Valgimigli Marco, Malagutti Patrizia, Aoki Jiro, Garcia-Garcia Héctor M, Rodriguez Granillo Gaston A, van Mieghem Carlos A G, Ligthart Jurgen M, Ong Andrew T L, Sianos George, Regar Evelyn, Van Domburg Ron T, De Feyter Pim, de Jaegere Peter, Serruys Patrick W
Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands.
J Am Coll Cardiol. 2006 Feb 7;47(3):507-14. doi: 10.1016/j.jacc.2005.09.040. Epub 2006 Jan 18.
The purpose of this study was to investigate the long-term clinical and angiographic profile of sirolimus-eluting stent (SES) versus paclitaxel-eluting stent (PES) in patients undergoing percutaneous intervention for left main (LM) coronary disease.
The long-term clinical and angiographic impact of SES as opposed to PES implantation in this subset of patients is unknown.
From April 2002 to March 2004, 110 patients underwent percutaneous intervention for LM stenosis at our institution; 55 patients were treated with SES and 55 with PES. The two groups were well balanced for all baseline characteristics.
At a median follow-up of 660 days (range 428 to 885), the cumulative incidence of major adverse cardiovascular events was similar (25% in the SES group vs. 29%, in the PES group; hazard ratio 0.88 [95% confidence interval 0.43 to 1.82]; p = 0.74), reflecting similarities in both the composite death/myocardial infarction (16% in the SES group and 18% in the PES group) and target vessel revascularization (9% in the SES group and 11% in the PES group). Angiographic in-stent late loss (mm), evaluated in 73% of the SES group and in 77% of the PES group, was 0.32 +/- 74 in the main and 0.36 +/- 0.59 in the side branch in the SES group vs. 0.46 +/- 0.57 (p = 0.36) and 0.52 +/- 0.42 (p = 0.41) in the PES group, respectively.
In consecutive patients undergoing percutaneous LM intervention, PES may perform closely to SES both in terms of angiographic and long-term clinical outcome.
本研究旨在调查接受经皮介入治疗左主干（LM）冠状动脉疾病患者中，西罗莫司洗脱支架（SES）与紫杉醇洗脱支架（PES）的长期临床和血管造影特征。
在这一亚组患者中，与植入PES相比，SES的长期临床和血管造影影响尚不清楚。
2002年4月至2004年3月，110例患者在我院接受了经皮介入治疗LM狭窄；55例患者接受SES治疗，55例接受PES治疗。两组在所有基线特征方面均衡良好。
在中位随访660天（范围428至885天）时，主要不良心血管事件的累积发生率相似（SES组为25%，PES组为29%；风险比0.88[95%置信区间0.43至1.82]；p=0.74），反映出在复合死亡/心肌梗死（SES组为16%，PES组为18%）和靶血管再血管化（SES组为9%，PES组为11%）方面相似。在SES组的73%和PES组的77%中评估的血管造影支架内晚期管腔丢失（mm），SES组主支为0.32±0.74，侧支为0.36±0.59，而PES组分别为0.46±0.57（p=0.36）和0.52±0.42（p=0.41）。
在接受经皮LM介入治疗的连续患者中，在血管造影和长期临床结果方面，PES的表现可能与SES相近。
