Background: Percutaneous coronary intervention (PCI) with stent implantation is the therapy of choice for treatment of decreased blood flow through the coronary arteries.
Aim: We evaluated the efficacy of the bare metal stent (BMS) for treatment of symptomatic coronary artery disease and compared BMS with the drug eluting stent (DES) to find out which one is better in the prevention of major adverse cardiac events (MACE) six months after stent implantation.
Materials and methods: Our retrospective analysis included 387 consecutive patients with BMS implantation and 74 consecutive patients with DES implantation. Efficacy of BMS was evaluated by residual in-stent stenosis after the procedure. According to the Taxus II-Trial definition, MACE include cardiac death, acute myocardial infarction (AMI) and target vessel revascularization; the latter includes PCI with stent implantation or coronary artery bypass graft on previously revascularized vessel.
Results: In BMS group mean pre-procedure stenosis diameter was 81.9 ± 12.8% and mean post-procedure stenosis was 4.8% ± 12.5%. The residual in-stent stenosis was significantly higher in patients with longer lesions (p<0.05). Hypertension was the most frequent risk factor in both groups and AMI the commonest indication for stent implantation in the group with BMS, while stable and unstable angina pectoris in the group with DES, respectively. During the first six months after the implantation of DES, the incidence of MACE was significantly lower (p<0.05) compared to BMS. The most frequent subgroup of MACE present in the group with BMS was cardiac death, and in the group with DES it was repeated PCI with stent implantation.
Conclusions: BMS provides and efficacious choice of treatment for patients with symptomatic coronary artery disease. Patients with longer lesions have higher residual in-stent stenosis after BMS implantation. Implantation of DES is more successful in preventing MACE in comparison with the implantation of BMS.