Percutaneous coronary intervention in diabetics versus non diabetics

This study was conducted to compare the clinical outcome of percutaneous coronary intervention [PCI] in diabetics versus non diabetics. The study involved fifty three patients, thirty diabetic patients and twenty three non diabetic patients as a control group. All patients were subjected to thorough history taking, physical examination, electrocardiography, routine laboratory work up and echocardiography pre-catheterization .Sixty-four stents were inserted, thirty-eight of them in diabetic patients and twenty six in the non -diabetic patients. All patients had coronary angiography pre immediately post stenting and at follow-up within 6 months and the diameter of the vessel was calculated before, immediately post and at follow up angiography. Also the time of inflation and the maximum pressure, stent diameter, type, and length of stents were recorded. Statistical analysis of the results of this study showed a significantly higher incidence of stent restenosis among diabetic group compared to non diabetic group. 14 patients in the diabetic group had stent restenosis versus 6 patients in non diabetic group [P<0.05]. Also, the incidence of stent restenosis was significantly higher among patients presenting with unstable angina, left ventricular dysfunction, IDDM, total coronary occlusion and those who experienced coronary dissection during PCI. At follow up Coronary angiography, the mean TIMI flow of non diabetic patients was 2.6 +/- 0.82 and for diabetic group was 2.17 +/- 1.2 and the difference was statistically significant [P < 0.05]. Regarding complications during PCI 3 patients [10%] in diabetic group had acute coronary occlusion versus non of the non diabetic group. The results showed that stent restenosis was significantly higher among diabetic patiens than non diabetics and the incidence of restenosis was particularly higher amonge diabetic patients having unstable angina, left ventricular dysfunctton, ZDDM, type B or C coronary lesions and those who experienced coronary dissection during PCI

Comparison of carbon ion implanted stent with bare metal stent in patients with coronary artery disease

This study was conducted to evaluate the role of the inert stents in decreasing the incidence of stent restenosis after percutaneous coronary intervention [PCI] and to assess the clinical outcome of these stents. The study comprised 57 patients [49 males and 8 females, mean age 53.3 +/- 0.9 years] with angiographically documented CAD. They were admitted to the Coronary care unit at Benha University Hospital and underwent stent implantation in 57 de novo lesions. Patients were categorized into two groups; group I for whom the traditional bare metal Stainless-steel stents were deployed [30 lesions in 30 pts; 26 M and 4 F with a mean age of 50 yrs], group II for whom Inert stents [carbon [on implanted stents] were deployed [27 lesions in 27 pts; 23 M and 4 F with a mean age of 51 yrs]. Procedural success: was defined as 30% residual stenosis post procedure. Clinical success: was defined as procedural success without the occurrence of MACE [Major Acquired Coronary Events] namely, death, myocardial infarction, or Target vessel revascularization].Clinical follow-up for the occurrence of MACE was performed one and six months after the procedure. Angiographic follow-up was done after six months or after the occurrence of any of the clinical endpoints. Procedural and clinical success were documented in 100% of patients during hospital stay, there was no MACE in both groups. None of patients developed MACE during the 30-days follow-up period. Also, at 6-months follow-up, there was no statistically significant difference between the 2 groups regarding the occurrence of MACE as 4 patients [13.3%] of group I and 3 patients [11.1%] of group II developed MACE. Re-stenosis rate showed also statistically insignificant difference between the 2 groups [5 patients [16.7%] in; group I and 5 [18.5%] patients in group II, [P= > 0.05]. The implantation of Inert stent is safe and feasible, with a high acute procedural success. These stents proved also favorable short term results regarding the thrombotic complication. Inert stent did not add any beneficial effect to the bare metal uncoated stainless-steel stents regarding 6-months in-stent restenosis