bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 3322: Chronic Vascular Responses To Sirolimus-eluting Stent Compared With Bare-metal Stent In Diabetic Patients: Evaluated By Optical Coherence Tomography.
Authors: Kubo Takashi , Imanishi Toshio , Matsumoto Hiroki , Kashiwagi Manabu , Tsujioka Hiroto , Okochi Keishi , Ikejima Hideyuki , Arita Yu , Kuroi Akio , Ueno Satoshi , Kataiwa Hideaki , Tanimoto Takashi , Yamano Takashi , Kitabata Hironori , Takarada Shigeho , Tanaka Atsushi , Nakamura Nobuo , Mizukoshi Masato , Akasaka Takashi 
Published: July 2021

OBJECTIVE: An optical coherence tomography (OCT) study was performed to compre the vascular response to sirolimus-eluting stent (SES) with bare-metal stent (BMS) in patients with diabetic mellitus (DM).
BACKGROUND: Despite advances in the medical treatment and revascularization procedures, coronary artery disease remains a leading cause of morbidity and mortality in patients with DM. Few retrospective subgroup analyses of pivotal clinical trials have suggested that SES may be effective for reduction of restenosis in diabetic patients. OCT is a new intravascular imaging method with a high resolution of approximately 10 micrometer and allows us to evaluate instent neointimal hyperplasia (NIH) in vivo.
METHODS and RESULTS: Serial OCT analyses were performed in 60 lesions (SES in DM patients=19; SES in non-DM patients=14; BMS in DM patients=10; BMS in non-DM patients=17) at 9-month follow-up. A total of 6920 stent struts were visualized by OCT and NIH thickness inside each strut and incidence of exposed stnet struts were evaluated in cross-sectional image. The NIH thickness was significantly different among 4 groups (97 +/− 100 vs. 43 +/− 61 vs. 425 +/− 206 vs. 209 +/− 138 micrometer, respectively). The NIH thickness of SES in DM was significantly thicker than that of SES in non-DM (p<0.001), although it was significantly thinner than that of BMS in DM (p<0.001) or BMS in non-DM (p<0.001). All struts of BMS were covered by neointima, but 14% of struts of SES were exposed. The incidence of exposed struts and exposed struts with inadequate apposition in DES were significantly lower in DM compared with those in non-DM (5% vs. 34%, p<0.0001; 2% vs. 5%, p <0.001, respectively). Moreover, the frequency of DES with partially exposed strut was significantly lower in DM than non-DM (32% vs. 71%, p<0.027).
CONCLUSION: The present OCT study revealed that DES inhibited the NIH effectively with low incidence of exposed stent strut in DM patients at 9-month after implantation.
Abstract 448: Platelets Contribute to Arterial and Venous Thrombosis in vivo
Authors: Koellnberger Maria , von Bruehl Marie-Luise , Bergmeier Wolfgang , Wagner Denisa , Mackman Nigel , Massberg Steffen 
Published: July 2021

Background: Arterial (AT) and venous thromboses (VT) are the major causes of morbidity in industrialized countries. While the critical contribution of platelets to AT has been recognized, the molecular and cellular mechanisms that trigger the development of VT are not yet fully understood.
Methods: We established a novel model of VT, where thrombus formation occurs after venous stasis in the absence of mechanical endothelial injury. In contrast to published models, our approach closely resembles the triggers that lead to VT in humans. The molecular and cellular events in VT were assessed using intravital and electron microscopy. In particular, we evaluated the differential contribution of platelets (pts) and leukocytes (lcs) to AT and VT.
Results: We found that in AT pts adhere rapidly, whereas only few lcs are recruited. The loss of platelet P-Selectin reduced lc accumulation during AT, was associated with thrombus destabilization, but had no effect on pt adhesion/aggregation. The loss of GPIIb led to a complete lack of pt adhesion/aggregation in AT. While AT largely depends on pts, lc adhesion was the prominent initial phenomenon during VT and involved both P-selectin and Mac-1. P-Selectin−/− as well as Mac-1−/− mice showed a massive reduction in lc accumulation. The lack of P-Selectin was accompanied by a reduction of the thrombus size 48 hours after stasis and was only marginally reduced in Mac 1−/− mice, indicating that lc rolling is sufficient to promote VT. The expression of tissue factor by lcs played a pivotal role for VT. Accordingly, mice with reduced TF expression showed a dramatic reduction in venous thrombus size. In addition to TF-bearing lcs, pts were recruited to the vessel wall early in VT. Pt accumulation involved both the fibrinogen and the vWF receptor and was virtually abolished in mice lacking GPIIb or GPIbα. To our surprise, we observed that pts do not accumulate during VT but play a functional role. Reduced pt adhesion in mice lacking either GPIIb, GPIbα, or VWF was associated with a significant reduction in venous thrombus size.
Conclusion: Together, we show that VT, unlike AT depends on the concerted action of both lcs and pts. Hence, targeting pt activation and adhesion might provide a promising strategy in the prophylaxis and treatment of VT.
Abstract 3329: Discontinuation of Antiplatelet Therapy Correlates with Angioscopic Subclinical Thrombus After Sirolimus Eluting Stent Implantation
Authors: Nishino Masami , Nakatani Shinpei , Hara Masahiko , Hashimoto Akihito , Yamagami Kiyoshi , Matsuoka Ken , Kato Hiroyasu , Egami Yasuyuki , Shutta Ryu , Yamaguchi Hitoshi , Tanaka Kenjiro , Tanouchi Jun , Yamada Yoshio 
Published: July 2021

