Adnan Yasir, Noor Lubna, Dar Muhammad Habeel, Ali Umair, Hafizullah Muhammad
Dr. Yasir Adnan, FCPS Cardiology, Department of Cardiology, Police and Services Hospital, Peshawar, Pakistan.
Dr. Lubna Noor, FCPS Cardiology, Department of Cardiology, Lady Reading Hospital, Peshawar, Pakistan.
Pak J Med Sci. 2017 Jul-Aug;33(4):959-962. doi: 10.12669/pjms.334.13068.
BACKGROUND & OBJECTIVE: The risk of restenosis and other adverse cardiovascular events with bare-metal stents have increased with smaller stent diameters and longer stent lengths. However, the exact impact of stent size on the short-term outcomes of drug-eluting stent (DES) implantations has not been much classified in Pakistani population. This study was designed to evaluate the impact of size (length and diameter) of Drug Eluting Stents on Clinical outcomes in patient with stable coronary artery disease at three months of implantation in Pakistani Population.
This is a prospective study which was carried out in the Department of Cardiology, Lady Reading Hospital Peshawar from April 2011 and July 2012. All consecutive patients with stable coronary disease undergoing Percutaneous Intervention (PCI) with DES implantation at Cardiology Unit Lady Reading Hospital, were included prospectively. Clinical outcomes (Myocardial infarction [MI], unstable angina[UA], and positive ETT) at three months stratified by 3 tertiles of stent length and diameter each, were measured in patients who underwent PCI with DES for coronary artery lesions. All patients were followed and reassessed after three months from the index procedure. Exercise Tolerance Test(ETT) was performed on every patient and recorded on proforma. Data analysis was done using SPSS software version 16.
A total of 376 patients were included prospectively in this study. The mean age was 57±9.313 years. Male patients were 271(72.1%). Mean length of drug eluting stent was 27.313±7.235 mm while mean diameter of stent was 2.90±0.2483mm. There were slightly higher rates of MI, U.A and positive ETT in the longest stent length tertile(>28mm) compared with the shortest stent length tertile (<22mm) at three months, but they were statistically not significant. We also observed that for DES, there was no clear relationship between stent diameter and outcome for any of the clinical outcome variables.
In our single-center prospective study, stent length and diameter defined in tertiles, had no impact on the short-term clinical outcomes of DES in patients with stable coronary artery disease.
裸金属支架再狭窄及其他心血管不良事件的风险会随着支架直径变小和长度增加而上升。然而，在巴基斯坦人群中，支架尺寸对药物洗脱支架（DES）植入短期疗效的确切影响尚未得到充分分类研究。本研究旨在评估在巴基斯坦人群中，药物洗脱支架的尺寸（长度和直径）对稳定型冠状动脉疾病患者植入三个月后的临床疗效的影响。
这是一项前瞻性研究，于2011年4月至2012年7月在白沙瓦市莱迪·里德医院心脏病科开展。所有在莱迪·里德医院心脏病科接受DES植入经皮冠状动脉介入治疗（PCI）的连续稳定型冠心病患者均被前瞻性纳入研究。对因冠状动脉病变接受DES植入PCI治疗的患者，按支架长度和直径的三分位数分层，测量三个月时的临床疗效（心肌梗死[MI]、不稳定型心绞痛[UA]和运动平板试验阳性）。所有患者在索引手术三个月后进行随访和重新评估。对每位患者进行运动耐量试验（ETT）并记录在表格上。使用SPSS软件16版进行数据分析。
本研究共前瞻性纳入376例患者。平均年龄为57±9.313岁。男性患者271例（72.1%）。药物洗脱支架的平均长度为27.313±7.235毫米，而支架的平均直径为2.90±0.2483毫米。在三个月时，最长支架长度三分位数组（>28毫米）的MI、UA和运动平板试验阳性率略高于最短支架长度三分位数组（<22毫米），但差异无统计学意义。我们还观察到，对于DES，任何临床疗效变量的支架直径与疗效之间均无明确关系。
在我们的单中心前瞻性研究中，按三分位数定义的支架长度和直径对稳定型冠状动脉疾病患者DES的短期临床疗效无影响。
