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ABS20191030_0006
| Stents (bare-metal, drug-eluting) | |
| Polymer Free Drug-Eluting Stents Versus Durable Polymer Drug-Eluting Stents in Elective Percutaneous Coronary Interventions in Patients with Stable Coronary Artery Disease Patients | |
| Sherif Mohammad Aziz Altoukhy1, Ahmed Abdul Moneim Abdul Salam Rezq1, Basem Enany Basem Enany2, Walid Abdelazim Mohammad Elhamady1, Mohsen Fahmy Metwally1, Mohammad Awad Ahmed Taher1 | |
| Ainshams University, Egypt1, Castle Hill Hospital, United Kingdom2 | |
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Background:
The risk of restenosis is one of the most worrisome complications after drug eluting stents (DES). One of the suggested causes is the inflammatory response to the polymer in the DES. The aim of this study is to compare the inflammatory response of polymer-free versus permanent polymer drug-eluting stents in patients with stable coronary artery disease undergoing elective PCI, and the effect of this inflammatory response on the 6 month clinical outcomes.
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Methods:
This randomized prospective comparative study was conducted on 100 patients with stable coronary artery disease planned for elective PCI divided into 50 patients with deployed permanent polymer DES (PP-DES) groups and 50 patients with polymer free DES (PF-DES). Blood samples were taken to assess serum level of hs-CRP before the procedure and the first day after the procedure. The target end points were the recurrence of effort angina, incidence of target lesion revascularization (TLR) over a period of 6 months and the inflammatory response by measuring the percentage of rise in hs-CRP level.
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Results:
There was no statistically significant difference in the clinical outcome in the first six months between the patients who had PP-DES and the patients who had PF-DES regarding recurrence of effort angina (p-value = 0.822) and TLR (p-value = 0.727), with no patients developing myocardial infarction or stent thrombosis. There was a statistically significant inflammatory response after stent deployment in both groups represented by a significant rise in the serum level of hs-CRP on the first day after the procedure in both groups (p-value < 0.001), but there was no statistically significant difference in the inflammatory response between PP-DES and PF-DES (p-value = 0.978). The number of patients having recurrence of anginal symptoms and TLR with hs-CRP rise > 11.36% was higher than those having the same with hs-CRP < 11.36%. However, this difference was not statistically significant regarding recurrence of anginal symptoms (p = 0.057) and TLR (p = 0.092).
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Conclusion:
The PF-DES was proved to be non-inferior to PP-DES regarding the short-term clinical outcome and the early inflammatory response. It was concluded that the presence of polymeric coating in PP-DES did not add to the magnitude of the inflammatory response and it did not significantly increase the incidence of recurrence of anginal symptoms and TLR in this group of patients.
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