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1.
Pharmaceutics ; 16(7)2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-39065566

RESUMEN

Since the earliest days, people have been employing herbal treatments extensively around the world. The development of phytochemical and phytopharmacological sciences has made it possible to understand the chemical composition and biological properties of a number of medicinal plant products. Due to certain challenges like large molecular weight and low bioavailability, some components of herbal extracts are not utilized for therapeutic purposes. It has been suggested that herbal medicine and nanotechnology can be combined to enhance the benefits of plant extracts by lowering dosage requirements and adverse effects and increasing therapeutic activity. Using nanotechnology, the active ingredient can be delivered in an adequate concentration and transported to the targeted site of action. Conventional therapy does not fulfill these requirements. This review focuses on different skin diseases and nanotechnology-based herbal medicines that have been utilized to treat them.

2.
Proc Natl Acad Sci U S A ; 121(30): e2322330121, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39008665

RESUMEN

Ice is emerging as a promising sacrificial material in the rapidly expanding area of advanced manufacturing for creating precise 3D internal geometries. Freeform 3D printing of ice (3D-ICE) can produce microscale ice structures with smooth walls, hierarchical transitions, and curved and overhang features. However, controlling 3D-ICE is challenging due to an incomplete understanding of its complex physics involving heat transfer, fluid dynamics, and phase changes. This work aims to advance our understanding of 3D-ICE physics by combining numerical modeling and experimentation. We developed a 2D thermo-fluidic model to analyze the transition from layered to continuous printing and a 3D thermo-fluidic model for the oblique deposition, which enables curved and overhang geometries. Experiments are conducted and compared with model simulations. We found that high droplet deposition rates enable the continuous deposition mode with a sustained liquid cap on top of the ice, facilitating smooth geometries. The diameter of ice structures is controlled by the droplet deposition frequency. Oblique deposition causes unidirectional spillover of the liquid cap and asymmetric heat transfer at the freeze front, rotating the freeze front. These results provide valuable insights for reproducible 3D-ICE printing that could be applied across various fields, including tissue engineering, microfluidics, and soft robotics.

3.
Curr Genomics ; 25(2): 69-87, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38751601

RESUMEN

SARS-CoV-2 is a highly contagious and transmissible viral infection that first emerged in 2019 and since then has sparked an epidemic of severe respiratory problems identified as "coronavirus disease 2019" (COVID-19) that causes a hazard to human life and safety. The virus developed mainly from bats. The current epidemic has presented a significant warning to life across the world by showing mutation. There are different tests available for testing Coronavirus, and RT-PCR is the best, giving more accurate results, but it is also time-consuming. There are different options available for treating n-CoV-19, which include medications such as Remdesivir, corticosteroids, plasma therapy, Dexamethasone therapy, etc. The development of vaccines such as BNT126b2, ChAdOX1, mRNA-1273 and BBIBP-CorV has provided great relief in dealing with the virus as they decreased the mortality rate. BNT126b2 and ChAdOX1 are two n-CoV vaccines found to be most effective in controlling the spread of infection. In the future, nanotechnology-based vaccines and immune engineering techniques can be helpful for further research on Coronavirus and treatment of this deadly virus. The existing knowledge about the existence of SARS-CoV-2, along with its variants, is summarized in this review. This review, based on recently published findings, presents the core genetics of COVID-19, including heritable characteristics, pathogenesis, immunological biomarkers, treatment options and clinical updates on the virus, along with patents.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38716551

RESUMEN

Cancer remains a significant global health challenge, necessitating innovative approaches to enhance the efficacy and specificity of therapeutic interventions while minimizing adverse effects on healthy tissues. Nanotechnology has emerged as a promising avenue in cancer treatment, offering novel strategies for targeted drug delivery. Nanoparticles, liposomes, and polymer-based systems have played pivotal roles in revolutionizing cancer therapy. Nanotechnology possesses unique physicochemical properties, enabling efficient encapsulation of therapeutic agents and controlled and prolonged release at tumour sites. Advancement in formulations using nanotechnology has made it possible to make multifunctional systems that respond to the microenvironment of a tumour by releasing payloads in response to changes in pH, temperature, or enzymes. Stimuli-responsive polymers can release drugs in response to external cues, enabling site-specific drug release and minimizing systemic exposure. This review explores recent studies and preclinical trials that show how nanoparticles, liposomes, and polymerbased systems could be used to treat cancer, discussing challenges such as scalability, regulatory approval, and potential toxicity concerns along with patents published recently.

