TY - JOUR
T1 - Comparison of Supraflex Cruz 60 μm Versus Ultimaster Tansei 80 μm Stent Struts in High Bleeding Risk PCI Patients
T2 - Study design and Rational of Compare 60/80 HBR trial
AU - Paradies, Valeria
AU - Maurina, Matteo
AU - Tonino, Pim
AU - Hofma, Sjoerd H.
AU - Vos, Jeroen
AU - van Kuijk, Jan Peter
AU - Oemrawsingh, Rohit M.
AU - Mafragi, Amar Al
AU - Spano, Fabrizio
AU - Pisters, Ron
AU - Polad, Jawed
AU - Ijsselmuiden, Sander
AU - Cambero, Maribel Madeira
AU - Smits, Pieter C.
N1 - Funding Information:
The COMPARE 60/80 HBR study is an investigator-initiated trial, sponsored by the Research Maatschap Cardiologen Rotterdam Zuid (Maasstad Hospital, Rotterdam, The Netherlands), which received an unrestricted research grant from Sahajanand Medical Technologies, Surat, India.
Publisher Copyright:
© 2023
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Up to 45% of patients who underwent percutaneous coronary intervention (PCI) may have a high bleeding risk (HBR), depending on the bleeding risk definition.1 This condition is often associated with an enhanced risk of thrombotic events with a negative impact on short- and long-term outcomes,2–8 making the choice of an appropriate antithrombotic regimen after PCI particularly challenging. Advances in stent technologies, in which the introduction of newer generations of thinner strut drug-eluting stents (DES), have significantly reduced the rate of thrombotic complications and may justify a shorter dual antiplatelet therapy (DAPT) duration. Both in vitro and in vivo studies have shown that local hemodynamic factors may critically affect the natural history of atherosclerosis. Strut thickness correlates with flow disturbances and endothelial shear stress. Flow separation within struts determines areas of recirculation with low endothelial shear stress which promotes local concentration of activated platelets.9 By mitigating inflammation, vessel injury, and neointimal proliferation, thin and streamlined struts have been associated with faster vascular healing and re-endothelization and have resulted in lower rates of thrombotic events after PCI.10 11 The use of thin strut and ultra-thin strut stents may lead to a favorable trade-off in bleeding and ischemic events in patients with HBR. However, dedicated studies evaluating the performance of thin strut versus ultrathin strut stents in patients with HBR are lacking.
AB - Up to 45% of patients who underwent percutaneous coronary intervention (PCI) may have a high bleeding risk (HBR), depending on the bleeding risk definition.1 This condition is often associated with an enhanced risk of thrombotic events with a negative impact on short- and long-term outcomes,2–8 making the choice of an appropriate antithrombotic regimen after PCI particularly challenging. Advances in stent technologies, in which the introduction of newer generations of thinner strut drug-eluting stents (DES), have significantly reduced the rate of thrombotic complications and may justify a shorter dual antiplatelet therapy (DAPT) duration. Both in vitro and in vivo studies have shown that local hemodynamic factors may critically affect the natural history of atherosclerosis. Strut thickness correlates with flow disturbances and endothelial shear stress. Flow separation within struts determines areas of recirculation with low endothelial shear stress which promotes local concentration of activated platelets.9 By mitigating inflammation, vessel injury, and neointimal proliferation, thin and streamlined struts have been associated with faster vascular healing and re-endothelization and have resulted in lower rates of thrombotic events after PCI.10 11 The use of thin strut and ultra-thin strut stents may lead to a favorable trade-off in bleeding and ischemic events in patients with HBR. However, dedicated studies evaluating the performance of thin strut versus ultrathin strut stents in patients with HBR are lacking.
UR - http://www.scopus.com/inward/record.url?scp=85171793700&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2023.08.046
DO - 10.1016/j.amjcard.2023.08.046
M3 - Article
C2 - 37708755
AN - SCOPUS:85171793700
SN - 0002-9149
VL - 206
SP - 230
EP - 237
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -