Skip to main content
Elsevier - PMC COVID-19 Collection logoLink to Elsevier - PMC COVID-19 Collection
. 2008 Sep 26;71(7):342–346. doi: 10.1016/S1726-4901(08)70136-9

Short-term Follow-up Results of Drug-eluting Stenting in Premature Coronary Artery Disease Patients with Multiple Atherosclerotic Risk Factors

Ming-Hsiung Wang a,b, Wen-Lieng Lee a,c, Kuo-Yang Wang a,d, Yu-Cheng Hsieh a,c, Tsun-Jui Liu a,c, I-Hsiang Lin a,e, Wei-Wen Lin a, Chih-Tai Ting a,c, Kae-Woei Liang a,c,*
PMCID: PMC7129192  PMID: 18653396

Abstract

Background

Premature coronary artery disease (CAD) is a special entity with a strong link to familial hypercholesterolemia, family history of premature CAD, or multiple coexistent atherosclerotic risk factors. Drug-eluting stenting (DES), including paclitaxel-eluting stenting (PES) and sirolimus-eluting stenting (SES), has been proven to have a lower restenotic rate. However, to date, few studies have investigated the clinical and angiographic results of DES in premature CAD patients.

Methods

Between February 2004 and October 2005, premature CAD patients, defined as those younger than 50 years ofage, who were treated with DES in our medical center were all retrospectively enrolled. Their baseline clinical characteristics, clinical outcome and angiographic follow-up results were analyzed.

Results

A total of 26 patients (M/F: 23/3) were enrolled, with a mean age of 44 ±6 years (range, 24–50 years). Conventional atherosclerotic risk factors were prevalent in this study group, including diabetes mellitus (35%), hypertension (35%), hyperlipidemia (54%) and smoking (73%). Moreover, there was 1 homozygous and 1 heterozygous familial hypercholesterolemia case in our study group. In terms of angiographic results, there were 40 target lesions in 34 target vessels. Forty DES (39 PES, 1 SES) were implanted with a median stent diameter of 3 mm and median length of 24 mm. The clinical follow-up was counted up to May 2006, with a mean follow-up duration of 540 ±168 days; 11 (42%) patients had a second angiogram during the follow-up period (200 ±98 days after DES). None of the patients had target lesion revascularization (TLR). In addition, there was no difference in TLR or stent thrombosis between patients with or without acute coronary syndrome.

Conclusion

Based on our single-center experience, DES had good short-term follow-up results for a premature CAD group with diverse and multiple atherosclerotic risk factors.

Key Words: acute coronary syndrome, coronary artery disease, drug-eluting stent, familial hypercholesterolemia, premature CAD

