Background: It
has been suggested that the persistence of polymeric coating of
drug-eluting stents provokes delayed arterial healing and as well as a
cascade of cellular and biochemical events that cause
patho-physiological processes such as release of cytokines which trigger
the proliferation of smooth muscle cells, block the endothelialization
of the nearby tissue, and induce other side-effects such as late andvery
late stent thrombosis.
Aim:
The primary aim of our prospective study was tocompare between the uses
of BDP-DES and DP-DES in diabetic patients presented with ACS,
regarding stent thrombosis, ISR and MACE during 12 months clinical
followup and follow up coronary angiography in 6-12 months postACS index
admission as well.
Methods:
Our study enrolled 100 diabetic patients presentedto the Emergency
department at King Abdul-Aziz university hospital as a case of ACS who
were candidate for coronary angiography with PTCA and stenting.
Patients were divided into 2 groups according to the deployed stent:
Group A (BP-DES: 50 cases)
Group B (DP-DES: 50 cases)
Inclusion criteria: All patients post-Acute Coronary Syndromewho have DM and underwent for coronary angiography with PTCA and stenting.
Exclusion criteria:
1-Non diabetic patients. 2- known IschemicHeart Disease (IHD) or
previous coronary intervention (PCI). 3- Pregnancy. 4- Allergy or
contraindication to Aspirinand Plavix.
Results:
There was no statistically significant difference as regard
typical/atypical anginal symptoms in both groups in the 12 months follow
up after the procedure.
Also,
there was no statistically significant difference between the incidence
of ISR, stent diameter (p=0.791) and stent length (p=0.952) in both
groups. The mean diameter and length ± SD in the BDP-DES group and the
PP-DES group were (2.82 ± 0.39 and 2.88 ± 0.43), and (26.2 ± 11.9 and
30.1± 13.1) respectively.
ISR
was 10% in biodegradable polymer DES group and 12% in durable polymer
DES group and it wasn’t significant statistically (p=0.719).
There were no reported cases of stent thrombosis in both groups.
Conclusion:
BDP-DES, when compared to DP-DES, in diabetic patients presenting with
ACS, showed no statistically significant difference and the outcomes were
comparable between both the groups.
