Ikari Yuji, Kotani Junichi, Kozuma Ken, Kyo Eishou, Nakamura Masato, Yokoi Hiroyoshi
Tokai University School of Medicine, Isehara, Japan.
Circ J. 2009 Jun;73(6):1038-44. doi: 10.1253/circj.cj-08-0732. Epub 2009 Apr 14.
Clinical data of sirolimus-eluting stent (SES) implantation are under investigation in Japan.
The CYPHER stent Japan Post-Marketing Surveillance Registry (J-PMS) was conducted at 50 medical centers to assess the results of SES in daily clinical practice exclusively under aspirin plus low dose ticlopidine (200 mg/day). A total of 2,459 lesions in 2,054 patients were treated with 3,285 SES. The mean age was 67.1 +/-10.1 years, 75.6% were men and 43.3% were diabetics. Intravascular ultrasound was used in 77.2%. The 8-month angiographic and 1-year clinical follow-up data were available in 85.4% and 96.8%, respectively. Quantitative coronary angiography showed the reference vessel diameter and percentage diameter stenosis at baseline were 2.47 +/-0.58 mm and 72.0 +/-16.1%. The 8-month late loss was 0.20 +/-0.50 mm. The major adverse cardiovascular events at 1 year was 7.3%; cardiac death: 1.1%, myocardial infarction (MI): 1.2%, and target lesion revascularization (TLR): 4.2%. The rates of definite and probable stent thrombosis at 1 year were 0.30% and 0.10%, respectively. Hemodialysis was the strongest predictor of death/MI or TLR.
J-PMS showed the effectiveness of SES implantation under aspirin plus low dose ticlopidine administration at 1 year, although further studies are necessary to demonstrate the safety.
西罗莫司洗脱支架(SES)植入的临床数据正在日本进行研究。
CYPHER支架日本上市后监测注册研究(J-PMS)在50个医疗中心开展,以专门评估在阿司匹林加小剂量噻氯匹定(200毫克/天)治疗下SES在日常临床实践中的效果。2054例患者的2459处病变共植入了3285枚SES。平均年龄为67.1±10.1岁,男性占75.6%,糖尿病患者占43.3%。77.2%的患者使用了血管内超声。分别有85.4%和96.8%的患者获得了8个月的血管造影和1年的临床随访数据。定量冠状动脉造影显示,基线时参考血管直径和直径狭窄百分比分别为2.47±0.58毫米和72.0±16.1%。8个月时的晚期管腔丢失为0.20±0.50毫米。1年时主要不良心血管事件发生率为7.3%;心源性死亡:1.1%,心肌梗死(MI):1.2%,靶病变血运重建(TLR):4.2%。1年时明确和可能的支架血栓形成率分别为0.30%和0.10%。血液透析是死亡/MI或TLR的最强预测因素。
J-PMS显示了在阿司匹林加小剂量噻氯匹定治疗下植入SES 1年时的有效性,尽管需要进一步研究来证明其安全性。