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Cliflical evaluation of th' Orsiro LESS 10 diabetic subjects requiring coronary revasculariza t ion with Drug Eluting Stefl ts (DES) .880 subjects will be enrolled in this registry. The sample subjects size may be increased in order to reach the subgroup sizes (Small Vessel and AMI).
For the majority of Coronary Artery Disease (CAD), treatment with Percutaneous Transluminal Coronary Angioplasty (PTCA) provides high initial procedural success. However, the medium to long-term complications range from rather immediate elastic recoil or vessel contraction to longer processes like smooth muscle cell proliferation and excessive production of extra cellular matrix, thrombus formation and atherosclerotic changes like restenosis or angiographic re-narrowing. The reported incidence of restenosis after PTCA ranges from 30%-50%. Such rates of recurrence have serious economic consequences. Bare Metal Stents (BMS), designed to address the limitations of PTCA, reduced the angiographic and clinical restenosis rates in de novo lesions compared to PTCA alone and decreased the need for CABG. BMS substantially reduced the incidence of abrupt artery closure, but restenosis still occurred in about 20%-40% of cases, necessitating repeat procedures. The invention of Drug Eluting Stents (DES) significantly improved on the principle of BMS by adding an antiproliferative drug (directly immobilized on the stent surface or released from a polymer matrix), which inhibits neointimal hyperplasia. The introduction of DES greatly reduced the incidence of restenosis and resulted in a better safety profile as compared to BMS with systemic drug administration. These advantages and a lower cost compared to surgical interventions has made DES an attractive option to treat coronary artery disease.
An interesting group of analysis resulted to be diabetic patients. It has been concluded that the incidence of both nonocclusive and occlusive restenosis is higher in diabetic subjects after stenting as judged from comparison with historical control subjects. Results implicate accelerated restenosis as both a consequence of diabetes and a cause for increased mortality after PCI in diabetic patient.
Therefore this observational registry has been designed for the clinical evaluation of the Orsiro LESS in diabetic subjects (Diabetic patients type 1 or 2) requiring coronary revascularization with Drug Eluting Stents (DES). Results will contribute to the collection of clinical evidence for the clinical performance and safety of the Orsiro Drug Eluting Stent System in daily clinical practice.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Orsiro |
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| Measure | Description | Time Frame |
|---|---|---|
| Target Lesion Failure (TLF) | Composite of cardiac death, target vessel Q-wave or non Q-wave Myocardial Infarction (MI), Emergent Coronary Artery Bypass Graft (CABG), clinically driven Target Lesion Revascularization (TLR) | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Target Lesion Failure (TLF) | Composite of cardiac death, target vessel Q-wave or non Q-wave Myocardial Infarction (MI), Emergent Coronary Artery Bypass Graft (CABG), clinically driven Target Lesion Revascularization (TLR) | 6 months |
| Clinically Driven Target Vessel Revascularization (TVR) |
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Inclusion Criteria:
Inclusion Criteria
Diabetes Mellitus:
Patient has Symptomatic coronary artery disease
Target lesion must be a de novo lesion located in a native coronary artery with reference vessel diameter ≥2.25 mm & ≤4.00 mm, lesion length ≤40 mm by visual estimate
Patient should be receiving up to 3 stents and up to 2 stents per artery.
Target lesion must be in a major coronary artery or branch with visually estimated stenosis ≥50% & <100% with TIMI flow≥1.
Subject provides signed informed consent for data release
Subject is geographically stable and willing to comply with protocol required follow ups
Subject is ≥ 18 years of age
Exclusion Criteria:
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Diabetic Subjects requiring coronary revascularization with Drug eluting Stent (DES)
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| Name | Affiliation | Role |
|---|---|---|
| Upendra Kaul, Dr | Fortis Escorts Heart Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Queen Mary Hospital | Hong Kong | China | ||||
| KMC Manjpal |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D017202 | Myocardial Ischemia |
| D003922 | Diabetes Mellitus, Type 1 |
| D003924 | Diabetes Mellitus, Type 2 |
| D000072657 | ST Elevation Myocardial Infarction |
| D000072658 | Non-ST Elevated Myocardial Infarction |
| D007511 | Ischemia |
| D000787 | Angina Pectoris |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001161 | Arteriosclerosis |
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Any repeat revascularization of the target vessel. |
| 6 and 12 months |
| Clinically Driven Target Lesion Revascularization (TLR) | Any repeat revascularization of the target lestion. | 6 and 12 months |
| Stent Thrombosis rate using ARC definition | Definite, Probable and Possible Stent ThrombOsis | 12 months |
| Clinical device success | Successful delivery and deployment of the investigational stent(s) at the intended target lesion and successful withdrawal of the stent delivery system with attainment of a final residual stenosis of less than 50% by visual estimation and without use of a device outside the assigned treatment strategy. | Participants will be followed for the duration of hospital stay, an expected average of 2 days |
| Clinical Procedure Success | Successful delivery and deployment of the investigational stent(s) at the intended target lesion and successful withdrawal of the stent delivery system with attainment of a final residual stenosis of less than 50% of the target lesion as observed by visual estimate without using any adjunctive device* without the occurrence of ischemia-driven major adverse cardiac event (ID-MACE) during the hospital stay to a maximum of the first seven days post index procedure. In case of multiple lesions treatment, all treated lesions must meet the clinical procedural success. * Apart from post-dilatation with a non-compliant balloon | Participants will be followed for the duration of hospital stay, an expected average of 2 days |
| Manial |
| Karnataka |
| India |
| Fortis Hospitals-Bannerghatta Road | Bangalore | KA 560076 | India |
| Fortis Hospitals Bannerghatta Road | Bangalore | India |
| GKNM Hospital | Coimbatore | India |
| Divine Heart and Multi-Specialty Hospital | Lucknow | India |
| King George Medical University | Lucknow | India |
| Fortis Hospital | Mohali | India |
| Holy Family Hospital | Mumbai | India |
| BLK Super Speciality Hospital | New Delhi | India |
| Dharma Vira Heart Centre, Sir Ganga Ram Hospital | New Delhi | India |
| Fortis Escort Heart Institute | New Delhi | India |
| Ruby Hall Clinic | Pune | India |
| Institut Jantung Negara | Kuala Lumpur | Malaysia |
| Lanka Hospital | Colombo | Sri Lanka |
| National Hospital of Sri Lanka | Colombo | Sri Lanka |
| Sri Jaiewardenepura General Hospital | Colombo | Sri Lanka |
| Bach Mai Hospital | Hanoi | Vietnam |
| Cho Ray Hospital | Ho Chi Minh City | Vietnam |
| D001157 |
| Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D009203 | Myocardial Infarction |
| D007238 | Infarction |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |