Background: The  objective of  the present study  will  be  to determine  the  clinical  outcomes  of   the  patients  who  underwent  coronary artery stenting with Xience V everolimus eluting stents for the treatment of coronary  artery  disease (de  novo  coronary  artery  lesions).

Methods: Our study was carried out in department of cardiology, Batra hospital and medical research center. All consecutive patients who had undergone percutaneous coronary intervention with only XIENCE V everolimus eluting coronary stents in our hospital from May 2012 to February 2013 were selected and followed up after 1 year. Patient  case  file  and  records  were  reviewed from the  Cath  lab  and  record  section  of  our  hospital. Coronary angiography reports were reviewed for lesion characteristics. Mode of presentation, past history, course in hospital and lab reports were recorded as per the documents available. Coronary angiograms were reviewed if needed Clinical follow-up was performed by telephone contact or office visit at 12 months after the index procedure. Patients who visited the follow up clinics at 1 year, clinical status was recorded by clinical history, physical examination, laboratory tests   and   ECG.

Results: In a total of 128 patients, 154 lesions were treated with 165 stents. 3 patients (2.3%) died. 6  patients (4.7%) had an MI during the follow up period.8 (6.3%) patients had target lesion revascularization during the follow up period. 10 patients (7.8%) had to undergo target vessel revascularization in total during the follow up period. MACE as an end point was seen in 9.4% of the patients. All the patients were on dual antiplatelet at one year. A total of 3 patients (2.3%) died over one year. A total of six patients (4.7%) developed MI. 

Conclusion: Our study showed that in unrestricted daily practice , implantation of Xience V  EES  was  associated  with  low  rates  of  adverse  outcomes  like  MI  and death,  just  as  has  been  reported  from  various  randomised  controlled  trials and some registries.

Keywords: Coronary artery disease, Coronary Stent, de novocoronary artery lesion, Xience V everolimus eluting stents.

1. Dotter CT, Judkins MP et al. Transluminal treatment of arteriosclerotic obstruction: description of a new technique and preliminary reports of its application. 1964;30: 654–670 .
2. Hurst JW. The first coronary angioplasty as described by Andreas Gruentzig. J.Cardiol.1986;57 ;185–186 .
3. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, Nallamothu BK, Kent DM et al. Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet 2009;373: 911–918 .
4. Miller JM, Ohmann EM, Moliterno DJ. Restenosis et al: the critical issues. In: Textbook of Interventional Cardiology, 3^rd Edition. Topol EJ (Ed.). Sunders, PA, USA,379–415 (1999).
5. Rosamond W, Flegal K, Furie K et al. Heart disease and stroke statistics – 2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008;117, e25–e146 .
6. Fischman DL, Leon MB, Baim DS et al. A randomized comparison of coronary stent placement and balloon angioplasty in the treatment of coronary artery disease.Stent Restenosis Study Investigators. Engl. J. Med.1994;331(8): 496–501.
7. Serruys PW, de Jaegere P, Kiemeneij F et al. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group. Engl. J. Med.1994;331:489–495 .
8. Roberta Rossini, Giuseppe Musumeci, Alessandro Aprile and Orazio Valsecchi et al; Long-term outcomes in patients undergoing percutaneous coronary intervention with drug-eluting stents Expert Rev. Pharmacoeconomics Outcomes Res.2010; 10(1):49–61.
9. Butt M, Connolly D, Lip GY et al. Drug-eluting stents: a comprehensive appraisal. 2009;5(2): 141–157 .
10. Marroquin OC, Selzer F, Mulukutla SR et al. A comparison of bare-metal and drug-eluting stents for off-label indications. Engl. J. Med.2008;358:342–352.
11. Win HK, Caldera AE, Maresh K etal. Clinical outcomes and stent thrombosis following off-label use of drug-elutingstents. JAMA 2007;297: 2001–2009.
12. Sousa JE, Costa MA, Sousa AG etal.Two year angiographic and intravascular ultrasound follow-up after implantation of sirolimus-eluting stents in human coronary arteries. Circulation 2003;107(3):381–383.
13. Stone GW, Midei M, Newman W et al. Comparison of an everolimus-eluting stent and a paclitaxel-eluting stent in patients with coronary artery disease: a randomized trial. JAMA 2008; 299: 1903–1913.
14. Latib A, Ferri L, Ielasi A et al. Clinical outcomes after unrestricted implantation of everolimus-eluting stents. JACC Cardiovasc. Interv.2009; 2:1219-1226.
15. Stone GW, Rizvi A, Newman W Everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease. N. Engl.J. Med. 2010; 362: 1663–1674.
16. Kedhi E, Joesoef KS, McFadden E Second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice (COMPARE): a randomised trial. Lancet 2010; 375: 201–209 .
17. Serruys PW, Silber S, Garg S et al. Twelve months primary endpoint results of the RESOLUTE all-comers trial: a randomised comparison of a zotarolimus-eluting stent with an everolimus-eluting stent for percutaneous coronary intervention. NEJM 2010;363:136-146.
18. Byrne RA, Kastrati A, Kufner S et al. Randomized, non-inferiority trial of threelimus agent-eluting stents with different polymer coatings: the Intracoronary Stenting and Angiographic Results: Test Efficacy of 3 Limus-Eluting Stents(ISAR-TEST-4) trial. Heart j. 2009; 30:2441–2449 .
19. Ashok Seth , Tejas M. Patel b, Marrianne Stuteville C, Ravindra Kumar et al ; Three-year data from the XIENCE V_ INDIA study: Safety and efficacy of XIENCE V_ in 1000 real world Indian patients Indian Heart Journal 66(2014): 302-308.

Dr Sheikh Mohamad Tahir

Consultant Cardiologist, Department of Cardiology, Super Speciality Hospital, GMC Srinagar, J&K, India