coronary revascularization.Results:Among the 7712 patients included,4882(63.3%)underwent CPCI.Compared with non-CPCI patients,CPCI patients had higher 2-and 5-year incidences of MACE and total coronary revascularization.Following multivariable adjustment including stent type,CPCI was an independent predictor of MACE(adjusted hazard ratio[aHR]:1.151;95%confidence interval[CI]:1.017–1.303,P=0.026)and total coronary revascularization(aHR:1.199;95%CI:1.037–1.388,P=0.014)at 5 years.The results were consistent at the 2-year endpoints.In patients with CPCI,BP-DES use was associated with significantly higher MACE rates at 5 years(aHR:1.256;95%CI:1.078–1.462,P=0.003)and total coronary revascularization(aHR:1.257;95%CI:1.052–1.502,P=0.012)compared with that of DP-DES,but there was a similar risk at 2 years.However,BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization compared with DP-DES in patients with non-CPCI at 2 and 5 years.Conclusions:Patients underwent CPCI remained at a higher risk of mid-to long-term adverse events regardless of the stent type.The effect of BP-DES compared with DP-DES on outcomes was similar in CPCI and non-CPCI patients at 2 years but had inconsistent effects at the 5-year clinical endpoints.展开更多
To the Editor:Despite optimal secondary prevention treatments,a large proportion of patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI)are still at a high risk of recurrent cardiova...To the Editor:Despite optimal secondary prevention treatments,a large proportion of patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI)are still at a high risk of recurrent cardiovascular events.Inflammation is a well-known component of residual cardiovascular risk and contributes to progression of atherosclerosis,leading to destabilization and rupture of atheroma plaques.^([1])As a downstream protein in the activated inflammatory pathway that mediates the progression of atherosclerosis,high-sensitivity C-reactive protein(hsCRP)is widely used as a biomarker of inflammatory status and predictor of adverse outcomes in the settings of primary and secondary prevention of cardiovascular disease.展开更多
文摘Background Current studies,including randomized trials and meta-analyses evaluating clinical Results of bioresorbable scaffold(BRS),have raised concerns about the first-generation device with thicker struts and limited expansion capability.Newer BRS with thinner struts and improved deliverability are expected to enhance safety and efficacy profile.Bioheart(Bio-Heart,Shanghai,China)BRS is constructed from a PLLA backbone coated with a PDLLA layer eluting sirolimus.Sixmonth Results have proved preliminary safety and effectiveness of the Bioheart BRS in patients with single de novo coronary artery lesions.We sought to report serial intracoronary imaging findings at 1 year.
文摘Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet reactivity(HRPR)during DAPT therapy.Therefore,we performed a large prospective observational study to evaluate the platelet reactivity and related clinical outcomes in real-world patients with different renal insufficiency stage after PCI,and to examine whether HRPR is associated with higher incidence of adverse cardiovascular events in a 2-year follow up.
文摘Objective The SYNTAX score(Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery,SS)is now broadly accepted to guide and predict mortality of complex coronary artery disease(CAD)patients undergoing PCI or CABG.Recently,the clinical SYNTAX score which is a combination of age,ejection fraction,decrease in creatinine clearance and classic SYNTAX score,has been found to be superior in predicting adverse outcomes compared with the SYNTAX scores.Whether the clinical SS could help to determine which patients could be managed medically has never been explored.We sought to investigate the prognostic impact of the SS on long-term clinical outcomes in patients with three vessels disease undergoing medical therapy only.
基金supported by the National Key Research and Development Program of China(Nos.2016YFC1301300 and 2016YFC1301301)National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(No.NCRC2020013)+1 种基金Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)(No.2020-I2M-C&T-B-049)the National Natural Science Foundation for Young Scholars of China(No.81900323).
文摘Background:There are few data comparing clinical outcomes of complex percutaneous coronary intervention(CPCI)when using biodegradable polymer drug-eluting stents(BP-DES)or second-generation durable polymer drug-eluting stents(DP-DES).The purpose of this study was to investigate the safety and efficacy of BP-DES and compare that with DP-DES in patients with and without CPCI during a 5-year follow-up.Methods:Patients who exclusively underwent BP-DES or DP-DES implantation in 2013 at Fuwai Hospital were consecutively enrolled and stratified into two categories based on CPCI presence or absence.CPCI included at least one of the following features:unprotected left main lesion,≥2 lesions treated,≥2 stents implanted,total stent length>40 mm,moderate-to-severe calcified lesion,chronic total occlusion,or bifurcated target lesion.The primary endpoint was major adverse cardiac events(MACE)including all-cause death,recurrent myocardial infarction,and total coronary revascularization(target lesion revascularization,target vessel revascularization[TVR],and non-TVR)during the 5-year follow-up.The secondary endpoint was total coronary revascularization.Results:Among the 7712 patients included,4882(63.3%)underwent CPCI.Compared with non-CPCI patients,CPCI patients had higher 2-and 5-year incidences of MACE and total coronary revascularization.Following multivariable adjustment including stent type,CPCI was an independent predictor of MACE(adjusted hazard ratio[aHR]:1.151;95%confidence interval[CI]:1.017–1.303,P=0.026)and total coronary revascularization(aHR:1.199;95%CI:1.037–1.388,P=0.014)at 5 years.The results were consistent at the 2-year endpoints.In patients with CPCI,BP-DES use was associated with significantly higher MACE rates at 5 years(aHR:1.256;95%CI:1.078–1.462,P=0.003)and total coronary revascularization(aHR:1.257;95%CI:1.052–1.502,P=0.012)compared with that of DP-DES,but there was a similar risk at 2 years.However,BP-DES had comparable safety and efficacy profiles including MACE and total coronary revascularization compared with DP-DES in patients with non-CPCI at 2 and 5 years.Conclusions:Patients underwent CPCI remained at a higher risk of mid-to long-term adverse events regardless of the stent type.The effect of BP-DES compared with DP-DES on outcomes was similar in CPCI and non-CPCI patients at 2 years but had inconsistent effects at the 5-year clinical endpoints.
基金supported by grants from the National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(No.NCRC2020013)CAMS Innovation Fund for Medical Sciences(No.2020-12M-C&T-B-049).
文摘To the Editor:Despite optimal secondary prevention treatments,a large proportion of patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI)are still at a high risk of recurrent cardiovascular events.Inflammation is a well-known component of residual cardiovascular risk and contributes to progression of atherosclerosis,leading to destabilization and rupture of atheroma plaques.^([1])As a downstream protein in the activated inflammatory pathway that mediates the progression of atherosclerosis,high-sensitivity C-reactive protein(hsCRP)is widely used as a biomarker of inflammatory status and predictor of adverse outcomes in the settings of primary and secondary prevention of cardiovascular disease.
