Local Drug Delivery for the Prevention of Restenosis

Local Drug Delivery for the Prevention of Restenosis
Order 58994839
Local Drug Delivery for the Prevention of Restenosis
1 Stents coated with drugs like sirolimus and paclitaxel
reduce the incidence of in-stent restenosis. The main
effect of the drugs is on:
(A) Elastic recoil
(B) Arterial remodeling
(C) Smooth muscle cell proliferation/migration
(D) Extracellular matrix production
2 Which of the following is true regarding sirolimus?
(A) Sirolimus is a macrolide
(B) Sirolimus is the metabolic substrate of thefungus
Streptomyces hygroscopicus
(C) Sirolimus was at an early stage targeted as
rapamycin for use in renal transplantation
(D) Sirolimus influences regulator genes that control
the cell cycle
(E) A, B, C, and D are correct
3 Which of the following statements concerning paclitaxel (Taxus) is wrong?
(A) Paclitaxel induces disassembly of microtubules
(B) Paclitaxel was discovered in a crude extract from
the bark of a Pacific yew
(C) Paclitaxel is an antimicrotubule drug
(D) Paclitaxel was first evaluated as an antitumor
drug
4 Which of the following statements regarding drugeluting stent platforms is not correct?
(A) The sirolimus-eluting (Cypher) stent is composed of a stainless steel stent coated with a
nonerodable polymer
(B) Paclitaxel can only be used in combination with
a polymer-based stent platform
(C) Polymers are long-chain molecules, which form
a reservoir, and facilitate controlled and prolonged drug delivery
(D) A conceptually ideal drug-eluting stent should
have a large surface area, minimal gaps between
cells, and no strut deformation after deployment
5 Polymeric materials coated on stents:
(A) Allow a controlled and sustained release of
agents
149
150 900 Questions: An Interventional Cardiology Board Review
(B) Minimize the potential of underdosing or
overdosing of drug levels
(C) Serve as drug reservoir
(D) Are potentially toxic
(E) A to D are true
6 The first randomized comparison of a sirolimuseluting stentwith a standard bare-metal stent reduced
the rate of in-stent restenosis after 6 months to:
(A) 20%
(B) 15%
(C) 10%
(D) 1 year) stent thrombosis after drug-eluting stent
implantation:
(A) May be associated with chronic inflammation
of the arterial wall
(B) May be due to a hypersensitivity reaction to the
polymer
(C) Can be avoided by prescribing prolonged dual
antiplatelet therapy
(D) Carries a high morbidity and mortality
10 Which of the following antiproliferative agents is
under clinical investigation as new drug-eluting stent
systems?
(A) Tacrolimus
(B) Everolimus
(C) Biolimus
(D) Zotarolimus
(E) All of the above
Local Drug Delivery for the Prevention of Restenosis
11 The SIRTAX trial, a randomized, controlled, singleblind study comparing sirolimus-eluting stents with
paclitaxel-eluting stents in approximately 1,000 allcomer patients favors a treatment with a sirolimuseluting stent because of:
(A) Lower incidence of cardiac death
(B) Lower incidence of stent thrombosis
(C) Fewer major adverse cardiac events, primarily
by decreasing rates of clinical and angiographic
restenosis
(D) Better acute gain and higher success of stent
implantation
(E) B and C
12 A meta-analysis of randomized trials by Kastrati
et al. comparing sirolimus-eluting with paclitaxeleluting stents in patients with coronary artery disease
reported all except:
(A) Target lesion revascularization is less frequently
performed in patients treated with a sirolimuseluting stent
(B) Rate of death is comparable
(C) Angiographic restenosis is more frequently
observed in patients treated with a paclitaxeleluting stent
(D) Rates of myocardial infarction and stent thrombosis are lower in sirolimus-eluting stent treated
patients
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