The Application Of Endeavor Resolute Stents Versus Xience V Stents In Unstable Angina Pectoris Patients With Small Vessels And Long Lesions

Objective： To research the safety and efficacy between EndeavorResolute stents and Xience V stents in Unstable Angina Pectoris patients withsmall vessels and long lesions.Method: During September2010and September2012, a total of107unstable angina pectoris patients treated with percutaneous coronaryintervention were selected. Patients were randomly divided into two groups:Endeavor Resolute group(52patients) and Xience V group(55patients).Inclusion criteria:①Indication for use of DES based on NVVC and ESCguidelines and/or clinical judgment of interventional cardiologist;②Age≥18years and mentally capable to provide informed consent and Signed informedconsent;③Define the ends of target lesion at the reference vessel diameter≤2.75mm as the small vessel standard (any target vessel diameter≤2.75mm),and target lesion length≥30mm as the long lesions standard.④Patients withmuti-vessel lesion and met the inclusion criteria, calculation the arithmeticmean of the lesion number. Exclusion criteria:①ST-elevation myocardialinfarction (STEMI) or STEMI;②Planned staged revascularisationprocedure(include PCI and/or CABG)；③Renal failure requiringhaemodialysis；④Current participation in investigational drug or devicestudy；⑤Comorbidity or condition that could in the investigators opinion，would limit the patient’s ability to participate in the study，to comply withfollow-up requirements or could impact the scientific integrity of the study；⑥Life expectancy <1year；⑦If the choice of DES type is dictated by logisticreasons(e.g, if a DES with the required dimensions is provided by only onemanufacturer)；⑧Left main stenosis. According to the coronary angiographyresults of the two groups, we used balloon dilation. After TIMI blood flow≥ Ⅱ level, we implanted the appropriate stent. Balloon expanded should at atime intraoperation. Multiple position angiography was performed afterreceived the satisfactory results. We mainly observed the following indicators:Surgical success indicators: post-PCI TIMI flow grade,corrected TIMI framecount (CTFC), etc.; Postoperative safety indicators: We use major adversecardiac events(MACE, including cardiac death, non-fatal myocardialinfarction, revascularization, hospitalization required angina) as the endpointof the study; Postoperative indicators of efficacy, including target lesionrevascularization (TLR) and target vessel revascularization (TVR). In-stentlate lumen loss (LLL), segment late lumen loss (LLL), in-stent minimumlumen diameter (MLD), segment (within5mm on both ends) minimum lumendiameter (MLD) were used as alternative indicators of efficacy; compositeindicators: target lesion failure rate (TLF, including cardiac death, target vesselmyocardial infarction and target lesion revascularization). Date werestatistically analyed by SPSS13.0software, all the indicators were proceednormality test. Non-normal distribution data (e.g. triglycerides) weretransformed into natural logarithm to approximate normal distribution beforestatistical analysis.(To make the result simply, the original data were used).Continuous variables were presented as mean±standard deviation, andcategorical were presented as percentile. Date were compared by t-test orchi-squared test. A two-tailed p＜0.05was considered as statisticallysignificant.Results: The general materials of the two groups in age, gender, smoking,hypertension, diabetes, hyperlipidemia, cerebral vascular disease, criminal siteof vascular stenosis lesions, average MLD, average reference vessel diameter,average target lesion length, average number of stents, average stents diameter,length of stents, interventional operation success rate were unsignificance(P>0.05). The TIMI flow grade of postoperative at level III, corrected TIMIframe count had no significant difference between Endeavor Resolute groupand Xience V group (92.31%vs.94.54%,28.35±11.59vs.29.65±12.39, p>0.05); The hospitalization major adverse cardiac events of Endeavor Resolute group compared with Xience V group had no significant difference (7.69%vs.5.45%, p>0.05); we performed Coronary angiography at the6th month，in-stent minimum lumen diameter、In-segment minimum lumen diameter、In-stent late lumen loss、In-segment late lumen loss,TLF,TVR between thetwo groups had no significant difference (2.75±0.19mm vs.2.74±0.20mm,2.68±0.23mm vs.2.69±0.19mm,0.03±0.17mm vs.0.04±0.15mm,0.08±0.14mm vs.0.10±0.19mm, p>0.05); Followed up for6months,non-fatal myocardial infarction, cardiac death, TLR, TVR, angina requiringhospitalization had no significant difference (1.92%vs.1.82%,1.92%vs.0.00,1.92%vs.3.64%,3.85%vs.3.64%,13.46%vs.14.55%, p>0.05)；TLF alsohad no significant difference（9.62%vs.5.46%，p＞0.05）。Conclusion: The application of Endeavor Resolute and Xience Vdrug-eluting stents in unstable angina pectoris patients with small vessels andlong lesions was safe and effective, improved the quality of life and theshort-term prognosis of the patients.