Role of BMS in Des ERA

Abstract

AbstractBACKGROUND: DES has gained significant importance in coronary interventions due to its superiority of decrease in target vessel revascularization when compared to BMS. In this DES era, we want to study the role of BMS as it is more economical.MATERIAL AND METHODS: We have analyzed acute coronary syndrome (ACS) and chronic stable angina patients who underwent BMS implantation between January 2011 to March 2011 under government health scheme of Andhra Pradesh.RESULTS: We retrospectively analyzed the cardiac events in 4181 BMS implanted patients. 1938 (46.4%) patients were followed for 365 days. More men than women with 40 to 69 years were there. ST elevation MI was the common presenting symptom in 1902patients (45.49%). 1881 patients (44.98%) were diabetic. Single vessel disease was more common 2522(60.32%), Multivessel disease was seen in 210 patients (5.02%). LAD being the common vessel involved followed by RCA. Primary PCI was done in 320 patients(7.65%).Out of 4181 patients, 9366 lesions were stented with BMS, stainless steel BMS was used in 4988(53.26%) and cobalt chromium BMS was used in 4378 (46.74%) patients.Out of 4181 patients, 1938 patients (46.4%) were followed up of 1yr, post PCI 686 (35.4%) patients had worsening angina, 226(11.66%) patients had worsening heart failure, 17 (0.88%) patients had repeat STEMI, 11(0.56%) patients had repeat NSTEMI, 16(0.82%) patients had subacute stent thrombosis, 27(1.39%) patients developed late stent thrombosis, 51 patients (2.63%) underwent repeat target vessel revascularization(TVR). 52 (2.68%) patients died due to cardiac cause with in one year of follow up.CONCLUSIONS: Our study show that even in present era of DES, BMS implantation is effective and associated with less mortality and less stent thrombosis and less chances of target vessel revascularization with the limitations (as it was telephonic follow up).