西罗莫司洗脱支架与裸金属支架在接受择期经皮冠状动脉介入治疗的糖尿病患者中的疗效比较。

The efficacy of sirolimus-eluting stents versus bare metal stents for diabetic patients undergoing elective percutaneous coronary intervention.

作者信息

Aoki Jiro, Ong Andrew, Rodriguez-Granillo Gaston, VanMieghem Carlos, Daemen Joost, Sonnenschein Karel, McFadden Eugene, Sianos Georgios, van der Giessen Willem, de Feyter Pim, van Domburg Ron, Serruys Patrick

机构信息

Interventional Cardiology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands.

出版信息

J Invasive Cardiol. 2005 Jul;17(7):344-8.

PMID:16003016

Abstract

BACKGROUND

Diabetes mellitus is a well-known risk factor for future adverse cardiac events after coronary intervention with conventional metal stents. In this study, the impact of sirolimus-eluting stents (SES) were evaluated in a consecutive group of diabetic patients undergoing elective percutaneous coronary treatment and compared to a population treated with bare metal stents.

METHODS AND RESULTS

From April 2002, a policy of routine SES implantation has been instituted in our hospital. During 1 year of enrollment, a total of 112 consecutive diabetic patients with de novo coronary lesions were electively treated with SES (SES group). A similar group for comparison comprised 118 consecutive patients treated with bare metal stents in the preceding period (the pre-SES group). After 1-year follow-up, the cumulative rate of major adverse cardiac events (death, myocardial infarction, and any repeat revascularization) was 17.3% in the SES group versus 30.2% in the pre-SES group (hazard ratio, 0.54 [95% confidence interval, 0.32-0.91]; p = 0.02), mainly due to a marked reduction in the need for repeat revascularization (10.2% versus 23.5%; hazard ratio, 0.40 [95% confidence interval, 0.21-0.78]; p = 0.007).

CONCLUSIONS

Routine utilization of SES for diabetic patients significantly reduces the rate of adverse cardiac events at 1 year compared to bare metal stents.

摘要

背景

糖尿病是冠状动脉介入置入传统金属支架后发生未来不良心脏事件的一个众所周知的危险因素。在本研究中，对接受择期经皮冠状动脉治疗的糖尿病患者连续队列评估了西罗莫司洗脱支架（SES）的影响，并与接受裸金属支架治疗的人群进行比较。

方法和结果

自2002年4月起，我院制定了常规植入SES的政策。在入组的1年期间，共有112例连续性新发冠状动脉病变的糖尿病患者接受了SES择期治疗（SES组）。一个类似的比较组由前一时期接受裸金属支架治疗的118例连续性患者组成（SES前组）。经过1年的随访，SES组主要不良心脏事件（死亡、心肌梗死和任何再次血运重建）的累积发生率为17.3%，而SES前组为30.2%（风险比，0.54[95%置信区间，0.32 - 0.91]；p = 0.02），主要是由于再次血运重建需求的显著降低（10.2%对23.5%；风险比，0.40[95%置信区间，0.21 - 0.78]；p = 0.007）。