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Procedural microvascular activation in long lesions treated with bioresorbable vascular scaffolds or everolimus-eluting stents: The PROACTIVE trial
- Publication Year :
- 2020
-
Abstract
- Aims Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. Methods and results Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. Conclusions In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
- Subjects :
- Bioresorbable scaffold
medicine.medical_specialty
Stable angina
medicine.medical_treatment
Everolimus eluting stent
Coronary Artery Disease
Coronary Angiography
Prosthesis Design
law.invention
Postoperative Complications
Percutaneous Coronary Intervention
Randomized controlled trial
law
Absorbable Implant
Internal medicine
Absorbable Implants
medicine
Clinical endpoint
Drug-Eluting Stent
Humans
Platelet activation
Everolimus
Fractional flow reserve
Other technique
Tissue Scaffolds
business.industry
Stent
Percutaneous coronary intervention
Drug-Eluting Stents
Everolimu
Treatment Outcome
Conventional PCI
Cardiology
Postoperative Complication
Cardiology and Cardiovascular Medicine
business
Long lesions
Tomography, Optical Coherence
Human
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....8a1702b870faec9269b1be85c8f40615