5.
Pharmaceutics ; 16(3)2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38543191

RESUMEN

Prostate cancer is one of the most life-threatening disorders that occur in males. It has now become the third most common disease all over the world, and emerging cases and spiking mortality rates are becoming more challenging day by day. Several approaches have been used to treat prostate cancer, including surgery, radiation therapy, chemotherapy, etc. These are painful and invasive ways of treatment. Primarily, chemotherapy has been associated with numerous drawbacks restricting its further application. The majority of prostate cancers have the potential to become castration-resistant. Prostate cancer cells exhibit resistance to chemotherapy, resistance to radiation, ADT (androgen-deprivation therapy) resistance, and immune stiffness as a result of activating tumor-promoting signaling pathways and developing resistance to various treatment modalities. Nanomedicines such as liposomes, nanoparticles, branched dendrimers, carbon nanotubes, and quantum dots are promising disease management techniques in this context. Nanomedicines can target the drugs to the target site and enhance the drug's action for a prolonged period. They may also increase the solubility and bioavailability of poorly soluble drugs. This review summarizes the current data on nanomedicines for the prevention and treatment of prostate cancer. Thus, nanomedicine is pioneering in disease management.

6.
Mol Biol Rep ; 51(1): 423, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38489102

RESUMEN

BACKGROUND: Oral health remains a significant global concern with the prevalence of oral pathogens and the increasing incidence of oral cancer posing formidable challenges. Additionally, the emergence of antibiotic-resistant strains has complicated treatment strategies, emphasizing the urgent need for alternative therapeutic approaches. Recent research has explored the application of plant compounds mediated with nanotechnology in oral health, focusing on the antimicrobial and anticancer properties. METHODS: In this study, curcumin (Cu)-mediated zinc oxide nanoparticles (ZnO NPs) were synthesized and characterized using SEM, EDAX, UV spectroscopy, FTIR, and XRD to validate their composition and structural features. The antioxidant and antimicrobial activity of ZnO-CU NPs was investigated through DPPH, ABTS, and zone of inhibition assays. Apoptotic assays and gene expression analysis were performed in KB oral squamous carcinoma cells to identify their anticancer activity. RESULTS: ZnO-CU NPs showcased formidable antioxidant prowess in both DPPH and ABTS assays, signifying their potential as robust scavengers of free radicals. The determined minimal inhibitory concentration of 40 µg/mL against dental pathogens underscored the compelling antimicrobial attributes of ZnO-CU NPs. Furthermore, the interaction analysis revealed the superior binding affinity and intricate amino acid interactions of ZnO-CU NPs with receptors on dental pathogens. Moreover, in the realm of anticancer activity, ZnO-CU NPs exhibited a dose-dependent response against Human Oral Epidermal Carcinoma KB cells at concentrations of 10 µg/mL, 20 µg/mL, 40 µg/mL, and 80 µg/mL. Unraveling the intricate mechanism of apoptotic activity, ZnO-CU NPs orchestrated the upregulation of pivotal genes, including BCL2, BAX, and P53, within the KB cells. CONCLUSIONS: This multifaceted approach, addressing both antimicrobial and anticancer activity, positions ZnO-CU NPs as a compelling avenue for advancing oral health, offering a comprehensive strategy for tackling both oral infections and cancer.


Asunto(s)
Antiinfecciosos , Benzotiazoles , Carcinoma de Células Escamosas , Curcumina , Nanopartículas del Metal , Neoplasias de la Boca , Ácidos Sulfónicos , Óxido de Zinc , Humanos , Óxido de Zinc/farmacología , Óxido de Zinc/química , Curcumina/farmacología , Nanopartículas del Metal/química , Antioxidantes/farmacología , Antibacterianos/farmacología , Antibacterianos/química , Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias de la Boca/tratamiento farmacológico , Biopelículas , Extractos Vegetales/química , Pruebas de Sensibilidad Microbiana
7.
Heliyon ; 10(1): e23303, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38163139

