Maeng Michael, Jensen Lisette Okkels, Galloe Anders Michael, Thayssen Per, Christiansen Evald Hoej, Hansen Knud Nørregaard, Helqvist Steffen, Botker Hans Erik, Lassen Jens Flensted, Thuesen Leif
Department of Cardiology, Aarhus University Hospital, Skejby Hospital, Aarhus, Denmark.
Am J Cardiol. 2009 Feb 1;103(3):345-9. doi: 10.1016/j.amjcard.2008.09.084. Epub 2008 Nov 12.
The aim of the present study was to evaluate angiographic late luminal loss after the implantation of sirolimus-eluting Cypher stents and paclitaxel-eluting Taxus stents in patients with diabetes. The study was a Danish multicenter, open-label, randomized trial. One hundred fifty-three patients with diabetes with coronary artery disease were randomized to Cypher (n = 76) or Taxus (n = 77) stent implantation. All patients were followed for 8 months. The primary end point was 8-month angiographic in-stent late luminal loss. This primary end point was reduced in the Cypher group compared with the Taxus group (0.23 +/- 0.54 vs 0.44 +/- 0.52 mm, p = 0.025). Angiographic in-segment restenosis at 8-month follow-up, a secondary end point, was present in 16 patients (Cypher, n = 6; Taxus, n = 10; p = 0.24). Target lesion revascularization was performed in 5 patients (6.5%) and 9 patients (11.8%) in the Cypher and Taxus groups, respectively (p = 0.25). Definite stent thrombosis was observed in 2 patients (in the Taxus group), no patients had probable stent thrombosis, and 1 patient in each group had possible stent thrombosis. Major adverse cardiac events (cardiac death, myocardial infarction, definite stent thrombosis, or target lesion revascularization) were observed in 17 patients (Cypher, n = 6; Taxus, n = 11; p = 0.19). In conclusion, angiographic in-stent late luminal loss is significantly reduced in patients with diabetes by use of the sirolimus-eluting Cypher stent compared with the paclitaxel-eluting Taxus stent.
本研究的目的是评估西罗莫司洗脱Cypher支架和紫杉醇洗脱Taxus支架植入糖尿病患者后的血管造影晚期管腔丢失情况。该研究是一项丹麦多中心、开放标签、随机试验。153例患有冠状动脉疾病的糖尿病患者被随机分为接受Cypher支架植入组(n = 76)或Taxus支架植入组(n = 77)。所有患者均随访8个月。主要终点是8个月时血管造影显示的支架内晚期管腔丢失。与Taxus组相比,Cypher组的这一主要终点有所降低(0.23±0.54 vs 0.44±0.52 mm,p = 0.025)。作为次要终点的8个月随访时血管造影节段内再狭窄在16例患者中出现(Cypher组,n = 6;Taxus组,n = 10;p = 0.24)。Cypher组和Taxus组分别有5例患者(6.5%)和9例患者(11.8%)进行了靶病变血管重建(p = 0.25)。在2例患者(Taxus组)中观察到明确的支架血栓形成,无患者发生可能的支架血栓形成,每组各有1例患者发生可能的支架血栓形成。17例患者发生了主要不良心脏事件(心源性死亡、心肌梗死、明确的支架血栓形成或靶病变血管重建)(Cypher组,n = 6;Taxus组,n = 11;p = 0.19)。总之,与紫杉醇洗脱Taxus支架相比,糖尿病患者使用西罗莫司洗脱Cypher支架可显著减少血管造影显示的支架内晚期管腔丢失。