The Safety And Efficiency Of Drug-eluting Stents In Coronary Long Lesion, Small Vessel And Multi Vessel Disease Of Study

ObjectiveTo compare the safety and efficiency of three different drug eluting stents: everolimus-eluting stents (XIENCETM V EECSS),rampamycin-eluting stents(Lepu PARTNER TM)and Paclitaxel-eluting stents (Yin Yi(?) micro blind hole-drug coronary stents) in coronary long lesion, small vesscle and multi-vesscle disease using target vessel revascularization, reinfarction, cardiac death and stroke rate at6month after percutaneous coronary intervention (PCI).MethodFrom October2010to October2011,268patients with stenosis≥70%in any of main coronary artery determined by angiography were divided into long lesion, small vessel and multi-vesscle disease group. Patients in each group were randomized to receiving any of the three stents:XIENCETM V EECSS(evrolimus leluting stents, Abbott Corporation, USA), Yin Yi(?)(Paclitaxel micro blind hole-drug coronary stents. YinYI Biomaterial Corporation Dalian Liaoning China) or Lepu PARTNERTM drug-eluting stents(Beijing Medical Equipment Corporation). Baseline characteristics and details in PCI procedure were recorded for each patient. Follow-up was performed at6months after PCI, target vesscle revascularization (TVR). reinfarction, cardiac death, stroke and major adverse cardiac events (MACE) rate were compared with each group among three different stents.Statistic analyses were performed using SPSS17.0, two-tailed p<0.05was defined as significant. ResultsAmong268patients recruited,79(54male with mean age60.20±10.65),91(60male with mean age61.80±10.18) and98(71male with mean age58.64±11.61) patients were divided small vessel, long lesion and multi-vesscle group respectively according to angiographic characteristics. Within each group, there were no significant differences among patients in different stents subgroup in terms of baseline characteristics. Procedure succeccd rate was100%. After PCI, the target vessel stenosis≤20%or after review of Coronary angiography were TIMI flow3with Using the visual method.They were implanted stents for399in268patients, usage of X, P and Y stents were34%,35%and31%, p=0.408; The mean stents used in each patients were comparable among3groups:In small disease group, usage of X, P and Y stents were33%,32%and35%, p=0.876; In long lesion group, usage of X, P and Y stents were29%,39%and32%, p=0.220; In multi-vesscle disease group, usage of X, P and Y stents were38%,34%and28%, p=0.113.After PCI, the three drug eluting stents were compared in261patients. The total of events rates in the9.3%.High to low in the order of TVR3.1%, stroke2.7%, reinfarction2.3%, or cardiac death1.2%.They were significant differences(p<0.05). Amo-ng TVR(0vs.1.53vs.1.53%) XIENCETM V, Lepu PARTNER and YinYi(?) stents r-espectively,p=0.038), stroke(0vs.0.15vs.1.53%, p=0.054), reinfarction(0vs.0.77vs.1.53%, p=0.062), or cardiac death(0vs.0.77vs.0.38%, p=0.249).In small vesscle diasease group, there were no significant differences in TVR(0vs.4vs.4%in XIENCETM V, Lepu PARTNER and YinYi(?) stents respectively, p=0.438) reinfarction(0vs.0vs.4%, p=0.329), cardiac death(0vs.4vs.4%, p=0.438) or stroke(0vs.4vs.0%, p=0.329) within different stents. However, MACE was lower in the patients implanted XIENCETM V stents(0vs.12vs.12%in XIENCETM V, Lepu PARTNER and Yin Yi (?)stents respectively, p=0.077).In long lesion group, there were no significant differences in TVR(0vs.3.3vs.6.7%in XIENCETM V, Lepu PARTNER and Yin Yi (?)stents respectively, p=0.242), reiniarction(0vs.3.3vs.3.3%, p=0.439), cardiac death(0vs.3.3vs.0%, p=0.330) or strokc(0vs.0vs.3.3%. p=0.330) within different stents. However, MACE was lower in the patients implanted XIENCETM V stents(0vs.12vs.12%in XIENCETM V, Lepu PARTNER and Yin Yi(?) stents respectively, p=0.047).In multi-vesscle diasease group, there were no significant differences in TVR(0vs.6.3vs.3.1%in XIENCETM V, Lepu PARTNER and Yin Yi(?) stents respectively, p=0.242) reinfarction(0vs.3.1vs.6.3%, p=0.242), cardiac death(0vs.0vs.0%, p=0) or stroke(0vs.6.3vs.9.4%, p=0.110) within different stents. However, MACE was lower in the patients implanted XIENCETM V stents(0vs.15.6vs.18.8%in XIENCETM V, Lepu PARTNER and Yin Yi(?) stents respectively, p=0.008).Conclusion1. At6months after PCI, the rates of TVR, reinfarction, cardiac death and stroke were comparable among XIENCETM V EECSS, Lepu PARTNERTM and Yin Yi(?) micro blind hole-drug coronary stents in patients with long lesion, small vesscle disease or multi-vesscle disease. They were content with curative effect and were no difference.2. The events rates were comparable among yinyi, XIENCETM V EECSS and lepu stents, but were no significant difference, which indicated the safety of these two stents made in china with the small vesscle disease.3. The solo event rate was no significant difference among yinyi, XIENCETM V EECSS and lepu stents with long lesion and multi-vesscle disease. The two stents made in china were higher than Xience stents in the MACE, which indicated the two stents made in china were become better further.4. Three stents were implanted in the PCI and the procedure is alike. There were no difference of inflation pressre the three stents, which indicated the difficulty in procedure were comparable.5.They were high performance, the rate of adverse event was lower, procedure is simple and price in cheap with the two stents made in china. They were applicated to spread patients in coronary heart disease in the china.