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Archive » 2009 » 3 » | Archive » Medical field » Fields » Internal Medicine »

Incidence of Major Adverse Cardiac Events after Bare Metal and Drug Eluting Stent Implantation

 
Abstract:

This post is also available in: English Slovenščina (Slovenian)

Percutaneous coronary intervention with stent implantation is the therapy of choice for the treatment of patients with decreased blood flow through the coronary arteries. According to the Taxus II-Trial definition, major adverse cardiac events include cardiac death, acute myocardial infarction and target vessel revascularization; the latter includes percutaneous coronary intervention with stent implantation or coronary artery bypass graft on the same, previously revascularized vessel. Our analysis compared two types of stents to find out which one is better in the prevention of major adverse cardiac events. Another objective was to ascer­tain whether the discontinuation of clopidogrel has any effects on the incidence of major adverse cardiac events after drug eluting stent implantation. This retrospective analysis includ­ed 461 consecutive patients who had bare metal stent or drug eluting stent implanted between the 29th of April 2005 and the 30th of November 2005. The necessary data on the patients and their medical histories were gathered at various internal medicine departments of the Ljubljana University Medical Center, while the remaining data were obtained from the patients themselves. The incidence of major adverse cardiac events was calculated for the period of the first six months after the implantation of bare metal stents or drug eluting stents and a comparison of the two groups was performed using the two-sided Pearson’s chi-square test. The incidence of major adverse cardiac events after the implantation of drug eluting stents before and after the discontinuation of therapy with clopidogrel was determined using the Kaplan-Meier cumulative survival curve. During the first six months after the implantation of drug eluting stents, the incidence of major adverse cardiac events was significantly lower (p < 0.05) compared to bare metal stents because major adverse cardiac events were present in 2.7% of patients from the group with drug eluting stents and in 17.6% of patients from 178 the group with bare metal stents. The most frequent subgroup of major adverse cardiac events present in the group with bare metal stents was cardiac death, and in the group with drug eluting stents it was repeated percutaneous coronary intervention with stent implantation. The incidence of major adverse cardiac events was not significantly higher six months after the discontinuation of therapy with clopidogrel or eighteen months after implantation of drug eluting stents, respectively(p = 0.20).

Authors:
Dobošek Darja, Butenko Tita, Zupan Igor

Keywords:
major adverse cardiac events, percutaneus coronary intervention, clopidogrel

Cite as:
Med Razgl. 2009; 48: 177–87.

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