Domestic versus imported drug-eluting stents for the treatment of patients with acute coronary syndrome

Abstract

BACKGROUND:The application of coronary stents, especially drug-eluting stents (DESs), has made percutaneous coronary intervention (PCI) one of important therapeutic methods for CHD. DES has reduced the in-stent restenosis to 5%-9% and signifi cantly improved the long-term prognosis of patients with CHD. The study aimed to investigate the long-term effi cacy and safety of domestic drugeluting stents (DESs) in patients with acute coronary syndrome (ACS).METHODS: All patients with ACS who had undergone successful percutaneous coronary intervention (PCI) in the First Affi liated Hospital of Zhengzhou University from July 2009 to December 2010 were included in this study. Patients were excluded from the study if they were implanted with bare metal stents or different stents (domestic and imported DESs) simultaneously. The included patients were divided into two groups according to different stents implanted: domestic DESs and imported DESs. RESULTS:In the 1 683 patients of this study, 1 558 (92.6%) patients were followed up successfully for an average of (29.1±5.9) months. 130 (8.3%) patients had major adverse cardiovascular events (MACEs), including cardiac death in 32 (2.1%) patients, recurrent myocardial infarction in 16 (1%), and revascularization in 94 (6%). The rates of cardiac death, recurrent myocardial infarction, revascularization, in-stent restenosis, stent thrombosis and other MACEs were not signifi cantly different between the two groups (all P>0.05). Multivarite logistic regression revealed that diabetes mellitus (OR=1.75, 95%CI: 1.09-2.82, P=0.021), vascular numbers of PCI (OR=2.16, P=0.09) and PCI with left main lesion (OR=9.47, P=0.01) were independent prognostic factors of MACEs. The Kaplan-Meier method revealed that there was no significant difference in cumulative survival rates and survival rates free from clinical events between the two groups (all P>0.05). CONCLUSIONS:The incidences of clinical events and cumulative survival rates are not statistically different between domestic DESs and imported DESs. Domestic DES is effective and safe in the treatment of patients with ACS.

The association between an endothelial nitric oxide synthase gene polymorphism and coronary heart disease in young people and the underlying mechanism

“…With the improvement of the living standards, the incidence and mortality rates of CHD has increased rapidly, particularly within young people (≤40 years old) in China (2,3). The earlier incidence of CHD is not only threat to human health, but may burden a patient's families and society; CHD has gained increasing attention of researchers (4). It is well-known that smoking, drinking, obesity, hypertension and metabolic syndrome are risk factors for CHD.…”