在韩国人冠状动脉介入治疗的现实环境中，西罗莫司洗脱支架显示出比紫杉醇洗脱支架更好的一年期治疗效果。

Sirolimus-eluting stent showed better one-year outcomes than paclitaxel-eluting stent in a real life setting of coronary intervention in Koreans.

作者信息

Suh Jung-Won, Park Jin-Shik, Cho Hyun-Jai, Kim Min-Seok, Kang Hyun-Jae, Cho Young-Seok, Koo Bon-Kwon, Chung Woo-Young, Youn Tae-Jin, Chae In-Ho, Choi Dong-Ju, Kim Hyo-Soo, Sohn Dae-Won, Oh Byung-Hee, Park Young-Bae

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Korea.

出版信息

Int J Cardiol. 2007 Apr 12;117(1):31-6. doi: 10.1016/j.ijcard.2006.03.009. Epub 2007 Feb 8.

DOI:10.1016/j.ijcard.2006.03.009

PMID:17292498

Abstract

OBJECTIVE

The drug-eluting stent (DES) has been proven its efficacy in randomized trials. But the difference of efficacy between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in unselected patients is in controversy. Therefore, we investigated the clinical and angiographic outcomes of these two types of the DES.

METHODS

All consecutive patients treated with DES from March 2003 to March 2004 at two centers were analyzed.

RESULTS

We analyzed 440 patients with 519 lesions who were treated with the two types of DES (SES 353 lesions/296 patients, PES 166 lesions/144 patients). PES group had more acute myocardial infarction (AMI) patients. Angiographically, the number of stents per lesion, maximal deployment pressure, stent diameter and the percent residual stenosis after procedure were different between the two groups. Angiographic follow-up was available in 103 patients (71.5%) in the PES group and 208 patients (70.3%) in the SES group. PES showed the higher binary restenosis rate (PES 17.9%, SES 4.5%, p<0.0001) and the larger late loss (PES 0.60x0.83 mm vs. SES 0.16x0.40 mm, p<0.001) than SES. PES was the predictor of binary restenosis at six months (OR 4.67, CI 2.20-9.91). At one year follow-up, PES also had more cardiac events (composites of death of all cause, MI, and target lesion revascularization) than SES (PES 13.9% vs. SES 6.1%, p<0.001). PES was a significant predictor of cardiac events at one year (OR 2.47, CI 1.23-4.95).

CONCLUSION

SES showed better clinical and angiographic outcomes compared to PES in a daily routine practice of coronary intervention in Koreans.

摘要

目的

药物洗脱支架（DES）已在随机试验中证实其疗效。但在未经选择的患者中，西罗莫司洗脱支架（SES）与紫杉醇洗脱支架（PES）疗效的差异存在争议。因此，我们研究了这两种DES的临床和血管造影结果。

方法

分析了2003年3月至2004年3月在两个中心接受DES治疗的所有连续患者。

结果

我们分析了440例患者的519处病变，这些患者接受了两种类型的DES治疗（SES 353处病变/296例患者，PES 166处病变/144例患者）。PES组急性心肌梗死（AMI）患者更多。在血管造影方面，两组之间每处病变的支架数量、最大释放压力、支架直径和术后残余狭窄百分比有所不同。PES组103例患者（71.5%）和SES组208例患者（70.3%）可进行血管造影随访。与SES相比，PES显示出更高的二元再狭窄率（PES 17.9%，SES 4.5%；p<0.0001）和更大的晚期管腔丢失（PES 0.60×0.83mm对SES 0.16×0.40mm；p<0.001）。PES是6个月时二元再狭窄的预测因素（OR 4.67，CI 2.20 - 9.91）。在1年随访时，PES发生的心脏事件（全因死亡、心肌梗死和靶病变血运重建的复合事件）也比SES多（PES 13.9%对SES 6.1%；p<0.001）。PES是1年时心脏事件的显著预测因素（OR 2.47，CI 1.23 - 4.95）。