Background: Although some stent thorombois seems to be correlated with discontinuation of antiplatelet therapy, the suitable duration of antiplatelet therapy after silorimus eluting stent (SES) implantation is unknown. In this study, we evaluated effects of discontinuation of one of dual antiplatelet therapy on angioscopic subclincal thrombus in the patients who received dual antiplatelet therapy after SES implantation.
Methods: Six-month follow-up angioscope was performed in 110 consecutive patients with SES implantation. We divided our patients into two groups randomly: the patients who received dual antiplatelet theraphy (aspirin (100mg) and ticlopidine (200mg)/day) until 6-month follow-up angioscope (D-group) and the patients who stopped ticlopidine at 3 months after SES implantation (continued to receive only aspirin) (S-group). We compared the following parameters between the two groups: angioscopic parameters including existence of visible thrombus, grades of neointimal coverage (0: no neointimal coverage of stent struts, 1: partial coverage, 2: complete coverage), plaque color around stent (0: white, 1: yellow) and coronary risk factors including hypertension, hypercholesterolemia, smoking, diabetes mellitus and hemodialysis.

Results: Incidence of angioscopic visible thrombus in S-group was significalty higher than that in D group, while there were no significant differences of the other pamameters between the two groups (table

). Two patients among S-group (3%) and one patient among D group (2%) received revascularization therapy at 6 months after SES implanation (n.s.). All the study patients revealed no other major adverse cardiac events (MACE); death, acute myocardial infarction and coronary bypass surgery.

Conclusions: Only three months discontinuation of ticlopidine may affect on product of angioscopic sublicnical thrombus, however it was not correlated with MACE during 6 months follow-up after SES implantation.
Abstract 3346: Percutaneous Treatment Of Unprotected Left Main Coronary Stenoses With Paclitaxel-eluting Stents. Mid-term Results Of A French Prospective Multicenter Study (friend Register)
Authors: Carrié Didier , Eltchaninoff Hélène , Lefèvre Thierry , Silvestri Marc , Levy Gérard , Maupas Eric , Brunel P , Glatt B , Blanchard Didier 
Published: July 2021

Purpose : We assessed early and mid-term results of patients (pts) treated for ULMCA disease in the FRIEND registry.
Methods: After ethical committee approval and informed consent, all consecutive pts with unprotected left main stenoses treated with Taxus stents were included in a multicenter prospective study from 23 centers. Major adverse cardiacl events (MACCE) : death, myocardial infarction, stroke, target lesion (TLR), target vessel revascularisation (TVR), acute, sub-acute and late thrombosis were adjudicated at 1and 6 months by an independent committee. Immediate and 9-month angiographic results were assessed by a central core lab. For the distal lesion of ULMCA, a strategy of main branch stenting with provisional T-stenting of the side branch followed by kissing balloon inflation was strongly recommanded.
Results : From December 2005 to July 2006, 155 pts were included, mean age 68 ± 11 years, 83 % male, 31 % unstable angina, 25% diabetics, 46 % 3-vessel disease. The mean Euroscore was 4.2 ± 2.8 (estimated in-hospital mortality rate after surgery 4.1%). The LM reference diameter was 3.6 ± 0.5mm. LM lesion was ostial-proximal in 28 %,mid shaft 18 % and distal 66%. In this group, 72 % were located at the bifurcation including LAD, LCX or both ostia affected. All patients were successfully treated on the LM (stent length 15.7 ± 5.2 mm) and a final kissing balloon inflation was performed in 90%. Apart from the LM stenosis, a total of 1.2 ± 0.8 lesions were treated during the hospitalisation (total stent length 47 ± 16mm). In-hospital MACCE rate was 4.5 % : death in 2.6% (3 acute stent thrombosis at day 2, 3, 5 and 1 before PCI) ; 2 Pts had asymptomatic non-Q-wave MI,1 pt Q-wave MI and 1CABG. At 9-month follow-up (122 pts) there was one extra-cardiac death, no cardiac failure and 3 pts (2.5 %) had recurrence of symptoms. The global rate of event-free survival was 93.5 % with a very low angiographic restenosis rate of 3 %.
Conclusion: LM PCI using the TAXUS stent is feasible and safe. Preliminary results showed favourable 9-month follow-up. Stenting deserves to be considered a safe and effective alternative to CABG in institutions performing large numbers of PCIs. Adjudicated clinical and angiographic long-term (9-month) data are warranted and will be available for presentation.
Abstract 461: Sildenafil Improves Ischemia-Induced Neovascularization in ApoE-Deficient Mice
Authors: Dussault Sylvie , Ménard Catherine , Michaud Sophie-Elise , Haddad Paola , Groleau Jessika , Turgeon Julie , Rivard Alain 
Published: July 2021

