The Clinical Contrast Investigation Of Second-generation Drug-eluting Stent In Patients With Coronary Heart Disease

Objective: This study sought to compare the clinical effect of the secondgeneration drug-eluting stents Endeavor and Xience in the treatment ofcoronary heart disease; evaluate the safety and effectiveness of the secondgeneration drug-eluting stent by contrasting with the first generationdrug-eluting stent Partner.Methods: From June2010to June2011,156patients according with theresearch standard underwent PCI,from the Department of Cadiology,the2ndhospital of Hebei Medical University,were randomly divided into Endeavoegroup（n=56）,Xience group（n=46）and Parter group（n=54）by the differentdrug eluting stents palnted.PCI were performed with the standardprocedure.Compare the general clinical information,the results of CAG andPCI,economic cost of the3groups. All of the patients were followed up after1month,6months and at the end of the following up.And the contents offollow-up include:MACE, recurrence of angina pectoris, the lumen loss ofstent, in-stent restenosis and stent thrombosis.Results: after statistics analysis, among3groups there were nosignificant difference in general clinical information and angiographiccharacteristics（P＞0.05）. There were8（14.3%）,12（26.1%）,20（33.3%）patients in3groups of IRA （infarction related artery）type B2and thedifference was significant （P=0.024）.The rest of IRA types were similar（P＞0.05）. Characteristics of the target vessels and stents planted in the3groupswere similar too（P＞0.05）.TIMI flow in3groups were simila before PCI andall of the patients’ TIMI flow grade after PCI were TIMI3.There were noacute thrombosis at that moment.143of the patients were followed-up,meanrate of follow-up was91.7%,and there were no significant difference in3groups （92.9%vs84.8%vs96.3%,P＞0.05）. After1month of the operation,there were no death in3groups and1patient in Partner group gotnonlethal MI.There were1（1.9%），2（5.1%）,3（5.8%）patients in3groupsgot lightened angina,P=0.585.Rate of MACE in3groups were no signicantdifference（P=0.139）.After6months of the operation,1patient died of acutecerebrovascular disease in Endeavor group,1patient die of cadiac suddendeath in Xience group and2patients died in Partner group,one died of lethalMI and the other one died of severe heart failture.The rate of angina andMACE in3groups were no signicant difference（P＞0.05）.At the end of thefollow-up, cardiac motality in3groups were no signicant difference（P=0.224）. There were9（17.3%），10（25.6%）,12（23.1%） patients in3groups got lightened angina,P=0.605. One patient of Partner group gotTLR,and it didn’t occurred in the rest2group（sP=0.414）. Rate of MACE andnonlethal MI in3groups were no signicant difference （P＞0.05）.Butbetween the groups of Endeavor and Partner,it had signicant difference inMACE（P=0.038）. There were9（16.1%），8（17.4%）,8（14.8%） patientsin3groups got followed-up by CAG or CT.Only2patients in Partner groupwere varified the lumen loss of stent and one of them got TLR.There were nosignicant difference in3groups（P＞0.05）.The total cost in hospital and thecost of operation in3groups were no signicat difference. But between the2groups of Xience and Partner,it had signicant difference（P=0.036）.Conclusion: the second generation DES Endeavor and Xience is safe andeffective in the treatment of percutaneous coronary intervention; The secondgeneration DES Endeavor and Xience have similar effect with the firstgeneration DES in the early and middle period after PCI; but Endeavor andXience have lower rate of MACE and TLR.