Comparative Study Of Using Biodegradable Polymer Drug Eluting Stents And Durable Polymer Drug Eluting Stents In The Treatment Of Coronary Artery Disease With Multiple Risk Factors

BackgroundCardiovascular disease has become one of the main "killers" which affect human health in our country recent years, and show a trend of increased year by year. Coronary heart disease is a major type of cardiovascular diseases, and its incidence increased year by year, which lead to great burden to patients, family and society. Fortunately, mortality rate of coronary heart disease is decreasing in home and aboard year by year by application of the Percutaneous coronary intervention.Coronary heart disease is caused by multiple risk factors. Previous research showed that smoking, hypertension, dyslipidemia, and diabetes were the four major risk factors for cardiovascular disease, and it accounted for more than 60% in coronary heart disease(CHD) patients with two or more risk factors. At present, coronary heart disease were treated by drug, PCI and coronary artery bypass grafts(CABG).There are three development stages including simple balloon expansion(PTCA) and bare metal stents(, BMS), drug-eluting stents(DES) in PCI successively. Recently, compare with permanent polymer drug eluting stents, the incidence of cardiac events is low in biodegradable polymer drug eluting stents in a large number of randomized clinical studies at home and abroad. But analysis of two or more risk factors in patients with PCI was not reported in the past.Above all, we analyze the efficacy and safety by biodegradable drug-eluting stents and permanent polymer drug eluting stents in the treatment of two or multiple risk factors for coronary heart disease patients, and assess value of clinical practice in the study.Part I. Risk factors in patients with PCI in hospitalObjective: Analyze the distribution of risk factors of patients after PCIMethods: This was a cross sectional study.1. From 2008.01 to 2012.12, a total of 1227 patients diagnosed as coronary heart disease and received PCI in our hospital were enrolled in this study. Inclusion criteria:(1) diagnosis of coronary heart disease patients, including stable angina pectoris, unstable angina pectoris and myocardial infarction;(2) PCI in hospital;(3) with two or more risk factors. Exclusion criteria:(1) patients with tumor, lung dysfunction, liver dysfunction, kidney dysfunction;(2) previous PCI therapy;(3) patients with intervention complications;(4) At the same time, accept biodegradable polymer drug eluting stents and durable polymer drug eluting stents;(5). incomplete clinical data.2. One assistant was in charge of case collection, telephone follow-up and unified questionnaire filling, Gender, age, medical history, risk factors, past medical history, clinical diagnosis, preoperative and postoperative medication of patients were collected through the medical records.3. Data are presented as percentages for categorical variables, as mean ± standard deviation for normally distributed continuous variables. Categorical variables were compared using the χ2 test. Normally distributed continuous variables were compared using the t test. These analyses were performed using SPSS version18.0statistical software for Windows(SPSS, Chicago, Illinois, USA). p-values of <0.05 was considered statistically significantly.Results: 1. Hypertension was the major risk factors of PCI patients, smoking was the highest risk factors of PCI patients in male. 2. The average age of patients with multiple risk factors of PCI was less in male than female.Conclusion: 1. the average age of patients with multiple risk factors of PCI was less in male than female. 2. The incidence is the highest in patients with hypertension. 3. Smoking can’t be ignored.Keywords: Percutaneous coronary intervention; Diabetes; High blood pressure; HighPart II. Comparative study of using biodegradable polymer drug eluting stents and durable polymer drug eluting stents in the treatment of coronary artery disease with multiple risk factorsObjective: To compare the short-term effect and safety of biodegradable polymer drug eluting stents and durable polymer drug eluting stents in the treatment of coronary artery disease with multiple risk factors.Methods:1. Retrospective analysis 809 consecutive patients with coronary arterial disease with multiple risk factors who were underwent drug eluting stents implantation from January 2008 to December 2012. Inclusion criteria:(1) diagnosis of coronary heart disease patients, including stable angina pectoris, unstable angina pectoris and myocardial infarction;(2) PCI in hospital;(3) with two or more risk factors; Exclusion criteria:(1) patients with tumor, lung dysfunction, liver dysfunction, kidney dysfunction;(2) previous PCI therapy;(3) patients with intervention complications;(4) At the same time, accept biodegradable polymer drug eluting stents and durable polymer drug eluting stents;(5). incomplete clinical data.2. The patients were divided into biodegradable polymer drug eluting stents group(n=197) and durable polymer drug eluting stents group(n=522).3. Target vascular remodeling, stent thrombosis, cardiac death, nonfatal myocardial infarction were the data collected.4. Data are presented as percentages for categorical variables, as mean ± standard deviation for normally distributed continuous variables. Categorical variables were compared using the χ2 test. Normally distributed continuous variables were compared using the t test. These analyses were performed using SPSS version 18.0 statistical software for Windows(SPSS, Chicago, Illinois, USA). p-values of <0.05 was considered statistically significantly.Results: The statistical difference in the baseline clinical information and angiography characteristics weren’t showed between the two groups(P>0.05). Compared with durable polymer drug eluting stents group, the incidence of cardiac mortality(2.5% vs 2.9%), nonfatal myocardial infarction rate(0.5% vs 1.0%), stent thrombosis rate(0.5% vs 0.6%), and the rate of target vessel reascularization(TVR)(4.6% vs 2.9%) weren’t significantly different in the two groups.Conclusion: The short-term effect and safety of biodegradable polymer drug eluting stents and durable polymer drug eluting stents in the treatment of coronary artery disease with multiple risk factors are similar.