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Primary percutaneous coronary intervention in CAD patients: A comparison of major adverse cardiovascular events of second- and third-generation drug-eluting stents

Affiliation
Department of Pharmacy ,Quaid-i-Azam University ,Islamabad ,Pakistan
Bibi, Salma;
Affiliation
Department of Pharmacy ,Quaid-i-Azam University ,Islamabad ,Pakistan
Khan, Amjad;
Affiliation
Discipline of Clinical Pharmacy ,School of Pharmaceutical Sciences ,Universiti Sains Malaysia ,George Town ,Penang ,Malaysia
Khan, Amer Hayat;
Affiliation
Department of Interventional Cardiology ,Hayatabad Medical Complex ,Peshawar ,Pakistan
Khan, Muhammad Niaz;
Affiliation
Department of Healthcare Biotechnology ,Atta-ur-Rahman School of Applied Biosciences ,National University of Sciences and Technology ,Islamabad ,Pakistan
Mushtaq, Saima;
Affiliation
Gomal Center of Pharmaceutical Sciences ,Faculty of Pharmacy ,Gomal University ,D.I.Khan ,Pakistan
Rashid, Sheikh Abdur

Background: Biodegradable polymer (BP) drug-eluting stents (DES) have been introduced as a novel solution to the problems of durable polymer (DP) stents. In Pakistan, very few studies are available for the treatment intervention in post-primary percutaneous coronary intervention (PPCI) patients. Our study will compare the major adverse cardiovascular events (MACEs) and their predictors in patients with coronary artery disease (CAD) undergoing PPCI with second- or third-generation DES. Methodology: An observational, retrospective, cohort study was carried out on CAD patients undergoing PPCI with either second- (DP-XIENCE Prime/XIENCE Xpedition) or third-generation (BP-BioMatrix NeoFlex/BioMatrix Alpha) DES. MACEs were assessed after 1 year of PPCI procedure in 341 patients and screened as per inclusion/exclusion criteria (167 in the second-generation group and 174 in the third-generation group). Results: The number of male patients (86.2%) was more than female patients in our study population. MACEs were reported in 4.19% patients after 1 year duration, and the percentage of MACEs was more in the second-generation DES group (4.77%) than in the third-generation group (3.44%); however, statistical analysis has not found any significant difference ( p = 0.534). The rate of myocardial infarction (1.19% vs. 0.57%) and stent thrombosis (1.8% vs. 1.15%) was more in the second-generation DES group. However, restenosis (1.19% vs. 1.15%) and cardiac death (0.59% vs. 0.57%) were almost same in both groups. A significant association was found between MACEs and diabetes mellitus ( p = 0.025), hypertension ( p = 0.035), smoking ( p = 0.008), and a family history of CAD ( p = 0.018). Conclusion: BP-BioMatrix and DP-XIENCE DES have comparable clinical outcomes. Findings of the current study will assist the policy makers and healthcare providers in the rationalization of scarce resources and evidence-based patient care. However, longer follow-up studies are required for convincing results.

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License Holder: Copyright © 2022 Bibi, Khan, Khan, Khan, Mushtaq and Rashid.

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