Efficacy and Safety of Sirolimus-Eluting Stent With Biodegradable Polymer Ultimaster™ in Unselected Korean Population: A Multicenter, Prospective, Observational Study From Korean Multicenter Ultimaster Registry.

BACKGROUND AND OBJECTIVES: Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease. METHODS: This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. RESULTS: A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS). At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. CONCLUSIONS: The present registry shows that Ultimaster™ stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

Transient complete atrioventricular block associated with curcumin intake.

Curcumin is a polyphenol responsible for the yellow color of turmeric, a curry spice. A large body of evidence showed that curcumin possessed a variety of beneficial activities. We report a case of transient complete atrioventricular block in a 38-year-old man, after intake of curcumin containing pills for on 1 month. Since all other possible causes of conduction disturbance were excluded and causal relation was achieved by re-intake of the same amount of turmeric containing pills, side-effect of the curcumin containing pills was identified as the most likely diagnosis. After cessation of the pills, no further conduction disturbances and associated symptoms were noticed for the ensuing 6 months since discharge.

Coronary artery thrombosis associated with Paclitaxel in advanced ovarian cancer.

A 63-year-old woman was diagnosed with ovarian cancer and peritoneal carcinomatosis. The day after paclitaxel was administered, an acute myocardial infarction occurred. Emergency coronary angiography revealed a filling defect in the left main coronary artery and total occlusion in the distal left anterior descending coronary artery, with no luminal irregularity or narrowing. Intravascular ultrasonography showed no significant plaque in the left main coronary artery. A thrombophilia work-up was negative, and the patient was treated with tirofiban, clopidogrel, and aspirin. The follow-up coronary angiogram showed that the occlusion of the distal obtuse marginal branch and distal left anterior descending artery had cleared. Paclitaxel has been associated with acute myocardial infarction. However, the pathogenesis of myocardial infarction associated with paclitaxel is not known. This case raises the possibility that paclitaxel can induce coronary artery thrombosis, resulting in myocardial infarction.