Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957

Influence de deux environnements climatiques contrastés sur le besoin énergétique d'entretien de la brebis tarie

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Influence de deux environnements climatiques contrastés sur le besoin énergétique d'entretien de la brebis tarie

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L'élevage de l'agneau à l'herbe. I. Effets de l'âge au sevrage sur les performances d'agneaux élevés à l'herbe puis engraissés en bergerie

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Impact du statut HPV sur l’évolution nutritionnelle au cours de la chimioradiothérapie des patients atteints d’un cancer de l’oropharynx

International audiencePatients with oropharyngeal cancer are at high nutritional risk before and during treatment. Little is known about the influence of human papillomavirus (HPV) infection on nutritional status and its evolution during treatment

[Endovascular treatment of SVC syndrome from neoplastic origin: a review of 34 cases].

International audienceTo report our experience with the treatment of 34 patients with SVC syndrome from neoplastic origin using the Wallstent

Nodular reverse halo sign in active pulmonary tuberculosis: A rare CT feature?

Purpose The purpose of this study was to investigate the prevalence of the nodular reverse halo sign (NRHS) in chest computed tomography (CT) in patients with active pulmonary tuberculosis. Materials and methods From March 2018 to March 2019, 29 consecutive patients with a culture-confirmed active pulmonary tuberculosis and who underwent chest CT examination during hospital-admission were retrospectively included in the study. There were 24 men and 5 women with a mean age of 40.9 ± 16.7 (SD) years (range: 18–80 years). Chest CT examinations of included patients were evaluated for the presence of NRHS and other tuberculosis-related CT signs. Results CT revealed the NRHS in 5 patients (5/29; 17%). The other CT signs of tuberculosis included consolidations in 18 patients (18/29; 62%), tree-in-bud pattern in 14 patients (14/29; 48%), cavitation in 12 patients (12/29; 41%), sparse nodules in 10 patients (10/29; 34%), and pleural effusion in 8 patients (8/29; 28%). Conclusion CT shows NRHS in 17% of patients with active pulmonary tuberculosis, indicating that the sign is not as rare as previously thought in patients with this condition

ACL 85. Nonlinear optical characterization of functionalized organometallic complexes using THG and Z-scan techniques

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Menses recovery and fertility after artery embolization for PPH: a single-center retrospective observational study

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