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安博诺(Endeavor)佐他莫司洗脱磷酸胆碱包被支架治疗原发性冠状动脉病变的随机、双盲、多中心研究。ENDEAVOR II试验的临床和血管造影结果。

Randomized, double-blind, multicenter study of the Endeavor zotarolimus-eluting phosphorylcholine-encapsulated stent for treatment of native coronary artery lesions. Clinical and angiographic results of the ENDEAVOR II Trial.

作者信息

Fajadet J, Wijns W, Laarman G-J, Kuck K-H, Ormiston J, Münzel T, Popma J J, Fitzgerald P J, Bonan R, Kuntz R E

机构信息

Clinique Pasteur, Toulouse, France.

出版信息

Minerva Cardioangiol. 2007 Feb;55(1):1-18.

Abstract

AIM

The use of the Endeavor stent might reduce restenosis and stent thrombosis at 9 months.

METHODS

Patients (n =1,197) treated for single coronary artery stenosis were enrolled in a prospective, randomized, double-blind study and randomly assigned to receive the Endeavor zotarolimus-eluting phosphorylcholine polymer-coated stent (n= 598) or the same bare metal stent but without the drug or the polymer coating (n=599).

RESULTS

The 2 groups were well matched in baseline characteristics. Diabetes was present in 20.1% of patients; the mean reference vessel diameter was 2.75 mm; and the mean lesion length was 14.2 mm. The primary end point of target vessel failure at 9 months was reduced from 15.1% with the bare metal stent to 7.9% with the Endeavor (P=0.0001), and the rate of major adverse cardiac events was reduced from 14.4% with the bare metal stent to 7.3% with the Endeavor (P=0.0001). Target lesion revascularization was 4.6% with Endeavor compared with 11.8% with the bare metal stent (P=0.0001). The rate of stent thrombosis was 0.5% with the Endeavor, which was not significantly different from 1.2% with the bare metal stent. In 531 patients submitted to angiographic follow-up, late loss was reduced from 1.03+/-0.58 to 0.61+/-0.46 (P<0.001) in stent and from 0.72+/-0.61 to 0.36+/-0.46 (P<0.001) in segment. The rate of in-segment restenosis was reduced from 35% to 13.2% with Endeavor (P<0.0001). There was no excessive edge stenosis, aneurysm formation, or late acquired malposition by intravascular ultrasound imaging. Differences in clinical outcome were maintained at 12 and 24 months (P<0.0001).

CONCLUSIONS

Compared with bare metal stents, the Endeavor stent is safe and reduces the rates of clinical and angiographic restenosis at 9, 12, and 24 months.

摘要

目的

使用安进支架可能会降低9个月时的再狭窄和支架血栓形成发生率。

方法

对因单支冠状动脉狭窄接受治疗的患者(n = 1197例)进行一项前瞻性、随机、双盲研究,并随机分配其接受安进佐他莫司洗脱磷酸胆碱聚合物涂层支架(n = 598例)或相同的无药物及聚合物涂层的裸金属支架(n = 599例)。

结果

两组患者的基线特征匹配良好。20.1%的患者患有糖尿病;平均参考血管直径为2.75mm;平均病变长度为14.2mm。9个月时靶血管失败的主要终点从裸金属支架组的15.1%降至安进支架组的7.9%(P = 0.0001),主要不良心脏事件发生率从裸金属支架组的14.4%降至安进支架组的7.3%(P = 0.0001)。安进支架组的靶病变血运重建率为4.6%,而裸金属支架组为11.8%(P = 0.0001)。安进支架的支架血栓形成率为0.5%,与裸金属支架组的1.2%无显著差异。在531例行血管造影随访的患者中,支架内晚期管腔丢失从1.03±0.58降至0.61±0.46(P < 0.001),节段内从0.72±0.61降至0.36±0.46(P < 0.001)。安进支架使节段内再狭窄率从35%降至13.2%(P < 0.0001)。血管内超声成像未发现过度边缘狭窄、动脉瘤形成或晚期获得性移位。临床结局的差异在12个月和24个月时仍持续存在(P < 0.0001)。

结论

与裸金属支架相比,安进支架安全,且能降低9个月、12个月和24个月时临床和血管造影再狭窄的发生率。

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