中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
10期
886-890
,共5页
李强%王乐丰%杨新春%葛永贵%王红石%李惟铭%徐立%倪祝华%夏昆
李彊%王樂豐%楊新春%葛永貴%王紅石%李惟銘%徐立%倪祝華%夏昆
리강%왕악봉%양신춘%갈영귀%왕홍석%리유명%서립%예축화%하곤
心肌梗死%血管成形术,经腔,经皮冠状动脉%支架
心肌梗死%血管成形術,經腔,經皮冠狀動脈%支架
심기경사%혈관성형술,경강,경피관상동맥%지가
Myocardial infarction%Angioplasty. transluminal. percutaneous coronary%Stents
目的 比较可降解涂层雷帕霉素洗脱支架(Excel)与不可降解涂层雷帕霉素洗脱支架(Cypher Select)在急性ST段抬高型心肌梗死直接经皮冠状动脉介入治疗中的有效性和安全性.方法 连续入选的228例急性ST段抬高型心肌梗死患者随机分至Cypher组(113例)和Excel组(115例).主要终点为术后12个月主要不良心脏事件(包括死亡、心肌梗死和靶血管重建),次要终点为9个月晚期管腔丢失和支架再狭窄.结果 术后9个月Cypher组和Excel组分别有43例(38.1%)和48例(42.1%)患者接受冠状动脉造影随访,两组支架内晚期管腔丢失[(0.17±0.26)mm比(0.18±0.33)mm,P=0.483]、节段内晚期管腔丢失[(0.19±0.36)mm比(0.20±0.42)mm,P=0.419)和支架内再狭窄(2.3%比2.1%,P=0.937)、节段内再狭窄(4.7%比6.3%,P=0.738)的发生率差异无统计学意义.术后12个月Cypher组和Excel组死亡(3.5%比2.6%,P=0.692)、心肌梗死(1.8%比2.6%,P=0.658)、靶血管重建(1.8%比2.6%,P=0.658)、主要不良心脏事件(5.3%比6.1%,P=0.788)及支架内血栓形成(4.4%比3.5%,P=0.724)的发生率差异无统计学意义.结论 可降解涂层与不可降解涂层雷帕霉素洗脱支架在直接经皮冠状动脉介入治疗急性ST段抬高型心肌梗死中的近期疗效和安全性可能是一致的,其远期效果有待进一步研究.
目的 比較可降解塗層雷帕黴素洗脫支架(Excel)與不可降解塗層雷帕黴素洗脫支架(Cypher Select)在急性ST段抬高型心肌梗死直接經皮冠狀動脈介入治療中的有效性和安全性.方法 連續入選的228例急性ST段抬高型心肌梗死患者隨機分至Cypher組(113例)和Excel組(115例).主要終點為術後12箇月主要不良心髒事件(包括死亡、心肌梗死和靶血管重建),次要終點為9箇月晚期管腔丟失和支架再狹窄.結果 術後9箇月Cypher組和Excel組分彆有43例(38.1%)和48例(42.1%)患者接受冠狀動脈造影隨訪,兩組支架內晚期管腔丟失[(0.17±0.26)mm比(0.18±0.33)mm,P=0.483]、節段內晚期管腔丟失[(0.19±0.36)mm比(0.20±0.42)mm,P=0.419)和支架內再狹窄(2.3%比2.1%,P=0.937)、節段內再狹窄(4.7%比6.3%,P=0.738)的髮生率差異無統計學意義.術後12箇月Cypher組和Excel組死亡(3.5%比2.6%,P=0.692)、心肌梗死(1.8%比2.6%,P=0.658)、靶血管重建(1.8%比2.6%,P=0.658)、主要不良心髒事件(5.3%比6.1%,P=0.788)及支架內血栓形成(4.4%比3.5%,P=0.724)的髮生率差異無統計學意義.結論 可降解塗層與不可降解塗層雷帕黴素洗脫支架在直接經皮冠狀動脈介入治療急性ST段抬高型心肌梗死中的近期療效和安全性可能是一緻的,其遠期效果有待進一步研究.
목적 비교가강해도층뢰파매소세탈지가(Excel)여불가강해도층뢰파매소세탈지가(Cypher Select)재급성ST단태고형심기경사직접경피관상동맥개입치료중적유효성화안전성.방법 련속입선적228례급성ST단태고형심기경사환자수궤분지Cypher조(113례)화Excel조(115례).주요종점위술후12개월주요불양심장사건(포괄사망、심기경사화파혈관중건),차요종점위9개월만기관강주실화지가재협착.결과 술후9개월Cypher조화Excel조분별유43례(38.1%)화48례(42.1%)환자접수관상동맥조영수방,량조지가내만기관강주실[(0.17±0.26)mm비(0.18±0.33)mm,P=0.483]、절단내만기관강주실[(0.19±0.36)mm비(0.20±0.42)mm,P=0.419)화지가내재협착(2.3%비2.1%,P=0.937)、절단내재협착(4.7%비6.3%,P=0.738)적발생솔차이무통계학의의.술후12개월Cypher조화Excel조사망(3.5%비2.6%,P=0.692)、심기경사(1.8%비2.6%,P=0.658)、파혈관중건(1.8%비2.6%,P=0.658)、주요불양심장사건(5.3%비6.1%,P=0.788)급지가내혈전형성(4.4%비3.5%,P=0.724)적발생솔차이무통계학의의.결론 가강해도층여불가강해도층뢰파매소세탈지가재직접경피관상동맥개입치료급성ST단태고형심기경사중적근기료효화안전성가능시일치적,기원기효과유대진일보연구.
Objective This prospective random control study was performed to compare the efficacy and safety of primary percutaneous coronary intervention (PCI) with biodegradable polymer ( Excel ) and with durable polymer ( Cypher Select) sirolimus-eluting stents in patients with acute ST-elevation myocardial infarction (STEMI). Methods Consecutive patients with STEMI underwent primary PCI were randomly divided into Cypher group ( n = 113 ) and Excel group ( n = 115 ). The primary endpoints were major adverse cardiac events (MACE, including death, reinfarction and target vessel revascularization) within 12 months.The second endpoints included late luminal loss and restenosis at 9 months. Results Angiographic follow-up data at 9 months were available in 43 (38%) patients in Cypher group and 48 (42%) in Excel group. The rates of in-stent restenosis and in-segment restenosis were 2. 3% vs. 2. 1% (P =0. 937) and 4. 7% vs.6. 3% ( P = 0. 738 ), respectively. The late luminal loss of in-stent and in-segment were (0. 17 + 0. 26 ) mmvs. (0.18 ±0.33)mm (P=0.483) and (0.19 +0.36) mm vs. (0.20 ±0. 42)mm (P=0.419),respectively. There were no significant differences in death (3.5% vs. 2. 6%, P =0. 692), reinfarction ( 1.8% vs. 2. 6%, P = 0. 658 ), target vessel revascularization ( 1.8% vs. 2. 6%, P = 0. 658 ), MACE (5.3% vs. 6. 1% , P=0.788) or stent thrombosis (4.4% vs. 3.5%, P=0.692) at 12 months between Cyper group and Excel group. Conclusions Excel and Cypher Select stents may have similar mid-term efficacy and safety in patients with STEMI treated with primary PCI. Further investigation is warranted to validate the long-term efficacy and safety.
