| Background and Purpose:Percutaneous coronary intervention(PCI) is an important treatment way for coronary heart disease(CHD). The implantation of drug eluting stents(DES)decreases the rate of in-stent restenosis( ISR) significantly, which made it be the third milestone in coronary intervention. Long-term safety of DES received widely attentions in recent years and the rate of late stent thrombosis(LST) in DES implant patients was considerably higher than in bare metal stent( BMS) ones. The polymer of first-generation permanent polymer drug eluting stents(PP-DES) residues in vessel lumen after releasing of drugs, thus triggering inflammation reaction and increasing the risk of LST. The biodegradable polymer drug eluting stent(BP-DES) was emerging to date, the covered polymer degrades into carbon dioxide and water after a certain time, eventually is ruled out of human body. BP-DES could compensate the disadvantages of polymer coating theoretically. However, the efficacy and safety of BP-DES compared with PP-DES have been less identified. So the aim of our study was to compare the long term outcomes of BP-DES vs. PP-DES in the real clinical practice.Methods:We analyzed the patients who underwent PCI from 2008 Jan to 2012 Dec in the second affiliated hospital of Third military medical university retrospectively. The patients were divided into BP-DES group and PP-DES group. Then we observed and analyzed the differences in major adverse cardiac events(MACE)and stent thrombosis(ST)in two groups. The MACE includes cardiac death, non-fatal myocardial infarction(MI)and target vessel revascularization(TVR). The data was analyzed by SPSS17.0 and P<0.05 was considered to be statistical differences.1. Excluded 236 cases who implanted polymer-free stents, and 458 cases who mix implanted biodegradable and permanent polymer drug-eluting stents, thus a total of 1190 patients are enrolled, 313 patients(799 stents)of them received BP-DES versus 877 patients(2166 stents)received PP-DES via percutaneous coronary intervention. The average follow-up time was(29.63±11.38)months in BP-DES group and(29.10±11.00)months in PP-DES group.2. The average number of implanted stents were(2.55±1.34) in BP-DES group and(2.47±1.23) in PP-DES group. The average diameter of stents was(3.10±0.38)mm vs.(3.11±0.42)mm and the average length of stents was(18.96±4.87)mm vs.(18.62±5.61)mm in the two groups respectively. Compared with PP-DES group, BP-DES group showed no statistical differences in clinical baseline data, coronary artery lesion characteristics and operating characteristics(all P > 0.05).3. There were no significant differences in total MACE(5.1% vs. 7.6%,P=0.132, cardiac death(1.3% vs. 2.6%,P=0.250), non-fatal myocardial infarction(2.2% vs. 2.9%,P=0.564)and TVR(1.6% vs. 2.1%,P=0.703) between two groups. Compared with PP-DES group, BP-DES group showed no significant advantage in definite/possible stent thrombosis(1.0% vs. 1.4%, P=0.793). The incidences of acute/subacute stent thrombosis(0% vs. 0.1%,P=1.000), late stent thrombosis(0.6% vs. 0.5%,P=1.000),very late stent thrombosis(0.3% vs. 0.8%,P=0.626)were similar in BP-DES and PP-DES groups.Conclusions:BP-DES and PP-DES have the similar safety and efficacy in treatment forcoronary heart disease. In the long time follow-up, given a rising trend in incidence of MACE,cardiac death,non-fatal myocardial infarction and very late stent thrombosis in PP-DES group, it was not statistically significant higher compared with BP-DES group. |
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