Faculty of Health Sciences
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Item The assessment of two year clinical outcomes after stent implantation for the treatment of coronary artery disease(2013-01-18) Harrypaul, Ashika; Adam, Jamila Khatoon; Dyer, Robby B.The sirolimus-eluting stent (Cypher) was the first approved drug- eluting stent by the Food and Drug Administration in April 2003. This is a stent that is based on a bare-metal stent and is coated with a layer of polymer incorporating sirolimus and releasing it by diffusion. Drug-eluting stents reduced risk of restenosis and repeat revascularization as compared with bare-metal stents. Clinical data has raised concerns that drug-eluting stents are associated with late untoward events. Objectives: The objective of this study was to test the hypothesis that stenting is safe and effective treatment for coronary artery disease. Methods and Results: Sirolimus-eluting stenting was performed in 30 patients with 34 coronary lesions. Detailed clinical follow-up data was collected by personal interview or telephone contact at 1, 6, 12 and 24 months. Patients were followed for 2 years for the occurrence of angina and cardiovascular events namely death, myocardial infarction, stent thrombosis and target lesion revascularization. The mean age of the cohort was 62.33±10.99 years; 83 percent were male, 6 percent were diabetic, 53 percent had hypertension. In spite of the overall patient and lesion complexity there were no incidences of major adverse cardiac events and all patients remained angina free out to two years. Dual antiplatelet therapy with aspirin and plavix varied from at least four weeks to one year. One patient had a bleeding event. Conclusions: Treatment of lesions with sirolimus-eluting stents is associated with a sustained clinical benefit two years after device implantation.Item Two year clinical outcomes after sirolimus-eluting stent implantation for the treatment of coronary artery disease(Medical Technology SA, 2012) Adam, Jamila Khatoon; Dyer, Robby B.; Harrypaul, Ashika; Rmaih, WafaaBackground Coronary artery stents are known to reduce rates of restenosis after coronary stenting, but it is uncertain how long this benefit is maintained. Clinical data has raised concerns that drug-eluting stents are associated with increased rates of late stent thrombosis, death or myocardial infarction. Objectives To evaluate the safety and reliability of sirolimus-eluting stents in real-world practice out to two years. Methods From January 2008 to June 2008, 30 patients were enrolled in the study after implantation of one or more sirolimus-eluting stents. We evaluated clinical follow-up information for up to two years after the implantation of Cypher® Select stents in 30 patients with 35 lesions. Results Mean patient age was 62.33 +/- 10.99 years, 7 percent were diabetic and 30 percent presented with acute myocardial infarctions. The procedure’s success rate was 100 percent for the sirolimus-eluting stent implantation, and follow-up rates were 100 percent. Mean total stent length was 22.32 +/- 6.63 mm, with 13 percent receiving more than one stent. Two year freedom from mortality, myocardial infarction, target vessel revascularization and stent thrombosis was 100 percent. Dual antiplatelet therapy was taken by 100 percent at 1 month, 53 percent at 6 months, 40 percent at 1 year and 0 percent of patients at 2 years. The rate of survival free of myocardial infarction, bypass surgery and repeated angioplasty for stented lesions was 100% at two years. Conclusions Treatment of lesions with sirolimus-eluting stents is associated with a sustained clinical benefit two years after device implantation.