Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 342-346, July 2008

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

  • Ming-Hsiung Wang

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Fong-Yuan Hospital, Fong-Yuan, Taiwan, R.O.C.
    • ,
  • Wen-Lieng Lee

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Kuo-Yang Wang

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Department of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.
    • ,
  • Yu-Cheng Hsieh

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Tsun-Jui Liu

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • I-Hsiang Lin

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Nantou Hospital, Nantou, Taiwan, R.O.C.
    • ,
  • Wei-Wen Lin

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Chih-Tai Ting

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Kae-Woei Liang

      Affiliations

    • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Institute of Clinical Medicine, Cardiovascular Research Center, and Department of Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Kae-Woei Liang, Cardiovascular Center, Taichung Veterans General Hospital, 160, Section 3, Taichung-Kang Road, Taichung 407, Taiwan, R.O.C

Received 25 July 2007; accepted 22 May 2008.

Article Outline

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

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References 

  1. Jalowiec DA , Hill JA . Myocardial infarction in the young and in women . Cardiovasc Clin . 1989;20:197–206
  2. Klein LW , Nathan S . Coronary artery disease in young adults . J Am Coll Cardiol . 2003;41:529–531
  3. Juan CC, Hwang B, Lee PC, Lin YJ, Chien JC, Lee HY, et al. The clinical manifestations and risk factors of a delayed diagnosis of Kawasaki disease . J Chin Med Assoc . 2007;70:374–379
  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
  5. Lai CC, Hsiao HC, Hsiao SH, Huang WC, Chiou CW, Yeh TC, et al  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
  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
  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
  8. Wong WW, Chen TL, Yang SP, Wang FD, Cheng NC, Kuo BI, et al  Clinical characteristics of fatal patients with severe acute respiratory syndrome in a medical center in Taipei . J Chin Med Assoc . 2003;66:323–327
  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
  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
  11. Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O'shaughnessy C, et al  Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery . N Engl J Med . 2003;349:1315–1323
  12. Stone GW, Ellis SG, Cox DA, Hermiller J, O'shaughnessy C, Mann JT, et al  A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease . N Engl J Med . 2004;350:221–231
  13. Morice MC, Colombo A, Meier B, Serruys P, Tamburino C, Guagliumi G, et al  Sirolimus-vs paclitaxel-eluting stents in de novo coronary artery lesions: the REALITY trial– a randomized controlled trial . JAMA . 2006;295:895–904
  14. Dawkins KD, Grube E, Guagliumi G, Banning AP, Zmudka K, Colombo A, et al  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
  15. Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D, et al  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
  16. Cole JH , Miller JI , Sperling LS , Weintraub WS . Long-term follow-up of coronary artery disease presenting in young adults . J Am Coll Cardiol . 2003;41:521–528
  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
  18. Stone GW, Moses JW, Ellis SG, Schofer J, Dawkins KD, Morice MC, et al  Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents . N Engl J Med . 2007;356:998–1008
  19. Schuster H . High risk/high priority: familial hypercholesterolemia–a paradigm for molecular medicine . Atherosclerosis . 2002;(Suppl 2):27–32
  20. Civeira F . Guidelines for the diagnosis and management of heterozygous familial hypercholesterolemia . Atherosclerosis . 2004;173:55–68
  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
  22. Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, et al  Optimal medical therapy with or without PCI for stable coronary disease . N Engl J Med . 2007;356:1503–1516

PII: S1726-4901(08)70136-9

doi:10.1016/S1726-4901(08)70136-9

Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 342-346, July 2008

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