Clinical follow up of patients with premature coronary artery disease (PCAD) implanted with drug-eluting stents

Xiaofeng Zhang, Yong Tang, Genshan Ma, Zhong Chen

Department of Cardiology, The Affiliated Nanjing Second Hospital of Southeast University, Nanjing, China.
Department of Cardiology, The Affiliated Zhongda Hospital and School of Medicine, Southeast University, Nanjing, China.

DOI: 10.4236/wjcd.2013.34052                

Abstract

Background: Drug-eluting stents (DESs) are associated with lower restenosis rates. However, minimal data on the follow up results of premature coronary artery disease (PCAD) treated with DESs exist. This study was to evaluate clinical characteristics and one- year prognosis of PCAD implanted with DESs in a Chinese population. Methods: 282 patients with PCAD, of which 177 implanted with DESs and 105 prescribed medicine alone were enrolled and analyzed. Major adverse cardiovascular events (MACEs) and the use of medications for secondary prevention were collected and analyzed. Results: Compared with those receiving medicine alone, patients implanted with DESs had higher ratios of males than females, they also had acute coronary syndromes, multi-vessel disease, higher values of cardiac troponin I, longer hospital stays, higher aspirin and clopidogrel use (all P < 0.05); though these patients had higher use of aspirin and clopidogrel in the hospital and during follow-up and higher β-blockers and statins use during follow-up, they had higher ratios of recurrent angina and composite MACEs during one-year follow- up (all P < 0.05). Logistic regression analyses showed that obesity (OR 1.757, 95% CI: 1.031 - 2.995), acute coronary syndrome (OR 1.716, 95% CI: 1.011 - 2.913) and reduced left ventricular ejection fraction (OR 2.539, 95% CI: 1.180 - 5.463) predict MACEs in a one-year follow-up among patients with PCAD. Conclusions: PCAD patients implanted with DESs have more unstable clinical phenotypes and higher MACEs during a one-year follow-up period, though they were prescribed higher ratios of optimal therapeutic medicine. Further enhanced strategies should be made for secondary prevention.

Keywords

Coronary Artery Disease; Optimal Medicine Therapy; Percutaneous Coronary Intervention; Secondary Prevention; Major Adverse Cardiac Events

Conflicts of Interest

The authors declare no conflicts of interest.

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