e0499 Long term clinical follow-up of patients with versus without overlapping drug eluting stents for long coronary lesions

Abstract

two groups according to left ventricle ejection fraction (LVEF) (N group: n¼4129, LVEF>40%; L group: n¼365, LVEF#40%). Results Patients in L group was younger (60.669.72 vs 65.2610.7 years; p<0.001). There was more previous myocardial infarction (MI) and diabetes and less hypertension and hyperlipidaemia in L group. Logistic regression analysis indicated that the age, previous MI, diabetes, previous PCI and hyperlipidaemia were independent indexes to left ventricle function of triple vessel disease. Eighty-three and 2301 patients in L and N group (22.7% and 55.7%, respectively) were treated with PCI. The follow-up period of L and N groups were 5816298 and 6396293 days, respectively. MACE rate was significantly high in L group (38.6% vs 18.9%; p<0.001), which was contributed by cardiac death, no fatal MI and TVR (9.6% vs 0.9%; p<0.001, 7.2% vs 2.0%; p<0.001 and 21.7% vs 16.0%; p¼0.173, respectively). There was no difference of total stent thrombosis or its components in both groups (total: 3.9% vs 3.5%; p¼1.000, early: 0.2% vs 0.9%; p¼0.256, late: 0.7% vs 1.3%; p¼0.404 and very late: 3.1% vs 1.3%; p¼0.201, respectively). Seven month Angiographic follow-up indicated that both in-stent and in-segment restenosis rate were significantly higher in L group (21.0% vs 11.1%; p¼0.034 and 24.0% vs 12.2%; p¼0.018). Conclusion This one center, large sample study showed clinical characteristics of ischaemic cardiomyopathy, MI and diabetes might contribute to its morbidity, and PCI might prevent its morbidity. PCI of patients with triple coronary arteries disease and impaired left ventricle (LV) function leaded to worse outcomes when compared with normal LV function. Objective To investigate the clinical safety and mid-and short-term efficacy of rapamycin eluting stent (Excel) in patients with coronary artery disease. Methods Between Jul. 2006 and Jun. 2009, 240 patients of coronary heart disease received percutaneous coronary intervention (PCI) with Excel stent and were followed up from 6 to 24 months for observing the incidence of angina pectoris, myocardial infarction, sudden death and revascularization. Results 327 pieces of Excel stent were implanted in 272 target lesions (269 with de novo and 3 of restenosis), but 2 cases failed due to seriously deformed middle anterior descending artery from calcification in 1 and the angle of middle circumflex branch larger than 90 degrees in another to prevent the passage. 325 pieces of stent were successfully implanted, and the postoperative follow-up in the 8 th to 18 th month showed that angina pectoris occurred in 5, restenosis in 2 and normal in 3 by coronary arteriongraphy, suspected thrombosis in 1 at the 5 th month after the operation regarding ventricular fibrillation, haemorrhage of upper digestive tract in 4 at the 6 th month of the intervention, in which 1 underwent inpatient therapy with blood transfusion. The postoperative major coronary adverse event accounted for 4.58% between 6 and 24 months. Conclusion Excel drug-eluting stent may be excellent in treatment of coron...