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药物洗脱支架安全性与有效性的批判性评估。

A critical appraisal of the safety and efficacy of drug-eluting stents.

作者信息

Maluenda G, Lemesle G, Waksman R

机构信息

Division of Cardiology, Washington Hospital Center, Washington, DC, USA.

出版信息

Clin Pharmacol Ther. 2009 May;85(5):474-80. doi: 10.1038/clpt.2009.8. Epub 2009 Mar 11.

Abstract

Drug-eluting stents (DESs) have largely demonstrated their superiority to bare-metal stents (BMSs) with respect to in-stent restenosis. Since the US Food and Drug Administration (FDA) approved the first DES in 2003, there has been a significant increase in the use of these devices. They are used in 70-80% of all stent procedures worldwide. Nevertheless, safety concerns stemming from reports of increased risk of late stent thrombosis (ST) and myocardial infarction (MI) have tempered the enthusiasm that the advent of these stents originally generated. New generation DESs with novel polymers, antiproliferative drugs, and improved platforms are now approved and available for use. In this review we provide a critical appraisal, based on published clinical data, of the safety and efficacy of various DESs.

摘要

药物洗脱支架(DES)在支架内再狭窄方面已充分证明其优于裸金属支架(BMS)。自2003年美国食品药品监督管理局(FDA)批准首个DES以来,这些装置的使用量显著增加。在全球所有支架手术中,70%-80%都使用了DES。然而,关于晚期支架血栓形成(ST)和心肌梗死(MI)风险增加的报告引发的安全担忧,减弱了这些支架问世最初所带来的热情。如今,具有新型聚合物、抗增殖药物和改进平台的新一代DES已获批准并可供使用。在本综述中,我们基于已发表的临床数据,对各种DES的安全性和有效性进行批判性评估。

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