The Long-term Efficiency And Safety Of Drug-eluting Stents In Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Objective Drug-eluting stents decrease late luminal loss and angiographic restenosis significantly, while the safety of drug-eluting stents has been called into question by recent reports of increased stent thrombosis, myocardial infarction and death in clinical practice. The goals of our study were to determine the long-term efficiency and safety of drug-eluting stents in patients with coronary artery disease undergoing percutaneous coronary intervention.Methods A total of 346 patients with coronary artery disease undergoing drug-eluting stents were retrospectively studied in Department of Cardiology of Huashan Hospital from November 2003 to December 2006. Overall clinical data (15-52 months) were generally obtained to assess the clinical efficiency and major adverse cardiac events (MACE) including cardiac deaths, non-fatal myocardial infarction and target vessel revascularization (TVR) as well as other adverse events such as stroke and major bleeding after percutaneous coronary intervention. Clinic follow-up in-stent restenosis(ISR), late stent thrombosis and stent aneurysm of target vessel were were analysed by coronary angiography again in 72 patients.Results 346 patients with CHD patients were treated with 674 drug-eluting stents by means of percutaneous coronary intervention successfully. After percutaneous coronary intervention, the symptom remission and clinical improvement were 207 and 109 patients respectively, so the total effective rate of PCI was 91. 3%. The overall rate of major adverse cardiac events (MACE) during hospitalization was 0.9% (3/346) , while the long-term follow-up study was 3. 7% (11/346) . The rate of late stent thrombosis (1/132) and stent aneurysm of target vessel (1/132) were analysed by coronary angiography again in 72 patients. The restenosis rate of DES was 4. 5% (6/132) , then four DES were implanted in the target vessel according to standard procedure. Hemorrhagic complications(37/346) and leukocytopenia(2/346) were observed duringprolonged dual antiplatelet therapy.Conclusion Drug-eluting stents in patients with coronary artery diseaseis relatively safe and provide good long-term efficacy. The incidence ofMACE and ISR is low,which contributed to the marked benefit ofdrug-eluting stents in reducing the need for subsequent revascularizationprocedures. Additional data with longer follow up and in high riskpopulations are needed to clarify issues on stent thrombosis because ofthe limitations of our small sample size.