Clinical analysis of permanent, biodegradable and polymer-free drug eluting stent in treatment of unprotected left main coronary artery disease

Abstract

Objective To compare the safety and efficacy of 3 kinds of permanent, biodegradable and polymer free drug eluting stents in the treatment of unprotected left main coronary artery disease (UPLM). Methods A total of 259 UPLM patients diagnosed by coronary angiography and underwent percutaneous coronary intervention (PCI) in our institute from January 2013 to June 2017 were recruited in this study. These cases were divided into 3 groups according to stent-type of left main implantation: permanent (PP-DES, n=153), biodegradable (BP-DES, n=54) and polymer free (PF-DES, n=52) groups. All the patients were followed up for 12 months. The target vessel failure (TVF), including cardiac death (CD), target vessel myocardial infarction (TVMI), target vessel revascularization (TVR), and major adverse cardiovascular events (MACE), including CD, nonfatal myocardial infarction (NFMI) and revascularization at 12 months after PCI were observed. Results There were no significant differences in sex, age, complicated high risk factors, lesions, stenting procedures, ratio of bifurcation lesions among the 3 groups (P>0.05). And no significant difference was seen in the incidences of TVF (P=0.596) and MACE (P=0.210) according to stent-type of left main implantation. Multivariate COX regression analysis showed that after 12-month follow-up, the risk of TVF and MACE had no significant correlation with stent-type of left main implantation (P>0.05). Conclusion Biodegradable and polymer free drug eluting stents have similar effects on the incidences of TVF and MACE in the treatment of UPLM when compared with permanent polymer drug eluting stent, and they are safe and effective for left main implantation.

Keywords

• coronary atherosclerotic heart disease
• unprotected left main coronary artery
• drug-eluting stent
• permanent polymer drug eluting stent
• biodegradable
• polymer free