Cihan Simsek

Erasmus MC | Erasmus MC

Aims: Statins are highly effective in reducing major adverse clinical events, but the direct effects on coronary plaque composition remain debatable. Our aim was to mechanistically evaluate the treatment effect of high-intensity statin therapy on compositional coronary plaque changes. Methods and results: The third Integrated Biomarker and Imagi...

Drug-eluting stents (DES) are widely used as first choice devices in percutaneous coronary interventions. However, certain concerns are associated with the use of DES, i.e. delayed arterial healing with a subsequent risk of neo-atherosclerosis, late stent thrombosis and hypersensitivity reactions to the DES polymer. Bioresorbable vascular scaffolds...

Near-infrared spectroscopy (NIRS) is capable of identifying lipid core-containing plaques, which can subsequently be quantified as a lipid core burden index (LCBI). Currently, no data are available on the long-term prognostic value of NIRS in patients with coronary artery disease (CAD). This study sought to determine the long-term prognostic value...

Although recent observations suggest a favorable initial healing process of the everolimus-eluting bioresorbable vascular scaffold (BVS), little is known regarding long-term healing response. This study assessed the in vivo vascular healing response using optical coherence tomography (OCT) 5 years after elective first-in-man BVS implantation. Of th...

Background: Invasive imaging modalities have shown restoration of vasomotion, prevention of restenosis and most importantly increase in lumen area between 6-months and 2-years after first-generation everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) implantation. Our aim was to assess whether these positive findings were sustained in t...

Interrupting myocardial reperfusion with intermittent episodes of ischemia (i.e., postconditioning) during primary percutaneous coronary intervention (PPCI) has been suggested to protect myocardium in ST-segment elevation myocardial infarction (STEMI). Nevertheless, trials provide inconsistent results and any advantage in long-term outcomes remains...

Newer generation everolimus-eluting stents (EES) improve clinical outcome compared to early generation sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES). We investigated whether the advantage in safety and efficacy also holds among the high-risk population of diabetic patients during long-term follow-up. Between 2002 and 2009, a to...

The aim of this study was to determine the relationship between clinical and blood characteristics of a vascular inflammatory milieu and coronary plaque composition visualized by near-infrared spectroscopy (NIRS) in percutaneous coronary intervention (PCI) patients. Between April 2009 and January 2011, we performed NIRS in 208 patients who underwen...

Aims: The clinical outcome of patients treated with the everolimus-eluting bioresorbable vascular scaffold (Absorb BVS) in the ABSORB Cohort A and B studies using mandatory intravascular ultrasound (IVUS) imaging showed encouraging results. The ABSORB EXTEND study aimed to include longer lesions, allow overlap and did not oblige IVUS imaging. We as...

Aims: Tryton side branch (SB) reverse culotte stenting has been employed for the treatment of left main (LM) stem bifurcations in patients at high risk for bypass surgery. The aim of this study was to assess acute angiographic results and six-month clinical outcome after implantation of the Tryton stent in the LM. Methods and results: We studied...

A 58-year-old man, included in cohort A of the Bioabsorbable Vascular Solutions First in Man Clinical Investigation: A Clinical Evaluation of the Bioabsorbable Vascular Solutions Everolimus Eluting Coronary Stent System in the Treatment of Patients With Single de Novo Native Coronary Artery Lesions (ABSORB) trial,1 had undergone implantation of a b...

Background: There is few information on the long-term efficacy and safety of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) compared to bare metal stents (BMS) in all-comer percutaneous coronary intervention (PCI)—patients complicated by renal insufficiency (RI). Objective: Our aim was to assess the 6-year clinical outcome of PC...

Acute coronary syndromes (ACS) are often caused by rupture of non-flow limiting "vulnerable" atherosclerotic plaque, characterised by a large necrotic core pool and a thin, inflamed fibrous cap that are unidentifiable with diagnostic coronary angiography. The implementation of novel invasive imaging modalities, such as intravascular ultrasound-virt...

Aims: To investigate the incidence of cardiac events in octogenarians who underwent percutaneous coronary intervention (PCI) with stenting, as well as to evaluate the efficacy and safety of drug-eluting stents (DES) in this population. Methods and results: The study included 6,129 consecutive patients who underwent PCI with stenting from 2000 to 20...

Objectives: The aim was to investigate the 7-year clinical outcomes of patients treated with either drug-eluting stents (DES) or bare-metal stents (BMS) for saphenous vein graft disease (SVG). Background: Atherosclerotic disease in SVG has several peculiarities which make it difficult to extrapolate outcomes of the use of DES as compared to BMS,...

Background: Thrombus aspiration (TA) in patients with ST segment elevation myocardial infarction (STEMI) results in a better myocardial perfusion. Optical coherence tomography (OCT) after stenting in STEMI, however, often reveals residual atherothrombotic material. We assessed the feasibility of quantification of residual atherothrombotic burden a...

