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Objectives: The authors investigate whether the combination of anti-CD34 antibody with DES is win-win cooperation., Background: DES may reduce the risk of restenosis compared to bare-metal stents (BMS), but they were found to inhibit the healing process of intima., Methods: Fifteen BMS, 17 DES, and 16 combined anti-CD34 antibody and DES were randomly implanted in the coronary arteries of 22 minipigs. Ten minipigs were followed up to 2 weeks. The stenting coronary segments were examined by histological examination and scanning electron microscopy after in vivo coronary angiography and intracoronary optical coherence tomography (OCT) examinations. The other 12 minipigs were followed up to 3 months. Coronary angiography and intracoronary OCT examination were performed in vivo and histological examination was performed on the stenting coronary segments., Results: After 2 weeks, the neointimal covering level of the DES was lower than that in BMS, but the covering level of the combined stents was even better than the BMS. After 3 months, neointimal hyperplasia was significant in the BMS, but not in the other two types of stents. The in-stent late lumen loss of the combined stents even showed a decreasing tendency when compared with the DES., Conclusion: The combination of anti-CD34 antibody and DES can not only well offset the short-term inhibitory effect on re-endothelialization but also slightly enhance the long-term antiproliferative effect., (Copyright © 2011 Wiley Periodicals, Inc.)

Background: Limited information is available about clinical outcomes following routine percutaneous coronary intervention (PCI) in the current era. This study aimed to identify predictors of adverse clinical or angiographic complications following PCI in patients from many different countries., Methods: RIVIERA is a multinational, prospective, observational study in patients undergoing elective or primary PCI. Consecutive patients (n=7962) were enrolled in 144 hospitals from 23 countries in four different continents. Primary outcome was death or myocardial infarction (MI). The mean age of the patients was 59 years and 77% were men; 92% of patients underwent elective and 8% primary PCI., Results: The rate of in-hospital outcomes was low: death 0.3%, MI 1%, any bleeding 3.4%. Angiographic complications occurred in 8.7% of patients, mainly coronary dissection (3.7%) and no reflow (2%). After multivariable analysis, the strongest independent predictors of death or MI were clinical presentation with non-ST-segment elevation acute coronary syndrome or ST-segment elevation myocardial infarction and administration of a glycoprotein (GP) IIb/IIIa inhibitor. Radial access, thienopyridine pretreatment and anticoagulation with enoxaparin were associated with a lower risk of death or MI. Female gender, PCI of coronary artery bypass graft, administration of a GP IIb/IIIa inhibitor and combined use of enoxaparin and unfractionated heparin were significantly associated with more bleeding. Radial access was the only variable associated with less bleeding., Conclusions: Routine PCI appears to be a relatively safe revascularization procedure. Many of the variables identified as predictors of adverse cardiac outcomes confirm results obtained in recent randomized PCI trials and are modifiable, suggesting that further improvements can be made.