Buza V V, Karpov Iu A, Samko A N, Deev A D, Lopukhova V V, Levitskiĭ I V, Sozykin A V
Kardiologiia. 2009;49(1):9-13.
The placement of sirolimus-eluting stents decreases the frequency of repeat revascularization procedures in patients undergoing percutaneous coronary intervention (PCI) in randomized clinical trials. However, there is uncertainty about the effectiveness of sirolimus-eluting stents, and increasing concern about their safety in routine clinical practice. From the prof. Samko PCI laboratory in Moscow, Russia, we identified 426 patients, who received either bare-metal stents alone or sirolimus-eluting stents alone during an index PCI procedure between March 1, 2002, and September 31, 2004.The primary outcomes of the study were the rates of target-lesion revascularization, myocardial infarction, death, late stent thrombosis. The 3-year rate of target-lesion revascularization was significantly lower among patients who received sirolimus-eluting stents than among those who received bare-metal stents (3.1% vs. 19 %, p=0.001). The 3-year mortality rate was not different between the bare-metal stent group and the sirolimus eluting stent group (5.9% vs. 7.2%, p=0.68), the 3-year rate of all ARC late stent thrombosis was similar in the two groups (5.9% and 7.2%, respectively; p=0.95). Sirolimus-eluting stents are effective in reducing the need for target-vessel revascularization without significantly increased rates of death, late stent thrombosis, myocardial infarction.
在随机临床试验中，西罗莫司洗脱支架的置入降低了接受经皮冠状动脉介入治疗（PCI）患者重复血运重建术的频率。然而，西罗莫司洗脱支架的有效性存在不确定性，并且在常规临床实践中对其安全性的担忧日益增加。我们从俄罗斯莫斯科的萨姆科教授PCI实验室中，确定了426例患者，他们在2002年3月1日至2004年9月31日期间的首次PCI手术中，单独接受了裸金属支架或单独接受了西罗莫司洗脱支架。该研究的主要结局是靶病变血运重建率、心肌梗死、死亡、晚期支架血栓形成。接受西罗莫司洗脱支架的患者中靶病变血运重建的3年发生率显著低于接受裸金属支架的患者（3.1%对19%，p = 0.001）。裸金属支架组和西罗莫司洗脱支架组的3年死亡率无差异（5.9%对7.2%，p = 0.68），两组中所有ARC晚期支架血栓形成的3年发生率相似（分别为5.9%和7.2%；p = 0.95）。西罗莫司洗脱支架在减少靶血管血运重建需求方面有效，且不会显著增加死亡、晚期支架血栓形成、心肌梗死的发生率。