Previous angiographic studies have failed to identify those quiescent plaques prone to progress or rupture, as most of them are non–flow limiting ([1][1]). Plaque composition was demonstrated not to be uniformly distributed along each coronary artery, and in patients with ST-segment elevation

To determine the risk of short- and long-term mortality and major adverse cardiac events (MACE) in acute myocardial infarction (AMI) patients complicated by cardiogenic shock (CS) in the contemporary practice of primary percutaneous coronary intervention with stenting. Of the 1,755 consecutive AMI patients undergoing percutaneous coronary intervent...

The no-reflow phenomenon has been shown to have a significant effect on clinical outcomes in patients with acute ST-segment elevation myocardial infarction. Angiographic features incorporated in the SYNTAX Score (SXScore) obtained on diagnostic angiography during primary percutaneous coronary intervention (PPCI) may be associated with the occurrenc...

Short- and long-term data showed that drug-eluting stents (DES) significantly decreased target vessel revascularization (TVR) and major adverse cardiac event (MACE) rates compared to bare-metal stents (BMS). However, conflicting long-term data remain for patients with ST-segment elevation myocardial infarction (STEMI). Our aim was to assess the 6-y...

We aimed to asses the generalizability of two 'all-comers' randomized clinical trials (AC-RCTs) in patients undergoing percutaneous coronary intervention (PCI). Recently two large AC-RCT's comparing drug-eluting stents were performed in our institution (LEADERS and RESOLUTE-III). During the inclusion period of these trials 1242 consecutive PCI pati...

Background: Treatment of bifurcation lesions with the Tryton Sidebranch stent has been shown to be feasible with an acceptable clinical outcome and low side branch late loss in the first in man trial. Objective: To report acute procedural and six month clinical follow-up after the use of the Tryton Sidebranch stent in an "all comer" registry. M...

The aims of this study were to evaluate the SYNTAX score (SXscore) calculated at 2 stages during a primary percutaneous intervention (PPCI), that is, SXscore I (diagnostic) and SXscore II (postwiring), and assess its additional value to standard clinical risk scores in acute myocardial infarction. SXscores I and II were applied to 736 consecutive a...

Magnetic guidewire assisted percutaneous coronary interventions (MPCI) could have certain advantages in coronary bifurcation lesions. We aimed to report the angiographic characteristics of the bifurcation lesions, as well as the procedural and clinical outcomes of the MPCI patients. The lesion characteristics and the treatment effect were assessed...

The occurrence of restenosis and acute vessel closure postballoon angioplasty was the driving force for the introduction of coronary artery stenting in the 1980s. Although the first generation of coronary artery stents were highly valuable and efficient in scaffolding (non-)threatened coronary vessels, they proved to be associated with iatrogenic s...

A myocardial infarction (MI) is usually caused by a sudden thrombotic obstruction of a coronary artery, superimposed on a ruptured atherosclerotic plaque. The location and duration of the occlusion, as well as the extent of collateral circulation are the main determinants of infarct size, whereas infarct size itself is a major determinant of progno...

The aim of this study was to assess the 6-year clinical outcome after unrestricted use of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) as compared with bare-metal stents (BMS) in consecutive de novo patients undergoing percutaneous coronary intervention (PCI). SES and PES have been shown to significantly decrease target vessel...

There are limited data on the long-term safety and efficacy profile of coronary stent implantation in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). We aimed to assess the 4-year clinical outcome in patients who received a bare-metal stent (BMS), sirolimus-eluting stent (SES), or a paclitaxel...

Chronic total occlusions (CTO) constitute a major challenge in percutaneous coronary revascularisation (PCI). The development of new interventional strategies, the availability of purpose made tools including dedicated catheters and wires, as well as increasing expertise by the operators, have contributed to the modest success rates which today hov...

BACKGROUNDDepression is associated with adverse prognosis in cardiac patients, warranting the availability of brief and valid instruments to identify depressed patients in clinical practice. OBJECTIVESWe examined whether the two-item Patient Health Questionnaire (PHQ-2) was associated with adverse events in percutaneous coronary intervention (PCI)...

It remains unclear whether feelings of being disabled are a relevant psychological factor that determines outcome after percutaneous coronary intervention (PCI). Therefore, we evaluated "feelings of being disabled" as an independent risk factor for mortality 4 years post-PCI. As part of the Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-...

Chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD) are both inflammatory conditions. Statins are commonly used in patients with PAD and have anti-inflammatory properties, which may have beneficial effects in patients with COPD. The relation between statin use and mortality was investigated in patients with PAD with a...

beta-Blocker use is associated with improved health outcomes in patients with cardiovascular disease. There is a general reluctance to prescribe beta-blockers in patients with chronic obstructive pulmonary disease (COPD) because they may worsen symptoms. We investigated the relationship between cardioselective beta-blockers and mortality in patient...