Background: Sildenafil is widely used to treat erectile dysfunction. Sildenafil inhibits phospho-diesterase 5 (PDE5), thereby increasing cGMP levels in target tissues. The NO-cGMP pathway has been shown to be essential for angiogenesis, vasculogenesis and postnatal neovascularization. Therefore, here we tested the hypothesis that sildenafil might improve neovascularization following ischemia.
Methods and results: Hypercholesterolemic ApoE−/− mice, which are characterised by reduced neovascularization in response to ischemia, were treated or not with sildenafil (40 mg/kg/day in water) for the whole duration of the study. Sildenafil was well tolerated by ApoE−/− mice and led to a significant increase of plasmatic cGMP levels compared to controls (13.4±1.9 vs. 4.6±2.6 pmol/mL, p<0.05). After two weeks of treatment, hindlimb ischemia was surgically induced by femoral artery removal. Sildenafil treatment led to a significantly faster rate of blood flow recovery, as assessed by Laser Doppler measurement at day 7 after surgery (55.5% increase, p<0.05). We found that sildenafil treatment is associated with an increased activation of angiogenic transduction pathways such as Akt, p44/42 MAPK, and p38 in ischemic muscles (phosphospecific Western blots). Moreover, sildenafil treatment leads to a significant reduction of oxidative stress in ischemic tissues (nitrotyrosine staining). Endothelial progenitor cells (EPCs) have been shown to participate to postnatal neovascularization. We found that ApoE−/− mice treated with sildenafil have a significant increase in the number of bone marrow EPCs (DiI-AcLDL and FITC-Lectin staining) compared to untreated mice (272±18 vs. 187±17 cells per field, p<0.05). Moreover, the adhesion (19.7±2.1 vs. 10.0±1.9 EPCs per field, p<0.05) and the migratory capacity (28.5±1.8 vs. 15.2±1.3 EPCs per field, p<0.0001) of EPCs are significantly improved in ApoE−/− mice treated with sildenafil.
Conclusions: Sildenafil treatment is associated with improved ischemia-induced neovascularization in hypercholesterolemic conditions. The mechanisms involve beneficial effects of sildenafil on angiogenic pathways in ischemic tissues together with an increase in the number and the functional activity of EPCs.
Abstract 3441: Differential endothelialization of stent struts across side branches: A Scanning Electron Microscopy analysis.
Authors: Zheng Yi , Fernandes Marlos R , Silva Guilherme V , Cardoso Cristiano O , Canales John F , Baimbridge Fred , Oliveira Edie M , Vaughn William , Hansen Maria G , Perin Emerson C 
Published: July 2021

Background: The higher incidence of MACE events in paclitaxel eluting stents (PES) has been attributed to the presence of coronary artery side branches (SB) within stented segments. This study aimed to evaluate PES struts overlying SB in a porcine model of coronary restenosis.
Methods: In a balloon overstretch model of coronary restenosis (balloon:artery ratio =1.2:1), 20 animals were randomized to either PES or bare metal stents (BMS). After 30 days, 22 stented segments were analyzed by Low Vacuum Scanning Electron Microscopy (SEM) and endothelialization was assessed using a score (0=100% endothelialization; 1=99 – 67%; 2=66 –34%; 3=33–1%; 4=0%). Comparison of the distribution of endothelialization scores for struts overlying and non-overlying SB was performed within each group by the Fisher exact test.

