ABSTRACT
Aim of the study was to compare efficacy of sirolimus covered (116 patients, group 1) and bare (117 patients, group 2) stents. Groups were comparable according to main characteristics. Proportion of patients with diabetes was 19 and 13.7%, with multivessel lesions--87.1 and 80.4%, with arterial diameter <2.75 mm--46.5 and 23.9% in group 1 and 2, respectively. Lesion length was 25.9+/-6.6 mm (28-93 mm) in group 1 and 22.1+/-7.8 mm (26-102 mm) in group 2. Overall 473 stents were implanted into 232 arteries (2.1 per artery). In group 1 184 stents were implanted in 116 arteries, in group 2--289 stents in 117 arteries. Immediate success rate was 97.4 and 99.1% in groups 1 and 2, respectively (p=0.74). There were no cases of acute stent thrombosis. Subacute thrombosis (after 1-3 weeks) occurred in 2 patients (1.7%) of group 1 and in 1 patient (0.85%) of group 2 (p=0.47). Angiographic restenosis was observed in 12 (10.6%) and 66 (56.9%) patients in groups 1 and 2, respectively (p<0.0025). In 47 of 66 patients (71.2%) in group 2 restenosis was diffuse. There was no case of diffuse restenosis in group 1. Twelve months survival without angina and major coronary events was 79.8% in group 1 and 31%--in group 2.
Subject(s)
Blood Vessel Prosthesis Implantation/instrumentation , Coated Materials, Biocompatible , Coronary Artery Disease/surgery , Immunosuppressive Agents/pharmacology , Sirolimus/pharmacology , Stents , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Coronary Restenosis/prevention & control , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
Immediate and long term results of 2 methods of coronary angioplasty (balloon dilatation and stenting) were analyzed retrospectively. During 10 years proportion of stent implantations increased 30-fold reaching 95-97% of coronary interventions. This was associated with improvement of immediate results of angioplasty: lowered rates of myocardial infarctions, urgent coronary artery bypass graftings and acute coronary artery occlusions (from 2.7% after balloon angioplasty to 0.6% after stenting). Improved long-term prognosis after stenting manifested in lower frequency of cardiovascular events. Five year survival was 98,8 and 92.7% after stenting and balloon angioplasty, respectively (p=0.004). However effect of stenting on rates of angiographic restenosis and repeat revascularizations was less pronounced (27.1 and 30.4%, respectively, after stenting vs. 30.1 and 34.5%, respectively, after balloon angioplasty).
