The Comparative Analysis Of The Prognosis Of Patients Of Acute Coronary Syndrome With Different Kinds Of Drug-Eluting Stents

Objective:To give clinical evidence for choosing correctly drug-eluting stents by comparativly analysis the validity and security of ACS patients with different drug-eluting stents,as well as to get a better clinical curative effect by research on the risk factors of patients who occured MACE after PCI.Methods:Chose 564 ACS patients who did PCI in Zhongshan Hospital from 2005.1～2007.1.(1) Devided the patients to Cypher support group(n=320) and Taxus support group(n=204).By clinical observed,phone call contacted and case form filled in,compared the general conditions,PCI information,MACE happened,callback information before/during/after the PCI operation.The observation end-point was the happening of MACE,including death,the cardiac arrest,the target lesion revascularization,the target vessel revascularization and the blood circulation reconstruction.(2) Devided the patients to Cypher support group(n=320) and Excel support group(n=40),the method and the observation standard was the same as part one.(3) Devided the patients to MACE occurred group(n=72) and no-MACE occurred group(n=413),analysised the patients｀general conditions,PCI informations,et al.to get the risk factors of MACE after PCI.Results:(1) Two groups of ordinary circumstances contrasts,target blood vessel characteristic,average target blood vessel diameter,average target pathological change,et al,P value＞0.05,statistics no discrepancy.The occurrence of blooding, arrhythmia and MACE(death,cardiac arrest,the target lesion revascularization and the target vessel revascularization) of Cypher support group compare to the Taxus support group,P value＞0.05,statistics no discrepancy during the hopital period.The MACE occurrence was increasing during the 6 months and 12 months after PCI..Tthe whole occurrence of MACE of the Cypher support group was showed statistics no discrepancy(P=0.082) compared to the Taxus support group both in 6 months and in 12 month,while the Cypher support group's cardiac arrest rate was evidently reduced compared to the Taxus support group(1.28%vs 4.52%,P=0.023,1.99%vs 7.06%,P=0.005),statistics discrepancy.(2) The ordinary circumstances contrasts, target blood vessel characteristic,average target blood vessel diameter,average target pathological change of the traditional Cypher sirolimus drug-eluting stent group (n=320) and the new pattern Excel biodegradable stent group(n=40),P value＞0.05, statistics no discrepancy.The occurrence of blooding,arrhythmia,MACE(death, target vessel revasculafization,target lesstion revascularization,cardiac arrest),P value＞0.05,statistics no discrepancy during the hopital period,as well as the 6 and 12 months after PCI.(3)The sex,hyperlipidemia,smoke,family history,stroke history and the heart function before PCI operation,P value＞0.05,statistics no discrepancy in MACE group compared to no-MACE group,while the age(66.43±10.12 vs 63.63±10.40,P=0.035),diabetes(31/72,43.06%vs 57/413,21.07%,P=0.001),insulin dependeut(12/72,19.45%vs 19/413,4.6%,P=0.031),hypertension(34/72,47.22% vs 156/413,37.77%,P=0.011),the steut number posted in and the stent whole length, P value＞0.05,statistics discrepancy.Also took these parameters into poly-factors analysis which showed diabetes(P=0.001,OR=6.25),hypertension(P=0.011, OR=2.13),age＞75(P=0.032,OR=1.24),and the number of posting stent in(＞2, P=0.048,OR=1.11),P value＜0.05,statistics discrepancy.Conclusion:(1)The sirolimus drug-eluting stent had advantage in reducing cardiac arrest after PCI compared to the paclitaxcel drug-eluting steut while the whole MACE occurrence rate was statistics no discrepancy in two groups.The research could not give enough evidence to show the sirolimus stent was better than the paclitaxel steut by the MACE occurrence rate.(2) In our research,the new pattern Excel biodegradable stent compared to the traditonal sirolimus drug-eluting steut,P value＞0.05,had no advantage in reducing MACE occurrence after the PCI.The validity and security between the two groups had no statistics discrepancy.(3) Diabetes,hypertension,Age, and the number of posting steut in were showed related with the MACE occurrence after PCI,P＜0.05,statistics discrepancy.