Role of BMS in Des ERA

Abstract

BACKGROUND: DES has gained significant importance in coronary interventions due to its superiority of decrease in target vessel revascularization when compared to BMS. In this DES era , we want to study the role of BMS as it is more economical . MATERIAL AND METHODS: We have analyzed acute coronary syndrome (ACS) and chronic stable angina patients who underwent BMS implantation between January 2011 to March 2011 under government health scheme of Andhra Pradesh. RESULTS: We retrospectively analyzed the cardiac events in 4181 BMS implanted patients. 1938 (46.4%) patients were followed for 365 days. More men than women with 40 to 69 years were there. ST elevation MI was the common presenting symptom in 1902patients(45.49% ). 1881 patients (44.98%) were diabetic. Single vessel disease was more common 2522(60.32%) ,Multivessel disease was seen in 210 patients (5.02%).LAD being the common vessel involved followed by RCA. Primary PCI was done in 320 patients(7.65%). Out of 4181 patients , 9366 lesions were stented with BMS , stainless steel BMS was used in 4988(53.26%) and cobalt chromium BMS was used in 4378 (46.74%) patients. Out of 4181 patients ,1938 patients (46.4%) were followed up of 1yr, post PCI 686 (35.4%) patients had worsening angina, 226(11.66%) patients had worsening heart failure, 17 (0.88%)patients had repeat STEMI, 11(0.56%)patients had repeat NSTEMI, 16(0.82%) patients had subacute stent thrombosis, 27(1.39%) patients developed late stent thrombosis, 51 patients (2.63%)underwent repeat target vessel revascularization(TVR). 52 (2.68%)patients died due to cardiac cause with in one year of follow up . CONCLUSIONS: Our study show that even in present era of DES , BMS implantation is effective and associated with less mortality and less stent thrombosis and less chances of target vessel revascularization with the limitations (as it was telephonic follow up).