[Comparison of stenting with sirolimus eluting stent and spot stenting with small vessel stent in treatment of small vessels with long lesions].

OBJECTIVE: To evaluate the short and long-term outcomes between stenting with sirolimus eluting stent (SES) and spot stenting with small vessel stent (SVS) for treatment of small vessels with long lesions. METHODS: 306 coronary heart disease patients in need of stenting in small vessel (diameter < 3.0 mm) with long lesions (> 20 mm) were divided into 2 groups: SES group (n = 93, receiving 157 CYPHER stents) and SVS group (n = 113, receiving spot stenting tactics). The clinical characteristics, success rate of procedure, rate of in-stent restenosis, target lesion revasculation (TLR), and major adverse cardiac events (MACE) were recorded after 6-month follow-up. RESULTS: The baseline clinical and angiographic characteristics were similar between these two groups. Two CYPHER stents failed to pass the tortuous and calcified lesions in the SES group; DRIVER stents were used instead and succeeded in the passing. The rates of in-stent restenosis, TLR, and MACE of the SES group were 4.0%, 2.2%, and 3.2% respectively, all significantly, lower than those of the SVS group (26.5%, 10.6%, and 13.3% respectively, all P < 0.05). CONCLUSION: In treatment of small vessel with long lesions, the rates of in-stent restenosis, TLR, and MACE are all much lower in the SES group than in the SVS group. Spot stenting with SVS may be feasible for small vessels with long and tortuous lesions, especially for those in which SES fails to pass through.

[The changes and their clinical significance of D-dimer and platelet glycoprotein in patients with coronary heart disease].

OBJECTIVE: To explore the changes and their clinical significance of D-dimer and platelet glycoprotein (GP) in patients with coronary heart disease. METHODS: D-dimer and GP in 20 patients with stable angina (SA group), 48 patients with unstable angina (UA group), and 20 control cases were measured. The changes of D-dimer and GP in patients with and without coronary events were compared. The sensitivity of those changes in the diagnosis of coronary events was evaluated. RESULTS: There were significant differences of D-dimer and GP between UA group and SA group or control group (P < 0.01), while there was no significant difference between SA group and control group (P > 0.05). There were also significant differences of D-dimer and GP between patients with coronary events and patients without coronary events (P < 0.05). In the sensitivity test for detecting coronary events, D-dimer and GPIIb, GPIIIa were much more sensitive than other parameters. CONCLUSIONS: D-dimer and GPIIb, GPIIIa may be regarded as the indexes of coronary thrombosis and used for predicting the severity of coronary events.