الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Our study is a single blinded randomized controlled trial .The study aimed to evaluate one year out comes of the polymer free drug eluting stents in comparison to polymer permanent drug eluting stents in patients presented with non ST elevation acute coronary syndrome Inclusion criteria: Patients from 18 to 85 years of both genders presented with NSTE-ACS (which include non ST elevation myocardial infarction and unstable angina) with TIMI score ( ≥ 3), who were subjected to invasive strategy, whose coronary angiography showed de novo coronary artery disease with stenotic lesion(s) ≥ 70 % requiring fixation with coronary stent(s). Methods: The study was conducted on patients presented with NSTE-ACS fulfilling the inclusion criteria who were subjected to the invasive strategy , the patients were divided into two groups, group (I) included thirty patients treated with the polymer-free stent using Cre8 stents , group (63) included thirty patients treated with the polymer-permanent stent using Xience stents . The study was conducted in Critical Care Department of Cairo University , from December 2019 to July 2021. Patients included in the study were subjected to the following: Before the intervention : History: Analysis of presenting complaint . Past history of previous similar complaints. Risk factors (Diabetes mellitus, hypertension , smoking,). Other co-morbidities and therapeutic history . Examination: Blood pressure, heart rate, respiratory rate, Jugular Venous Pressure (JVP), cardiac and chest examination. Investigations: Twelve lead ECG . Laboratory investigations : (Complete Blood Count, Prothrombine time and concentration ,Kidney function, HCV-Ab , HBs-Ag , HIV Ab , Creatine kinase(CK and CK-MB ) and Troponin Imaging: Echocardiographic evaluation with certain emphasis on the following parameters (Wall motion score index systolic function, diastolic function and cardiac dimensions). After the interention : The patients included in the study were followed up and re-evaluated at one month, six months and twelve months after the intervention by office visits or telephone calls . (1) Clinical Re-evaluation : At 1 , 6 and 12 months was directed towards identifying the major adverse cardiac events (MACE) and occurrence of stent thrombosis (ST). (2) Examination: Vital signs ,JVP ,chest and heart examination . (3)12-lead ECG and cardiac enzymes if needed . (4) Follow up coronary angiography was done when indicated , and repeat revascularization (TLR or TVR) was considered indicated if coronary angiography at follow-up shows a percent diameter stenosis ≥70% . The results of our study showed that : Regarding the clinical presentation , most of the patients in both groups presented with unstable angina with non statistically significant difference (p=0.781) . Concerning the coronary angiographic data the current study showed that there was with non statistically significant difference between both groups concerning number of coronary vessels affected (p=0.222) , with most of the patients in both groups had single vessel disease. . During the period of follow up our study showed that there was non statistically significant difference between both groups concerning occurrence of post infarction angina (P=1.000) , recurrent angina (P=0.671) , target lesion revascularization (TLR) (P=1.000) , LV dysfunction (p=1.000). None of the patients of both groups had arrhythmias or died during the period of follow up. The current study showed that one patient in group I had sub acute definite stent thrombosis (ST) , also in group II only one patient had late definite stent thrombosis during follow up, with non statistically significant difference (P=1.000) One patient in group I had in-stent restenosis during the 12th month of follow up , no cases of restenosis was recorded in group II with non statistically significant difference (P=1.000) Our study showed that there is non statistically significant difference between the polymer free drug eluting stent group and the polymer permanent drug eluting stent group regarding occurrence of post infarction angina , recurrent angina, target lesion or vessel revascularization, left ventricular dysfunction , arrhythmia , cardiac death , stent thrombosis and in-stent restenosis Depending on these results we can claim that the polymer free drug eluting stent is non inferior to the polymer permanent drug eluting stent concerning occurrence of major adverse cardiac events and stent thrombosis. Our study recommends further wide skill studies that include more patients, longer follow up period, more clinical, laboratory, echocardiographic and angiographic parameters to evaluate the efficacy of Polymer free drug eluting stent in non ST elevation acute coronary syndrome.