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使用西罗莫司洗脱支架对慢性完全闭塞病变进行冠状动脉支架置入术后的三年临床结果:来自鹿特丹心脏病医院雷帕霉素洗脱支架评估(RESEARCH)注册研究的见解

Three-year clinical outcomes after coronary stenting of chronic total occlusion using sirolimus-eluting stents: insights from the rapamycin-eluting stent evaluated at Rotterdam cardiology hospital-(RESEARCH) registry.

作者信息

García-García Héctor M, Daemen Joost, Kukreja Neville, Tanimoto Shuzou, van Mieghem Carlos A G, van der Ent Martin, van Domburg Ron T, Serruys Patrick W

机构信息

Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.

出版信息

Catheter Cardiovasc Interv. 2007 Nov 1;70(5):635-9. doi: 10.1002/ccd.21249.

Abstract

BACKGROUND

We previously reported that the 1-year survival-free from target lesion revascularization was 97.4% in patients with chronic total occlusion (CTO) treated with sirolimus-eluting stents (SES). There are currently no long-term results of the efficacy of SES in this subset of lesions. We assessed the 3-year clinical outcomes of 147 patients with CTO treated with either SES or bare metal stents (BMS).

METHODS AND RESULTS

A total of 147 (BMS = 71, SES = 76) patients were included. Four patients died in the BMS group while five patients died in the SES group, P = 0.8; two myocardial infarctions occurred in both groups, P = 0.9; and target vessel revascularization was performed in nine patients in the BMS and seven in the SES group, P = 0.5. The cumulative event-free survival of MACE was 81.7% in BMS group and 84.2% in SES group, P = 0.7. Two patients of the SES group had a coronary aneurism at 3-year angiographic follow-up.

CONCLUSIONS

The use of SES was no longer associated with significantly lower rates of target vessel revascularization and major adverse cardiac events in patients with CTOs after 3 years of follow-up compared with BMSs.

摘要

背景

我们之前报道过,接受西罗莫司洗脱支架(SES)治疗的慢性完全闭塞(CTO)患者中,无靶病变血管重建的1年生存率为97.4%。目前尚无该病变亚组中SES疗效的长期结果。我们评估了147例接受SES或裸金属支架(BMS)治疗的CTO患者的3年临床结局。

方法与结果

共纳入147例患者(BMS组71例,SES组76例)。BMS组有4例患者死亡,SES组有5例患者死亡,P = 0.8;两组均发生2例心肌梗死,P = 0.9;BMS组9例患者和SES组7例患者进行了靶血管重建,P = 0.5。BMS组MACE的累积无事件生存率为81.7%,SES组为84.2%,P = 0.7。SES组有2例患者在3年血管造影随访时出现冠状动脉瘤。

结论

与BMS相比,随访3年后,CTO患者使用SES不再与显著更低的靶血管重建率和主要不良心脏事件发生率相关。

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