Related Experiment Video

Updated: Dec 12, 2025

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

26.1K

Outcomes After First- Versus Second-Generation Drug-Eluting Stent Thrombosis (from the REAL-ST Registry)

Kazunori Horie1, Shoichi Kuramitsu2, Tomohiro Shinozaki3

  • 1Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan.

The American Journal of Cardiology
|August 10, 2020
PubMed

Insights

Stent thrombosis (ST) remains a serious risk with both first- and second-generation drug-eluting stents (DES). While second-generation DES showed lower revascularization rates, 1-year mortality for ST was similar between stent generations.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Drug-eluting stents (DES) have significantly reduced restenosis rates but stent thrombosis (ST) remains a critical complication.
  • Limited comparative data exist on clinical outcomes between first-generation DES (G1-DES) and second-generation DES (G2-DES) thrombosis.
  • Understanding these differences is crucial for optimizing patient care and stent selection.

Purpose of the Study:

  • To compare the clinical outcomes, specifically 1-year mortality and target lesion revascularization (TLR), after ST in patients treated with G1-DES versus G2-DES.
  • To identify risk factors associated with 1-year mortality following ST in this patient cohort.

Main Methods:

  • Retrospective analysis of the Multicenter Registry of Stent Thrombosis (ST) After First- and Second-Generation DES Implantation.
  • Inclusion of 655 ST patients, with 342 in the G1-ST group and 313 in the G2-ST group.
  • Propensity score matching was performed, resulting in a final study population of 159 matched patients for outcome comparison.

Main Results:

  • The cumulative 1-year mortality rate was similar between G1-ST (22.9%) and G2-ST (23.0%) groups (p=0.76).
  • The G2-ST group demonstrated a significantly lower rate of target lesion revascularization (TLR) compared to the G1-ST group (9.7% vs 17.1%, p=0.01).
  • Identified risk factors for 1-year mortality included cardiogenic shock/arrest, multivessel ST, low ejection fraction (≤40%), advanced age, and poor final TIMI flow (≤2).

Conclusions:

  • ST following G2-DES implantation carries a similar 1-year mortality risk as ST following G1-DES.
  • Despite advancements, ST remains a life-threatening event in the era of second-generation DES.
  • The lower TLR in G2-ST suggests potential benefits in lesion healing, though overall mortality risk persists.

More Related Videos

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model09:46

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model

Published on: September 14, 2009

14.2K
Using a Cell-Tracer Injection to Investigate the Origin of Neointima-Forming Cells in a Rat Saccular Side Wall Model05:41

Using a Cell-Tracer Injection to Investigate the Origin of Neointima-Forming Cells in a Rat Saccular Side Wall Model

Published on: March 16, 2022

2.6K

Related Concept Videos

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
924
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
113
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
348
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
180