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
Clinique Pasteur, Toulouse, France.
Minerva Cardioangiol. 2007 Feb;55(1):1-18.
The use of the Endeavor stent might reduce restenosis and stent thrombosis at 9 months.
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).
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).
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.
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。
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)。
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)。
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。