Results: A total of 18 struts overlying SB (10 PES and 8 BMS) sized from 200 to 1800μ m, were identified by SEM. In the BMS group, complete endothelialization was observed in 62.5% of SB struts and 100% of non-overlying SB struts. In PES only 20% of SB struts, but almost 100% of the non-overlying SB struts were completely endothelialized. The endothelialization of struts overlying SB was significantly different in PES and BMS groups(Fig 1A

and Fig 1B

), with a higher frequency of impaired endothelialization (scores 3 and 4) in PES struts crossing SB.

Conclusions: PES struts overlying SB showed significantly impaired endothelialization compared with BMS in a pig model of coronary restenosis. This results might offer a new insight to explain the higher incidence of adverse events in PES stented segments. Further studies are needed to confirm the present study results.
Abstract 3442: Pattern and Time Path of Neonintimal Healing in Drug Eluting versus Bare Metal Stents in the Rat Aortic Stent Model
Authors: Groenewegen Hendrik C , Roks Anton J , Goris Maaike , Zijlstra Felix , van Gilst Wiek H , de Smet Bart J 
Published: July 2021

Purpose:to determine if the neointima of drug-eluting stents is histological different from their bare metal controls. Neointimal formation in stented aortas was evaluated quantatively and qualitatively at two time points.
Methods:male Wistar rats were randomized to one of four groups: Express 2 stent , Taxus Express 2 stent , Bx Velocity stent and Cypher stent. Stents were implanted in the abdominal aorta. Histological analyses were performed after 1 and 4 weeks. After 1 week the inflammation score and neointimal cell density was measured. Stented aortas were also examined for acellularity of neointima and /or the presence of a hemorrhage in the neointima. After 4 weeks the same measurements were performed plus the neointimal area and neointimal thickness.
Results:no differences were observed after 1 week between bare metal stents and drug-eluting stents. At 4 weeks neointimal cell density was lower and inflammation-score was higher in the drug eluting stents. Furthermore in less than 10% of the bare metal stents acellularity of neointima and/or hemorrhage was found. On the contrary, in more than 90% of the drug eluting stents acellularity of neointima and/or hemorrhage was seen. Neointima area and neointimal thickness was reduced in the drug-eluting stents. No histological differences were found between the paclitaxel and the sirolimus eluting stent.
Conclusions:Both drug eluting stents are effective in reducing neointimal formation however in both drug eluting stents acellular areas were observed in the neointima of almost every single stent. This is likely to be a reflection of incomplete healing which persists after neointimal formation has peaked.

Table 1.

Histological measurements: results in the 4 week groups.
Abstract 3462: The Cardioprotective Effects Of The Angiotensin-converting Enzyme Inhibitor Perindopril In Patients With Stable Coronary Artery Disease Are Not Modified By Mild to Moderate Renal Insufficiency: Results From The Europa-trial.
Authors: Brugts Jan Jasper , Boersma Eric , Chonchol Michel , Deckers Jaap , Remme Willem , Bertrand Michel , Ferrari Roberto , Fox Kim , Simoons Maarten 
Published: July 2021

The cardioprotective effects of the ACE-inhibitor perindopril in patients with stable coronary artery disease are not modified by renal function: Results from the EUROPA-trial.
Objective: To examine whether the cardioprotective effects of perindopril are modified by renal function in patients with stable coronary artery disease.
Background: A recent study reported that an impaired renal function identified a subgroup of patients with stable coronary artery disease more likely to benefit of ACE-inhibition therapy. In light of the growing interest in tailored-therapy for targeting medications to specific subgroups, remarks on the consistency of the treatment effect by ACE-inhibitors are highly important.
Methods: The present study involved 12056 patients with stable coronary artery disease without heart failure randomized to perindopril or placebo. Estimated GFR (eGFR) was calculated using the abbreviated MDRD-equation.

Results: Mean eGFR was 76.2 (18.1) ml/min per 1.73 m
2
. During follow-up, the primary endpoint (cardiovascular death, non-fatal myocardial infarction, or resuscitated cardiac arrest) occurred in 454/5761 patients (7.9%) with eGFR ≥ 75 and in 631/6295 patients (10.0%) with eGFR<75. Treatment benefits of perindopril were apparent in both patient groups either with eGFR≥ 75 (HR 0.77; 95%CI 0.64 – 0.93) or eGFR≥ 75 (HR 0.84; 95%CI 0.72– 0.98). We observed no significant interaction between renal function and treatment benefit (Pv=0.47). Using different cut-off points of eGFR at the level of 60 or 90 resulted in similar trends.

