Comparative Study Of Polymer Free And Biodegradable Polymer Drug Eluting Stents

Objectives The present study aimed to evaluate the safety and efficacy of polymer free paclitaxel-eluting stents(YINLONG stent)in comparison with biodegradable polymer sirolimus-eluting stent(EXCEL)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 169 patients with STEMI hospitalized in Department of Cardiology of Tang Shan Gong Ren Hospital within October 2013 to October 2015 who successfully underwent emergency PCI treatment and single brand stent implantation,according to the principle of random distribution and the different type of stent implantation,86 cases were divided into YINLONG group(the actual stent implantation was 111),83 cases were divided into EXCEL group(the actual stent implantation was 106).The two groups were observed and compared with the basic clinical situation and characteristics of coronary artery lesions,the basic technical indexes and the interventional perioperative situation,follow-up was started immediately following DES implantation and up to 12 mouths after implantation by regular telephone or clinical appointment.The primary endpoints were major adverse cardiovascular events(MACE)such as cardiac death,nonfatal myocardial infarction,target vessel revascularization(including reintervention or coronary artery bypass grafting).Secondary end points were all-cause mortality,stent thrombosis,rehospitalization,bleeding events.All clinical and follow-up data were analyzed with software SPSS 17.0.Continuous variables and categorical variables were respectively expressed as mean±standard deviation(SD)and percentage,Continuous variables using Student's t test and categorical variables using chi square test or Fisher's test to analyze the difference between the two groups,the P value less than 0.05 was defined as the difference was statistically significant.Results The general condition such as age,sex,body mass index,hyperlipidemia,hypertension,diabetes,smoking history,family history of coronary heart,etc.There were no statistically significant differences between the groups(P < 0.05).86 patients were included in the YINLONG group(111 stents were implanted actually),the average number of stent implanted were 1.29±0.37,the average stent diameter were 3.19±0.46 mm,the average length of stent were 22.10±4.55 mm.83 patients were included in the EXCELgroup(106 stents were implanted actually),the average number of stent implanted were1.28±0.51,the average stent diameter were 3.21±0.51 mm,the average length of stent were 23.28±5.70 mm.There was no significant difference between the two groups in the distribution of coronary artery lesions and stent implantation(P > 0.05).Clinical followup of 1 years in YINLONG group,Major adverse cardiovascular events occurred in 5patients(5.81%),1 cases of cardiac death(1.16%),2 cases of non fatal myocardial infarction(2.33%),3 cases of target vessel revascularization(3.49%);All cause death in 2patients(2.33%);The total number of stent thrombosis events was 1(1.16%);The total number of rehospitalization was 10(11.63%);The total number of bleeding events occurred in 9 patients(10.47%).Clinical follow-up of 1 years in EXCEL group,Major adverse cardiovascular events occurred in 4 patients(4.82%),1 cases of cardiac death(1.20%),1 cases of non fatal myocardial infarction(1.20%),2 cases of target vessel revascularization(2.41%);All cause death in 1 patients(1.20%);The total number of stent thrombosis events was 1(1.16%);The total number of rehospitalization was 8(9.64%);The total number of bleeding events occurred in 7 patients(8.43%).However,there was no significant difference in the incidence of clinical events between the two groups(P >0.05).Conclusions 1 There was no significant difference in the MACE event,TVR,cardiac death,nonfatal myocardial infarction between two groups in patients with STEMI who recept emergency PCI treatment.2 There was no significant difference in stent thrombosis,hospitalization rates and bleeding events between the YINLONG and EXCEL group in 1years.3 In this single center,randomized study,the safety and effectiveness between two groups are quite the same in STEMI patients who recept emergency PCI,It is necessary for longer clinical follow-up.