Usefulness of drug eluting stent in percutaneous coronary intervention--a single center experience in Taiwan.
OBJECTIVE
Drug eluting stents (DES) have been shown to reduce in-stent restenosis rate and target vessel revascularization in large clinical trials. However, the safety and efficacy of DES use in the Taiwanese population has not been reported. We designed this trial to analyze the clinical results in patients using DES in a single tertiary center.


METHODS
We retrospectively analyzed the clinical data of all patients treated at National Taiwan University Hospital, Taipei, Taiwan, with sirolimus- or paclitaxel-eluting stents between September 2003 and January 2005.


RESULTS
A total of 585 patients (466 men, 119 women; mean age, 64.5 +/- 11.2 years) were enrolled. Meanwhile, 205 sirolimus- and 717 paclitaxel-eluting stents were implanted, with a mean of 1.6 stents per patient. Half (50.2%) of the stents were placed in the left anterior descending artery. Among the enrolled patients, 41.8% had diabetes mellitus, 25% had a diagnosis of acute coronary syndrome, and 10.7% was treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Overall 8-month target vessel revascularization, major adverse cardiac event rate, and cardiac death rate were 8.8%, 9.7% and 2.5%, respectively. There was no difference in clinical events between sirolimus- and paclitaxel-eluting stents. The overall subacute stent thrombosis rate was 1.36%, significantly lower than that in patients who presented with acute coronary syndrome (4%).


CONCLUSIONS
The use of DES in the Taiwanese population yielded comparable results as those in large clinical trials. Subacute stent thrombosis rate was higher in acute coronary syndrome. The safety of DES in these situations should be further clarified.
Hwang
Juey-Jen
JJ
Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hsu
Chih-Neng
CN
Hung
Chi-Sheng
CS
Lin
Yen-Hung
YH
Kao
Hsien-Li
HL
Chiang
Fu-Tien
FT
Chao
Chia-Lun
CL
Lee
Chii-Ming
CM
Wang
Tzung-Dau
TD
Liau
Chiau-Suong
CS
Hsu
Kwan-Lih
KL
Lin
Lung-Chun
LC
Tsai
Chia-Ti
CT
Tseng
Chuen-Den
CD
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D013624:Taiwan; D016896:Treatment Outcome
D017239:Paclitaxel; D020123:Sirolimus