Arch Hellen Med, 29(4), July-August 2012, 468-476
Angioplasty with bare metal stent or drug eluting stent:
C. Mallios,1 E. Panagouli,2 I. Donta,3 T. Troupis,2 A. Spanos,4 D. Venieratos2
OBJECTIVE Cardiovascular diseases are presently the prime cause of mortality. Percutaneous coronary intervention (PCI), aided by the use of intravascular prostheses, such as drug-eluting stents (DES) and bare metal stents (BMS), is a significant innovation in the treatment of coronary disease. The goal of this study was comparison between these two types of stent, DES and BMS, regarding the rates of stent restenosis and its correlation with factors predisposing to atheromatous lesions and vascular stenosis.
METHOD The study sample was recruited from the population of patients suffering from coronary disease who underwent DES and BMS stent angioplasty in the First Cardiology Clinic of the Hellenic Naval Hospital of Athens during the period between June 2005 and June 2010. The patients who suffered restenosis within the first 3−6 months post-angioplasty were selected from the total pool of patients.
RESULTS In total, 57 patients presented restenosis (51 males and 6 females), of whom 37 had DES and 20 BMS. Patients with BMS (8 of 20, 40%) presented a higher restenosis incidence at 3 months than those with DES (11/37, 29.7%), but this difference was not statistically significant (p>0.05, p=0.432). Obese persons with BMS had a greater rate of restenosis (9/20, 45%) while persons with DES and a family history of coronary disease presented lower restenosis rates at 3 months than at 6 months. Average blood levels of total cholesterol, triglycerides, C-reactive protein (CRP) and LDL at the time of restenosis were higher in persons with DES with restenosis at 3 months than those with restenosis at 6 months. The circumflex artery was found to be significantly more frequently affected by restenosis at 6 months than at 3 months. The stent was also significantly more frequently subject to distal restenosis at 3 months than at 6 months, and such restenosis occurred more frequently in DES than in BMS.
CONCLUSIONS According to this study BMS presented earlier restenosis, at 3 months, compared with DES. Among predisposing factors, obesity played a significant role in BMS restenosis as opposed to DES, while family history appeared to be a more frequent predisposing factor in persons with DES for with restenosis at 6 months. Lipid factors, such as LDL-cholesterol and triglycerides were increased in patients with DES who developed restenosis at 3 months.
Key words: Angioplasty, Coronary disease, Predisposing factors, Stents.