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Biodegradable Polymer Vs Non-biodegradable Polymer Drug-eluting Stent in the Treatment of Acute Stemi: a Comparative Effectiveness Research

Author: WangLin
Tutor: QuPeng
School: Dalian Medical University
Course: Internal Medicine
Keywords: sirolimus biodegradable polymer percutaneous coronary intervention antiplatelet
CLC: R541.4
Type: Master's thesis
Year: 2013
Downloads: 9
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Abstract


Objectives: To make a comparative effectiveness research in acute STEMI onusing two different kinds of stents: China-made biodegradable polymersirolimus-eluting stent (Excel) and non-biodegradable polymer sirolimus-eluting stent(Partner).Methods: All290hospitalized patients of the2nd Affiliated Hospital of DalianMedical University with Acute ST-Elevation Myocardial Infarction who were due toundergo PCI are randomly divided into two groups: Biodegradable drug-eluting stents(Excel group) and non-Biodegradable drug-eluting stents (Partner group). Aftersuccessful Percutaneous Coronary Intervention both group receive aspirin100mg,clopidogrel75mg, low molecular heparin and statins. Compare baseline data, cardiacuhrasonography date, target vessel and stents’ information. Both groups were followedfor a period of12to70months post-stenting by outpatient and inpatient service ortelephone. The primary end point of the study was the incidence of Major AdverseCardiovascular Events (including cardiac death, non-fotal myocardial infarction, stentthrombosis and TVR) survival time and cardiac function.Results: All290patients had a successful stent implantation of either Excel orPartner and they were grouped respectively (Excel group n=145and Partner groupn=145). There was no significant difference in terms of age, sex, height, weight,presence or absence of hypertension, diabetes mellitus, hyperlipidemia, preoperativeserum creatinine, blood lipids levels, fasting blood sugar levels, cardiac function andstructure in acute MI period and target lesion. During the follow-up period (12to70months) the Excel group lost6patients (4.1%,4/145) and the Partner group lost7patients (4.8%,7/145). The incidence of MACE in the Excel group was19patients andin the Partner group was18patients out of which cardiac death took8patients (5.5%) inthe Excel group and8patients (5.5%) in the Partner group; Non-fatal myocardial infarction affected7patients (4.8%) in Excel group and9patients (6.2%) in Partnergroup (p=0.607); Target Vessel Revascularisation: the Excel group had4patients (2.7%)and Partner group4patients (2.7%). Definite stent thrombosis: the Excel group had1patients（0.7%）, Partner group3patients（2.1%）; sub-Acute stent thrombosis: Excelgroup had1patient（0.7%）, Partner group had no one.Excel group is better than Partner group in cardiac function improvement. Survivaltime between the two groups: Excel group:65.65±1.51months; and Partner group:65.73±1.47months, χ2=0.047（p=0.828>0.05）; non-MACE survival time: Excelgroup:60.25±2.07months; Partner group:61.45±1.91months, χ2=0.23(p=0.630); nostent thrombus time: Excel group:68.96±0.73months; Partner group:68.22±1.04,χ2=0.243（p=0.622）.Conclusion: The results from this study show that China-made biodegradablepolymer drug-eluting stents Excel and non-biodegradable polymer drug-eluting stentsPartner have similar MACE incidence in acute ST-segment elevation myocardialinfarction treated by PCI. In very late stent thrombosis, Partner stent has a higher trend.Primary PCI with Excel stent in acute ST-segment elevation myocardial infarction canremarkably improve cardiac function.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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