References

  • 1.Jalowiec DA, Hill JA. Myocardial infarction in the young and in women. Cardiovasc Clin. 1989;20:197–206. [PubMed] [Google Scholar]
  • 2.Klein LW, Nathan S. Coronary artery disease in young adults. J Am Coll Cardiol. 2003;41:529–531. doi: 10.1016/s0735-1097(02)02861-9. [DOI] [PubMed] [Google Scholar]
  • 3.Juan CC, Hwang B, Lee PC, Lin YJ, Chien JC, Lee HY, Meng CC. The clinical manifestations and risk factors of a delayed diagnosis of Kawasaki disease. J Chin Med Assoc. 2007;70:374–379. doi: 10.1016/S1726-4901(08)70023-6. [DOI] [PubMed] [Google Scholar]
  • 4.Fong MC, Chen KC, Leu HB, Chen LC. Coronary revascularization in a patient with immune thrombocytopenic purpura. J Chin Med Assoc. 2006;69:436–438. doi: 10.1016/S1726-4901(09)70287-4. [DOI] [PubMed] [Google Scholar]
  • 5.Lai CC, Hsiao HC, Hsiao SH, Huang WC, Chiou CW, Yeh TC, Hwang HR. Role of shortened QTc dispersion in in-hospital cardiac events in patients undergoing percutaneous coronary intervention for acute coronary syndrome. J Chin Med Assoc. 2006;69:297–303. doi: 10.1016/S1726-4901(09)70262-X. [DOI] [PubMed] [Google Scholar]
  • 6.Hsiao HC, Chen CH, Kong CW, Liu CP. Acute effects of dual-chamber pacing on the left ventricular systolic function and relaxation in patients with advanced AV block and sick sinus syndrome. J Chin Med Assoc. 2006;69:32–36. doi: 10.1016/s1726-4901(09)70108-x. [DOI] [PubMed] [Google Scholar]
  • 7.Liang KW, Lee WL, Hsueh CW, Chen YT, Ting CT. Atrial demand pacemakers in sick sinus syndrome: an efficient and reliable approach in selected patients. J Chin Med Assoc. 2003;66:709–714. [PubMed] [Google Scholar]
  • 8.Wong WW, Chen TL, Yang SP, Wang FD, Cheng NC, Kuo BI, Yu KW. Clinical characteristics of fatal patients with severe acute respiratory syndrome in a medical center in Taipei. J Chin Med Assoc. 2003;66:323–327. [PubMed] [Google Scholar]
  • 9.Holbrook JH, Grundy SM, Hennekens CH, Kannel WB, Strong JP. Cigarette smoking and cardiovascular diseases: statement for health professionals by a task force appointed by the Steering Committee of the American Heart Association. Circulation. 1984;70:1114A–1117A. [PubMed] [Google Scholar]
  • 10.Kannel WB, D'Agostino RB, Belanger AJ. Fibrinogen, cigarette smoking, and risk of cardiovascular disease: insights from the Framingham Study. Am Heart J. 1987;113:1006–1010. doi: 10.1016/0002-8703(87)90063-9. [DOI] [PubMed] [Google Scholar]
  • 11.Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O'shaughnessy C, Caputo RP. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003;349:1315–1323. doi: 10.1056/NEJMoa035071. [DOI] [PubMed] [Google Scholar]
  • 12.Stone GW, Ellis SG, Cox DA, Hermiller J, O'shaughnessy C, Mann JT, Turco M. A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med. 2004;350:221–231. doi: 10.1056/NEJMoa032441. [DOI] [PubMed] [Google Scholar]
  • 13.Morice MC, Colombo A, Meier B, Serruys P, Tamburino C, Guagliumi G, Sousa E. Sirolimus-vs paclitaxel-eluting stents in de novo coronary artery lesions: the REALITY trial– a randomized controlled trial. JAMA. 2006;295:895–904. doi: 10.1001/jama.295.8.895. [DOI] [PubMed] [Google Scholar]
  • 14.Dawkins KD, Grube E, Guagliumi G, Banning AP, Zmudka K, Colombo A, Thuesen L. Clinical efficacy of polymerbased paclitaxel-eluting stents in the treatment of complex, long coronary artery lesions from a multicenter, randomized trial: support for the use of drug-eluting stents in contemporary clinical practice. Circulation. 2005;112:3306–3313. doi: 10.1161/CIRCULATIONAHA.105.552190. [DOI] [PubMed] [Google Scholar]
  • 15.Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D, O'shaughnessy CD. Comparison of a polymerbased paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA. 2005;294:1215–1223. doi: 10.1001/jama.294.10.1215. [DOI] [PubMed] [Google Scholar]
  • 16.Cole JH, Miller JI, 3rd, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. J Am Coll Cardiol. 2003;41:521–528. doi: 10.1016/s0735-1097(02)02862-0. [DOI] [PubMed] [Google Scholar]
  • 17.Mauri L, Hsieh WH, Massaro JM, Ho KK, D’Agostino R, Cutlip DE. Stent thrombosis in randomized clinical trials of drugeluting stents. N Engl J Med. 2007;356:1020–1029. doi: 10.1056/NEJMoa067731. [DOI] [PubMed] [Google Scholar]
  • 18.Stone GW, Moses JW, Ellis SG, Schofer J, Dawkins KD, Morice MC, Colombo A. Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. N Engl J Med. 2007;356:998–1008. doi: 10.1056/NEJMoa067193. [DOI] [PubMed] [Google Scholar]
  • 19.Schuster H. High risk/high priority: familial hypercholesterolemia–a paradigm for molecular medicine. Atherosclerosis. 2002;(Suppl 2):27–32. doi: 10.1016/s1567-5688(01)00019-8. [DOI] [PubMed] [Google Scholar]
  • 20.Civeira F. Guidelines for the diagnosis and management of heterozygous familial hypercholesterolemia. Atherosclerosis. 2004;173:55–68. doi: 10.1016/j.atherosclerosis.2003.11.010. [DOI] [PubMed] [Google Scholar]
  • 21.van't Hof AW, de Boer MJ, Suryapranata H, Hoorntje JC, Zijlstra F. Incidence and predictors of restenosis after successful primary coronary angioplasty for acute myocardial infarction: the importance of age and procedural result. Am Heart J. 1998;136:518–527. doi: 10.1016/s0002-8703(98)70230-3. [DOI] [PubMed] [Google Scholar]
  • 22.Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1503–1516. doi: 10.1056/NEJMoa070829. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Chinese Medical Association are provided here courtesy of Elsevier

RESOURCES