RESUMEN

The complicated chemical reactions involved in the production of the newer drug delivery systems have mainly impeded efforts to build successful targeted drug delivery systems for a prolonged duration of time. Nanosponges, a recently created colloidal system, have the potential to overcome issues with medication toxicity, decreased bioavailability, and drug release over a wide area because they can be modified to work with both hydrophilic and hydrophobic types of drugs. Nanosponges are small sized with a three-dimensional network having a porous cavity. They can be prepared easily by crosslinking cyclodextrins with different compounds. Due to Cyclodextrin's outstanding biocompatibility, stability, and safety, a number of Cyclodextrin-based drug delivery systems have been developed promptly. The nanosponge drug delivery system possesses various applications in various ailments such as cancer, autoimmune diseases, theranostic applications, enhanced bioavailability, stability, etc. This review elaborates on benefits and drawbacks, preparation techniques, factors affecting their preparation, characterization techniques, applications, and most current developments in nanosponges.

8.
Int J Pharm ; 652: 123819, 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38242256

RESUMEN

In-situ gel technology is a promising drug delivery strategy that undergoes a 'sol to gel' transition upon administration, providing controlled and prolonged drug release. These gels are composed of cross-linked 3D networks of polymers, with hydrogels being a specific type of absorbing water while retaining their shape. Gelation can be triggered by various stimuli, such as temperature, pH, ions, and light. They offer several advantages like improved patient compliance, extended drug residence time, localized drug delivery, etc, but also have some disadvantages like drug degradation and limited mechanical strength. In-situ gel falls into three categories: temperature-sensitive, ion-sensitive, and pH-sensitive, but multi-responsive gels that respond to multiple stimuli have better drug release characteristics. The mechanism of in-situ gel formation involves physical and chemical mechanisms. There are various applications of in-situ gel, like ocular drug delivery, nose-to-brain delivery, etc. In this review, we have discussed the types, and mechanisms of in-situ gel & use of in-situ gel in the treatment of different diseases through various routes like buccal, vaginal, ocular, nasal, etc., along with its use in targeted drug delivery.


Asunto(s)
Sistemas de Liberación de Medicamentos , Hidrogeles , Femenino , Humanos , Geles/metabolismo , Hidrogeles/metabolismo , Ojo/metabolismo , Polímeros/metabolismo
9.
Curr Drug Deliv ; 2024 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-38265385

RESUMEN

Malaria is still a major endemic disease transmitted in humans via Plasmodium-infected mosquitoes. The eradication of malarial parasites and the control measures have been rigorously and extensively deployed by local and international health organizations. Malaria's recurrence is a result of the failure to entirely eradicate it. The drawbacks related to malarial chemotherapy, non-specific targeting, multiple drug resistance, requirement of high doses, intolerable toxicity, indefinable complexity of Plasmodium's life cycle, and advent of drug-resistant strains of P. falciparum are the causes of the ineffective eradication measures. With the emergence of nanotechnology and its application in various industrial domains, the rising interest in the medical field, especially in epidemiology, has skyrocketed. The applications of nanosized carriers have sparked special attention, aiming towards minimizing the overall side effects caused due to drug therapy and avoiding bioavailability. The applications of concepts of nanobiotechnology to both vector control and patient therapy can also be one of the approaches. The current study focuses on the use of hybrid drugs as next-generation antimalarial drugs because they involve fewer drug adverse effects. The paper encompasses the numerous nanosized delivery-based systems that have been found to be effective among higher animal models, especially in treating malarial prophylaxis. This paper delivers a detailed review of diagnostic techniques, various nanotechnology approaches, the application of nanocarriers, and the underlying mechanisms for the management of malaria, thereby providing insights and the direction in which the current trends are imparted from the innovative and technological perspective.

10.
Artículo en Inglés | MEDLINE | ID: mdl-37861010

RESUMEN

There are several vaccines available for preventing various bacterial and viral infections, but still, there are many challenges that require the development of noninvasive, more efficient, and active vaccines. The advancement in biotechnological tools has provided safer antigens, such as nucleic acids, proteins etc., but due to their lower immunogenic property, adjuvants of stronger immune response are required. Nanovaccines are effective vaccines when compared with conventional vaccines as they can induce both Humoral and cell-mediated immune responses and also provide longer immunogenic memory. The nanocarriers used in vaccines act as adjuvant. They provide site-specific delivery of antigens and can be used in conjugation with immunostimulatory molecules for enhancing adjuvant therapy. The nanovaccines avoid degrading cell pathways and provide effective absorption into blood vessels. The higher potential of nanovaccines to treat various diseases, such as Acquired Immuno Deficiency Syndrome, Cancer, Tuberculosis, Malaria and many others, along with their immunological mechanisms and different types, have been discussed in the review.

