Safety and efficacy of drug-eluting stents in women: a patient-level pooled analysis of randomised trials

BACKGROUND The safety and efficacy of drug-eluting stents (DES) in the treatment of coronary artery disease have been assessed in several randomised trials. However, none of these trials were powered to assess the safety and efficacy of DES in women because only a small proportion of recruited participants were women. We therefore investigated the safety and efficacy of DES in female patients during long-term follow-up. METHODS We pooled patient-level data for female participants from 26 randomised trials of DES and analysed outcomes according to stent type (bare-metal stents, early-generation DES, and newer-generation DES). The primary safety endpoint was a composite of death or myocardial infarction. The secondary safety endpoint was definite or probable stent thrombosis. The primary efficacy endpoint was target-lesion revascularisation. Analysis was by intention to treat. FINDINGS Of 43,904 patients recruited in 26 trials of DES, 11,557 (26·3%) were women (mean age 67·1 years [SD 10·6]). 1108 (9·6%) women received bare-metal stents, 4171 (36·1%) early-generation DES, and 6278 (54·3%) newer-generation DES. At 3 years, estimated cumulative incidence of the composite of death or myocardial infarction occurred in 132 (12·8%) women in the bare-metal stent group, 421 (10·9%) in the early-generation DES group, and 496 (9·2%) in the newer-generation DES group (p=0·001). Definite or probable stent thrombosis occurred in 13 (1·3%), 79 (2·1%), and 66 (1·1%) women in the bare-metal stent, early-generation DES, and newer-generation DES groups, respectively (p=0·01). The use of DES was associated with a significant reduction in the 3 year rates of target-lesion revascularisation (197 [18·6%] women in the bare-metal stent group, 294 [7·8%] in the early-generation DES group, and 330 [6·3%] in the newer-generation DES group, p<0·0001). Results did not change after adjustment for baseline characteristics in the multivariable analysis. INTERPRETATION The use of DES in women is more effective and safe than is use of bare-metal stents during long-term follow-up. Newer-generation DES are associated with an improved safety profile compared with early-generation DES, and should therefore be thought of as the standard of care for percutaneous coronary revascularisation in women. FUNDING Women in Innovation Initiative of the Society of Cardiovascular Angiography and Interventions.

Zur Abwehr : Widerlegung der im Starkenburger Boten Nr. 92 (resp. Ausgab. Postztg.) u. 69 gegen das Judenthum erhobenen Beschuldigungen

von [Julius] Landsberger

What happens to the bone flap? Long-term outcome after reimplantation of cryoconserved bone flaps in a consecutive series of 92 patients.

BACKGROUND Reimplantation of cryoconserved autologous bone flaps is a standard procedure after decompressive craniotomies. Aseptic necrosis and resorption are the most frequent complications of this procedure. At present there is no consensus regarding the definition of the relevant extent and indication for surgical revision. The objective of this retrospective analysis was to identify the incidence of bone flap resorption and the optimal duration of follow-up. METHODS Between February 2009 and March 2012, 100 cryoconserved autologous bone flaps were reimplanted at the Department of Neurosurgery, Inselspital Bern. Three patients were not available for follow-up, and five patients died before follow-up. All patients underwent follow-up at 6 weeks and a second follow-up more than 12 months postoperatively. A clinical and CT-based score was developed for judgment of relevance and decision making for surgical revision. RESULTS Mean follow-up period was 21.6 months postoperatively (range: 12 to 47 months); 48.9 % (45/92) of patients showed no signs of bone flap resorption, 20.7 % (19/92) showed minor resorption with no need for surgical revision, and 30.4 % (28/92) showed major resorption (in 4 % of these the bone flap was unstable or collapsed). CONCLUSIONS Aseptic necrosis and resorption of reimplanted autologous bone flaps occurred more frequently in our series of patients than in most reports in the literature. Most cases were identified between 6 and 12 months postoperatively. Clinical observation or CT scans of patients with autologous bone flaps are recommended for at least 12 months. Patient-specific implants may be preferable to autologous bone flaps.

Ms. hebr. oct. 92 - Megilat sefer (ṿ-igerot)

Vorbesitzer: Abraham Merzbacher

Ms. Barth. 92 - Sammelhandschrift

Vorbesitzer: Jungo Frosch; Bartholomaeusstift Frankfurt am Main

Hebräische Drucke in Deutschland : (Fortsetzung von Bd. I S. 382: Berlin)

Moritz Steinschneider

Psalm 92 : (Gedicht)

Dolorosa

Die Juden in Babylonien unter Sabur II. (309-382)

Salomon Funk

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 382 - Abschrift über die Bescheinigung des Königlichen Preußischen Land- und Stadtgerichts-Depositorium betreffend die "Michael-Andreas-Schopenhauersche-Curatel-Masse"

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Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 92 - Auseinandersetzung mit französischen Schriftsteller und Autoren

u.a.: Stellenwert der französischen Tragödie; Hervorhebung von Hamburg; Wirtschaft und Kommerz; Bioleau, Jean Racina; Pierre Comeille; Prosper Jolyot de Crébillo; Voltaire; Rousseau; Emanuel de Pott; Johanna Schopenhauer;

Na 1 Nachlass Max Horkheimer, 307 - Korrespondenzen u.a. mit Arcadius Rudolf L. Gurland (p. V 92, 1-38)

Institut für politische Wissenschaft Berlin: Informationen; beteiligt: Arcadius Rudolf L. Gurland, 1960-1962; 16 Briefe mit Beilagen zwischen Arcadius Rudolf L. Gurland und Max Horkheimer, 1954-1957; Briefwechsel zwischen Prof. Carlo Schmid und Max Horkheimer, 1954; 3 Briefe zwischen Prof. Wilhelm Hennis und Max Horkheimer, 1953;