The comparison of clinical outcomes of the first and the second-generation drug-eluting stents implanted in vein grafts after coronary artery bypass graft
- VernacularTitle:冠状动脉旁路移植术后静脉移植血管内植入 两代药物支架的临床结局比较
- Author:
Xiao-wei LI
1
Author Information
1. Department of CCU, Tianjin Chest Hospital, Tianjin Cardiovascular Diseases Institute, Tianjin 300222, China
- Publication Type:Journal Article
- Keywords:
saphenous vein graft;
major adverse cardiac events;
coronary artery bypass graft;
drug eluting stent
- From:
Tianjin Medical Journal
2018;46(9):947-951
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical outcomes of the first and the second-generation drug-eluting stents
(DES) implanted in saphenous vein grafts (SVG) in patients after coronary artery bypass graft (CABG). Methods A total of
108 patients with coronary angiography and DES implanting in SVG due to ischemia symptoms after CABG were collected in
this study, including 69 patients with the first-generation of DES (drug-eluting: sirolimus) and 39 patients with the secondgeneration
of DES (drug-eluting: zotarolimus or everolimus). The success rate of stents and mortality in hospital were
compared between two groups of patients. The major adverse cardiac events (MACE), such as all-cause death, target vessel
revascularization (TVR) and acute myocardial infarction (AMI) in 2-year follow-up were also compared between the two
groups of patients. The survival curve was drawn by Kaplan-Meier method, and the MACE free survival rates of two groups of
patients were compared. Cox regression analysis was used to evaluate the risk factors for MACE in patients with SVG stent
implantation. Results There were no significant differences in the success rate of stents and mortality in hospital between
the two groups. In average 2-year follow-up, a total of 37 cases of MACE were performed. There was no statistical difference
in the incidence of MACE between the two groups (34.8% vs. 33.3%, P＞0.05). The proportion of TVR was significantly
lower in the second-generation group than that of the first-generation group (13.0% vs. 2.6%, P＜0.05). Kaplan-Meier
survival analysis showed that there were no statistically differences in the survival rates of no-cumulative events between the
two groups (81.2% vs. 79.5%, Log-rank χ2=0.029, P＞0.05). COX regression analysis showed that diabetes (HR=2.530, 95%
CI: 1.008-6.345, P=0.041) and stent diameter (HR=1.143, 95% CI: 1.043-1.253, P=0.004) were independent predictors for
the MACE in patients implanted stents in SVG. Conclusion There are no significant differences in mortality in hospital
and the MACE in 2-year follow-up between the patients of two generations of DES implanting in the SVG after coronary
artery bypass grafting. The proportion of TVR is lower in the second-generation DES group. Patients with diabetes and large
diameter stents have a poor prognosis.