11.
Pharm Nanotechnol ; 2023 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-37496251

RESUMEN

Over the past few decades, advancements in nanocarrier-based therapeutic delivery have been significant, and niosomes research has recently received much interest. The self-assembled nonionic surfactant vesicles lead to the production of niosomes. The most recent nanocarriers, niosomes, are self-assembled vesicles made of nonionic surfactants with or without the proper quantities of cholesterol or other amphiphilic molecules. Because of their durability, low cost of components, large-scale production, simple maintenance, and high entrapment efficiency, niosomes are being used more frequently. Additionally, they enhance pharmacokinetics, reduce toxicity, enhance the solubility of poorly water-soluble compounds, & increase bioavailability. One of the most crucial features of niosomes is their controlled release and targeted diffusion, which is utilized for treating cancer, infectious diseases, and other problems. In this review article, we have covered all the fundamental information about niosomes, including preparation techniques, niosomes types, factors influencing their formation, niosomes evaluation, applications, and administration routes, along with recent developments.

12.
Curr Pharm Des ; 29(8): 604-619, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36852810

RESUMEN

3D printing in other fields, such as aviation, is quite old, but in the pharmaceutical area, it is an emerging technique. 3D printing is used to formulate various drug delivery systems and dosage forms with complex geometry. It allows large and fast production of products according to the need of the patient. Today, it is the widely used manufacturing technique in the healthcare field for the engineering of tissues and tissue models, production of medicines and medical devices, organ and tissue bioprinting, implant manufacturing, and production of polypills, vaginal rings, orodispersible films, etc. It allows the production of various dosage forms with complex release profiles containing multiple active ingredients. It is used for manufacturing medicines according to the need of individual patients focusing on the concept of personalized medicines. The idea of customized medicines allows change of dosage and design of the product as per individual and with decreased side effects. This review details various techniques of 3D printing used, such as stereolithography, fused deposition modeling, inkjet printing, etc., and applications and dosage forms developed with the latest patents. The significant challenges in the emergence of the 3D printing technique are the involvement of complex combinations to achieve desired properties, and also, the bioprinter involved provides slow and less resolution. The materials prepared by this technique are both biocompatible and printable, due to which additive manufacturing is increasing in the field of medicine.


Asunto(s)
Drogas de Diseño , Sistemas de Liberación de Medicamentos , Humanos , Preparaciones Farmacéuticas , Impresión Tridimensional , Medicina de Precisión/métodos , Tecnología Farmacéutica
13.
Environ Sci Pollut Res Int ; 30(44): 98548-98562, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35688971

RESUMEN

The present study described the synthesis and characterization of MOF-76(Tb) for hydrogen storage and humidity sensing applications. The structure and morphology of as-synthesized material were studied using powder X-ray diffraction, scanning, and transmission electron microscopy. The crystal structure of MOF-76(Tb) consists of terbium(III) and benzene-1,3,5-tricarboxylate(-III) ions, one coordinated aqua ligand and one crystallization N,N´-dimethylformamide molecule. The polymeric framework of MOF-76(Tb) contains 1D sinusoidally shaped channels with sizes of 6.6 × 6.6 Å propagating along c crystallographic axis. The thermogravimetric analysis of the prepared material exhibited thermal stability up to 600 °C. At 77 K and pressure up to 20 bar; 0.6 wt.% hydrogen storage capacity for MOF-76(Tb) was observed. Finally, the humidity sensing measurements (water adsorption experiments) were performed, and the results indicate that MOF-76(Tb) is not a suitable material for moisture sensing applications.