Conclusion: The treatment benefit of perindopril is consistent and not modified by the level of renal function.
Abstract 3521: Relationship Between Time from Symptom Onset to Hospital Presentation and Treatment with and Timeliness of Reperfusion Therapy for Patients with ST-Elevation Myocardial Infarction
Authors: Ting Henry H , Bradley Elizabeth H , Wang Yongfei , Nallamothu Brahmajee K , Curtis Jeptha P , Gersh Bernard J , Roger Veronique L , Lichtman Judith H , Krumholz Harlan M 
Published: July 2021

Background: Whether patients with STEMI with longer times from symptom onset to hospital presentation are less likely to be treated with any reperfusion therapy or treated with less urgency resulting in longer door-to-balloon and door-to-needle times is not known. The relationship between delay in hospital presentation and the quality of reperfusion therapy for patients with STEMI has not been examined
Methods: We constructed 3 cohorts of STEMI patients to analyze use of any reperfusion (n=440,398), door-to-balloon time (n=67,207), and door-to-drug time (n=183,441) as a function of delay in hospital presentation. We constructed multivariable generalized linear models for each outcome to estimate the associations between delay in hospital presentation adjusted for all patient and hospital characteristics.
Results: In adjusted analysis, longer times from symptom onset to hospital presentation was associated with lower use of any reperfusion therapy (p<0.0001 for trend). For early presenters with times of ≤1 hour, >1 to 2 hours, and >2 to 3 hours, 77%, 77%, and 73% of patients received any reperfusion therapy, respectively, and late presenters with times >9 to 10 hours, >10 to 11 hours, and >11 to 12 hours were treated with any reperfusion therapy in 53%, 50%, and 46%, respectively. Delay in hospital presentation was associated with longer drug-to-balloon and door-to-drug times (p<0.0001 for trend). For time intervals of ≤ 1 hour, >1 to 2 hours, >2 to 3 hours, >9 to 10 hours, >10 to 11 hours, and >11 to 12 hours, patients with STEMI were treated with door-to-balloon times of 99, 101, 106, 123, 125, and 123 minutes respectively. For delay time intervals of ≤ 1 hour, >1 to 2 hours, >2 to 3 hours, >9 to 10 hours, >10 to 11 hours, and >11 to 12 hours, patients were treated with door-to-drug times of 32, 34, 36, 46, 44, and 46 minutes, respectively.
Conclusions: Longer time from symptom onset to hospital presentation has important implications for subsequent treatment and was associated with lower use of any reperfusion therapy and longer door-to-balloon and door-to-drug times. Longer delay in hospital presentation is associated with worse system performance for reperfusion therapy quality and represents an opportunity to improve quality of care for STEMI patients.
Abstract 3529: Feasibility, Effectiveness and Safety of Intensive Glucose Control in Critically Ill Hyperglycemic Patients Hospitalized With Acute Coronary Syndromes
Authors: Kosiborod Mikhail , Inzucchi Silvio , Hamburg Mitchell , Riggs Lisa , Koshy Sindhu , Krumholz Harlan M , Xiao Lan , Khalid Adnan , Spertus John A 
Published: July 2021

Background: Elevated blood glucose (BG) is associated with higher mortality and complications in patients (pts) hospitalized with AMI. While current ACC/AHA guidelines recommend “normalization” of BG in critically ill AMI pts, experience with implementation of intensive BG control protocols in this population is extremely limited.
Methods: We implemented an intensive BG control protocol at the Mid America Heart Institute (MAHI) CCU beginning 08/2006, with the purpose of evaluating its feasibility, safety and effectiveness. All ACS patients with admission BG >140 mg/dL received a modified Yale-MAHI intravenous insulin infusion protocol, with a target BG range of 90–120 mg/dL. Demographic, clinical and laboratory data were abstracted from medical records of 94 consecutive pts that received the protocol (post-intervention), and compared with data on 138 consecutive ACS pts with admission BG >140 mg/dL hospitalized in CCU immediately prior to the protocol implementation (pre-intervention).

Results: There were no significant differences between pre and post-intervention pts in age (64 vs. 66, p=0.2), female gender (40 vs. 39%, p=0.8), known diabetes (57 vs. 51%, p=0.3), or admission BG (218 vs. 203 mg/dL, p=0.13). Mean 24 hour BG was markedly reduced in post-intervention vs. pre-intervention pts (132 vs. 181 mg/dL, p<0.001). The protocol was very effective in both rapid attainment and maintenance of BG targets (Figure

). The rate of hypoglycemia (BG <60 mg/dL) was 0.72%, and none of the hypoglycemic events were symptomatic.

Conclusions: Intensive BG control in critically ill ACS patients with the modified Yale-MAHI protocol is feasible, effective and safe.