COMPARISON OF SHORT- AND LONG-TERM OUTCOMES BETWEEN CYPHER AND TAXUS DRUG-ELUTING STENTS FOR IN-STENT RESTENOSIS

Objective To compare the short- and long-term clinical outcomes between sirolimus-eluting stent (Cypher stent) and paclitaxel-eluting stent (TAXUS stent) in patients with in-stent restenosis (ISR) lesions of the coronary arteries.Methods From December 2002 to March 2005, 253 patients with ISR lesions of the coronary arteries were selected and divided into two groups. Cypher group (152 cases) was treated with Cypher or Cypher Select stents, and TAXUS group (101 cases) with TAXUS stents. A total of 262 ISR lesions in these patients were treated with 308 drug-eluting stents (DESs), including 176 Cypher or Cypher Select stents and 132 TAXUS stents. All patients were followed up for 10 months. Procedure success rates of DES implantation in both groups were observed. Major adverse cardiac events (MACE) rates in hospital and at 10 months follow-up, as well as in-DES restenosis observed using coronary angiography at follow-up were compared between two groups. Results Success rate of DES implantation was 100% in both groups. No significant difference in MACE rate during hospitalization was found between the two groups. However, at 10 months follow-up, MACE rate was higher in TAXUS group than in Cypher group (16.00% vs. 6.67%, P=0.031). As for coronary angiography at 10 months follow-up, we observed an increasing tendency of in-DES restenosis rate in TAXUS group compared with Cypher group (29.41% vs. 14.04%, P=0.075). Conclusions Cypher and TAXUS DESs both have good short- and long-term outcomes in treating ISR. Cypher DES proved better long-term clinical outcome than TAXUS DES.

INFERIOR-SEPTAL MYOCARDIAL INFARCTION MISDIAGNOSED AS ANTERIOR-SEPTAL MYOCARDIAL INFARCTION:ELECTROCARDIOGRAPHIC,SCINTIGRAPHIC,AND ANGIOGRAPHIC CORRELATIONS

Objective To explore the infarct sites in patients with inferior wall acute myocardial infarction(AMI) concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R.Methods Five patients diagnosed as inferior,right ventricular,and anteroseptal walls AMI at admission were enrolled.Electrocardiographic data and results of isotope 99mTc-methoxyisobutylisonitrile(MIBI) myocardial perfusion imaging and coronary angiography(CAG) were analyzed.Results Electrocardiogram showed that ST segment significantly elevated in standard leads II,III,aVF,and leads V1-V3,V3R-V5R in all five patients.The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R.There was isotope 99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls.CAG showed that right coronary artery was infarct-related artery.Conclusions The diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows:(1) ST segment elevates≥2 mm in lead V1 in the clinical setting of inferior wall AMI;(2) the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R.With two conditions above,the basal inferior-septal wall AMI should be diagnosed.