Asunto(s)
Estructuras Metalorgánicas , Humedad , Terbio , Polímeros , Hidrógeno
14.
Adv Sci (Weinh) ; 9(27): e2201566, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35794454

RESUMEN

Water is one of the most important elements for life on earth. Water's rapid phase-change ability along with its environmental and biological compatibility also makes it a unique structural material for 3D printing of ice structures reproducibly and accurately. This work introduces the freeform 3D ice printing (3D-ICE) process for high-speed and reproducible fabrication of ice structures with micro-scale resolution. Drop-on-demand deposition of water onto a -35 °C platform rapidly transforms water into ice. The dimension and geometry of the structures are critically controlled by droplet ejection frequency modulation and stage motions. The freeform approach obviates layer-by-layer construction and support structures, even for overhang geometries. Complex and overhang geometries, branched hierarchical structures with smooth transitions, circular cross-sections, smooth surfaces, and micro-scale features (as small as 50 µm) are demonstrated. As a sample application, the ice templates are used as sacrificial geometries to produce resin parts with well-defined internal features. This approach could bring exciting opportunities for microfluidics, biomedical devices, soft electronics, and art.


Asunto(s)
Microfluídica , Impresión Tridimensional , Agua
15.
Chemosphere ; 305: 135467, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35764119

RESUMEN

Metal-organic frameworks (MOFs) represent a class of nanoporous materials built up by metal ions and organic linkers with several interesting potential applications. The present study described the synthesis and characterization of Gd(III)-based MOF with the chemical composition [Gd(BTC)(H2O)]·DMF (BTC - trimesate, DMF = N,N'-dimethylformamide), known as MOF-76(Gd) for hydrogen adsorption/desorption capacity and humidity sensing applications. The structure and morphology of as-synthesized material were studied using powder X-ray diffraction, scanning and transmission electron microscopy. The crystal structure of MOF-76(Gd) consists of gadolinium (III) and benzene-1,3,5-tricarboxylate ions, one coordinated aqua ligand and one crystallization DMF molecule. The polymeric framework of MOF-76(Gd) contains 1D sinusoidally shaped channels with sizes of 6.7 × 6.7 Å propagating along c crystallographic axis. The thermogravimetric analysis, heating infrared spectroscopy and in-situ heating powder X-ray diffraction experiments of the prepared framework exhibited thermal stability up to 550 °C. Nitrogen adsorption/desorption measurement at -196 °C showed a BET surface area of 605 m2 g-1 and pore volume of 0.24 cm3 g-1. The maximal hydrogen storage capacity of MOF-76(Gd) was 1.66 wt % and 1.34 wt % -196 °C and -186 °C and pressure up to 1 bar, respectively. Finally, the humidity sensing measurements (water adsorption experiments) were performed, and the results indicate that MOF-76(Gd) is a suitable material for moisture sensing application with a fast response (11 s) and recovery time (2 s) in the relative humidity range of 11-98%.


Asunto(s)
Estructuras Metalorgánicas , Adsorción , Humedad , Hidrógeno/química , Estructuras Metalorgánicas/química , Polvos
16.
J Med Cases ; 12(6): 226-229, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34429795

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that has caused a pandemic across the world in the years 2019 - 2020 with over 100 countries reporting high infection rates. The virus is unique in the wide spectrum of disease manifestations it can cause; one of the worst of which is the hypercoagulable state induced by severe infection. This case report focuses on a 33-year-old Hispanic male who developed severe acute respiratory syndrome requiring management with extracorporeal membrane oxygenation (ECMO) and developed deep venous thromboses during severe coronavirus disease 2019 (COVID-19) pneumonia. Since there are no current guideline(s) for routine screening for venous thromboembolism (VTE) in ECMO patients, we aim to highlight a proposed benefit of routine screening for VTE in patients with severe COVID-19 treated with ECMO pre-cannulation and post-decannulation, which minimizes the risk of cannulation-associated complications, as well as the risk of post-decannulation VTE respectively. While VTE is a known complication of ECMO therapy, the rates of increased incidence of VTE in patients with severe COVID-19 make the detection of such complications even more important to reduce overall morbidity and mortality.

17.
Am J Med Sci ; 361(5): 567-574, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33785204

RESUMEN

In December 2019 novel coronavirus-Severe Acute Respiratory Syndrome-Corona Virus2 (SARS-CoV2)-originated from Wuhan, China, and spread rapidly around the world. This literature review highlights the dynamic nature of COVID-19 transmission and presentation. Analyzing 59 relevant articles up to May 1st, 2020 reflects that the main reported clinical manifestation of COVID-19 pandemic is fever and respiratory involvement. Also, current literature demonstrates a wide spectrum of different and atypical presentation(s) of COVID-19. The definite route of SARS-CoV2 transmission is respiratory droplets, however, virus nucleic acid has been detected in the stool and urine specimens as well. The severity of symptoms and outcomes of COVID-19 vary based on the patient's medical background, age, sex, and concurrent medical conditions (e.g. pregnancy). This is the first review that classifies all essential points regarding COVID-19 manifestations at a glance to improve the outcome of the patients by a better insight into diagnosis and management.


