Comparison between a Bare–Metal Stents and Drug Eluting Stents in patients undergoing Percutaneous Coronary Intervention.

Abstract

Background: little researches have directly compared second-generation drug-eluting stents with each other or with baremetal stents. Aim of the work: To compare between outcomes after implantation of bare-metal stents [BMS] and two kinds of 2 nd generation drug eluting stents [DES] [Zotarolimus-Eluting Stents [ZES], and A Everolimus-Eluting Stents [EES]] in patients undergoing percutaneous coronary intervention. Patients and Methods: 160 Ischemic Heart Disease [IHD] patients undergoing PCI with 2 nd generation DES implantation [80 ZES and 80 EES] were analyzed against 50 IHD patients undergoing PCI with BMS implantation. Each patients group received up to 6 [in BMS group] or 24 months [in ZES and EES groups] of clopidogrel therapy. The key efficacy endpoint was the 24 months major adverse cardiac event [MACE] [death, myocardial infarction, or target lesion revascularization], whereas stent thrombosis [ST] was the safety endpoint. Results: The MACE rate was lowest in EES [19%; χ2= 7.661], highest in BMS [41.7%; χ2 =7.661], and intermediate in ZES [28.2%; χ2= 7.661] group with significant P Value =0.002.The 2-year incidence of ST in the EES group [1.3%] was similar to that in the ZES-S group [2.2%], whereas it was lower in contrast with BMS [7.5%] groups, with significant P value= 0.004]. Conclusion: DES have more efficacy and safety than BMS as EES have lowest MACE and ST rate while BMS have the highest rate and ZES have intermediate rate while the three stent groups have similar rate of mortality at 2 years follow up.

Microalbuminuria as a Predictor of Outcome in Non-Diabetic Patients Undergo Percutaneous Coronary Intervention for Acute Coronary Syndrome

“…Table (2) showed that there was no statistically significant difference found between the three studied groups regarding MA level or positivity with P-value = 0.056 and 0.306 respectively.…”

“…Percutaneous coronary intervention (PCI) is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD) (2) .…”

Frequency of In-Stent Restenosis among Different 2nd/3rd Drug Eluting Stents in Patients Presenting with ACS/Angina at Trtiary Cradiac Care Centre

“…11,12 However, it's not only the stent design/polymer that contributes solely for restenosis, there are certain other Risk factors for in-stent restenosis. These risk factors could be divided into factors like length of stent, diameter of vessel, ostial lesions, stent fracture, CTO, 13 or patient-related risk factors like diabetes mellitus, female gender, genetic polymorphism, hypertension and lipid profile. 14,15 After modification in structure and design frequency of ISR has been significantly reduced among new generation stent.…”