Raja Shahzad G, Dreyfus Gilles D
Department of Cardiac Surgery, Royal Hospital for Sick Children, Yorkhill NHS Trust, Dalnair Street, Glasgow, United Kingdom.
J Card Surg. 2006 Nov-Dec;21(6):605-12; discussion 613-4. doi: 10.1111/j.1540-8191.2006.00325.x.
The development of drug-eluting coronary stents has proved to be a quantum advance in interventional cardiology, rivaling the impact of stenting itself. Drug-eluting coronary stents deliver effective local concentrations of antiproliferative drugs (thus avoiding systemic toxicities), without substantially modifying the technique of percutaneous coronary intervention. Studies involving several different stent platforms and antiproliferative drug coatings have recently demonstrated dramatic reductions in restenosis rates, compared to conventional bare metal stents. Although the clinical benefits of drug-eluting stents are increasingly evident, important concerns about their long-term safety and costs have been raised. Furthermore, drug-eluting stents are being claimed to replace coronary artery bypass surgery in the near future. This review article evaluates the current best available evidence on the efficacy and safety of drug-eluting stents with a focus on the impact of this "revolutionary" new technology on the practice of coronary artery bypass surgery.
药物洗脱冠状动脉支架的发展已被证明是介入心脏病学的一项重大进步，其影响力可与支架本身相媲美。药物洗脱冠状动脉支架能提供有效的局部抗增殖药物浓度（从而避免全身毒性），同时基本不改变经皮冠状动脉介入技术。与传统裸金属支架相比，涉及几种不同支架平台和抗增殖药物涂层的研究最近显示再狭窄率显著降低。尽管药物洗脱支架的临床益处越来越明显，但人们对其长期安全性和成本提出了重要担忧。此外，有人声称药物洗脱支架在不久的将来将取代冠状动脉旁路移植术。这篇综述文章评估了关于药物洗脱支架疗效和安全性的当前最佳现有证据，重点关注这项“革命性”新技术对冠状动脉旁路移植术实践的影响。