Asunto(s)
COVID-19 , Pulmón , Pandemias , SARS-CoV-2/metabolismo , COVID-19/epidemiología , COVID-19/metabolismo , COVID-19/fisiopatología , COVID-19/transmisión , Humanos , Pulmón/metabolismo , Pulmón/fisiopatología , Pulmón/virología
18.
Adv Biosyst ; 4(10): e2000080, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32875741

RESUMEN

The evolution of tissue on a chip systems holds promise for mimicking the response of biological functionality of physiological systems. One important direction for tissue on a chip approaches are neuron-based systems that could mimic neurological responses and lessen the need for in vivo experimentation. For neural research, more attention has been devoted recently to understanding mechanics due to issues in areas such as traumatic brain injury (TBI) and pain, among others. To begin to address these areas, a 3D Nerve Integrated Tissue on a Chip (NITC) approach combined with a Mechanical Excitation Testbed (MET) System is developed to impose external mechanical stimulation toward more realistic physiological environments. PC12 cells differentiated with nerve growth factor, which were cultured in a controlled 3D scaffolds, are used. The cells are labeled in a 3D NITC system with Fluo-4-AM to examine their calcium response under mechanical stimulation synchronized with image capture. Understanding the neural responses to mechanical stimulation beyond 2D systems is very important for neurological studies and future personalized strategies. This work will have implications in a diversity of areas including tissue-on-a-chip systems, biomaterials, and neuromechanics.


Asunto(s)
Señalización del Calcio/fisiología , Calcio/metabolismo , Técnicas de Cultivo de Célula , Dispositivos Laboratorio en un Chip , Mecanotransducción Celular/fisiología , Animales , Técnicas de Cultivo de Célula/instrumentación , Técnicas de Cultivo de Célula/métodos , Diseño de Equipo , Neuronas/citología , Células PC12 , Ratas , Andamios del Tejido
20.
Curr Probl Cardiol ; 42(12): 404-417, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29110813

RESUMEN

To evaluate the efficacy and safety of long-duration dual antiplatelet therapy (L-DAPT) compared to short-duration dual antiplatelet therapy (S-DAPT) after drug-eluting stent implantation. We searched Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials assessing the clinical effect of L-DAPT vs S-DAPT after drug-eluting stent. Efficacy end points were all-cause mortality, cardiac mortality, myocardial infarction (MI), stent thrombosis (ST), and target vessel revascularization (TVR). Safety end points were TIMI major bleeding and stroke. Event rates were compared using a random-effects model. We identified 11 randomized controlled trials in which 33,520 patients were randomized to S-DAPT (N = 16,687) and L-DAPT (n = 16,833), respectively. Compared with L-DAPT, S-DAPT was associated with higher rate of MI and lower rate of TIMI major bleeding (1.40 [1.08-1.81] and 0.60 [0.41-0.89], respectively), without any significant differences in the rate of all-cause mortality, cardiac mortality, ST, TVR, and stroke (0.88 [0.75-1.04], 0.98 [0.79-1.22], 1.54 [0.95-2.50], 0.99 [0.73-1.34], and 1.01 [0.78-1.32], respectively). Our results showed that compared with L-DAPT, S-DAPT was associated with higher rate of MI and lower rate of major bleeding without any significant difference in the rates of all-cause mortality, cardiac mortality, ST, TVR, and stroke.


Asunto(s)
Enfermedad de la Arteria Coronaria/terapia , Intervención Coronaria Percutánea , Inhibidores de Agregación Plaquetaria/administración & dosificación , Distribución de Chi-Cuadrado , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/mortalidad , Trombosis Coronaria/etiología , Trombosis Coronaria/prevención & control , Esquema de Medicación , Quimioterapia Combinada , Stents Liberadores de Fármacos , Humanos , Infarto del Miocardio/etiología , Infarto del Miocardio/prevención & control , Oportunidad Relativa , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/instrumentación , Intervención Coronaria Percutánea/mortalidad , Inhibidores de Agregación Plaquetaria/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
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