急性和亚急性支架闭塞；离子型造影剂降低风险的作用

Acute and subacute stent occlusion; risk-reduction by ionic contrast media.

作者信息

Scheller B, Hennen B, Pohl A, Schieffer H, Markwirth T

机构信息

Division of Internal Medicine III , University of Saarland, Homburg/Saar, Germany.

出版信息

Eur Heart J. 2001 Mar;22(5):385-91. doi: 10.1053/euhj.2000.2319.

DOI:10.1053/euhj.2000.2319

PMID:11207080

Abstract

AIMS

Current data concerning the influence of X-ray contrast media on the incidence of thrombotic complications in interventional cardiology are controversial. The effect of ionic contrast media on acute (< or =72 h) and subacute (< or =30 days) stent thrombosis has not been investigated.

METHODS

Three thousand, nine hundred and ninety consecutive patients underwent coronary stent placement. Group I (n=1808) received non-ionic contrast media while group II (n=2182) was given the ionic Ioxaglate. All patients were treated with a standard regimen of aspirin and ticlopidine for 4 weeks post intervention.

RESULTS

Both acute and subacute stent occlusion occurred more frequently in patients receiving non-ionic contrast media compared to ionic contrast media (acute stent occlusion: 1.3% in group I vs 0.3% in group II, P=0.001; subacute stent occlusion: 2.4% in group I vs 0.7% in group II, P=0.001). The incidence of the combined clinical end-point of coronary artery bypass grafting, target lesion revascularization, and overall mortality within 12 months was significantly reduced by the use of Ioxaglate (22.9% vs 16.3%, P=0.001).

CONCLUSIONS

Based upon these data, we recommend the use of Ioxaglate in coronary interventions when stent placement is anticipated.

摘要

目的

目前关于X线造影剂对介入心脏病学中血栓形成并发症发生率影响的数据存在争议。离子型造影剂对急性（≤72小时）和亚急性（≤30天）支架血栓形成的影响尚未得到研究。

方法

连续3990例患者接受冠状动脉支架置入术。第一组（n = 1808）接受非离子型造影剂，而第二组（n = 2182）给予离子型碘克沙醇。所有患者在介入治疗后均接受阿司匹林和噻氯匹定标准方案治疗4周。

结果

与离子型造影剂相比，接受非离子型造影剂的患者急性和亚急性支架闭塞发生率更高（急性支架闭塞：第一组为1.3%，第二组为0.3%，P = 0.001；亚急性支架闭塞：第一组为2.4%，第二组为0.7%，P = 0.001）。使用碘克沙醇可使冠状动脉旁路移植术、靶病变血管重建和12个月内总死亡率的联合临床终点发生率显著降低（22.9%对16.3%，P = 0.001）。