Co Melissa, Tay Edgar, Lee Chi Hang, Poh Kian Keong, Low Adrian, Lim Jimmy, Lim Ing Han, Lim Yean Teng, Tan Huay Cheem
Cardiac Department, National University Hospital, Singapore, Singapore.
Am Heart J. 2008 Jan;155(1):128-32. doi: 10.1016/j.ahj.2007.08.031. Epub 2007 Nov 26.
We assessed the use of the endothelial progenitor cell (EPC) capture stent in primary percutaneous intervention in ST-elevation myocardial infarction (STEMI).
One hundred and twenty patients with acute STEMI without cardiogenic shock received 129 EPC capture stents. Procedural success was achieved in 95% of patients. Dual antiplatelet therapy was given for a month and statin therapy started immediately after the procedure. The study end points are major adverse cardiac events inhospital and at 30 days, 6 months, and 1 year. Hypertension was present in 47.5% and diabetes mellitus in 30% of the patients. The left anterior descending artery was the treated artery in 54% of the patients. Mean lesion length was 17.4 +/- 7.15 mm with mean reference vessel diameter of 3.18 +/- 0.6 mm. Platelet glycoprotein IIb/IIIa inhibitor was used in 14% of patients and 58% had thrombosuction before stent implantation. Ninety-five percent of patients achieved Thrombolysis in Myocardial Infarction 3 flow with cumulative major adverse cardiac event rate at 1.6% inhospital, 4.2% at 30 days, 5.8% at 6 months, and 9.2% at 1 year. There was 1 patient each with acute and subacute stent thrombosis but no incidence of late stent thrombosis.
Using EPC capture stent during primary percutaneous coronary intervention for STEMI is feasible and safe.
我们评估了内皮祖细胞(EPC)捕获支架在ST段抬高型心肌梗死(STEMI)的直接经皮冠状动脉介入治疗中的应用。
120例无心源性休克的急性STEMI患者接受了129枚EPC捕获支架。95%的患者手术成功。给予双重抗血小板治疗1个月,并在术后立即开始他汀类药物治疗。研究终点为住院期间以及30天、6个月和1年时的主要不良心脏事件。47.5%的患者存在高血压,30%的患者患有糖尿病。54%的患者的治疗血管为左前降支。平均病变长度为17.4±7.15mm,平均参考血管直径为3.18±0.6mm。14%的患者使用了血小板糖蛋白IIb/IIIa抑制剂,58%的患者在支架植入前进行了血栓抽吸。95%的患者达到心肌梗死溶栓3级血流,住院期间累积主要不良心脏事件发生率为1.6%,30天时为4.2%,6个月时为5.8%,1年时为9.2%。各有1例患者发生急性和亚急性支架血栓形成,但无晚期支架血栓形成的病例。
在STEMI的直接经皮冠状动脉介入治疗中使用EPC捕获支架是可行且安全的。