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西罗莫司洗脱冠状动脉支架植入联合阿司匹林加小剂量噻氯匹定给药的评估:来自CYPHER支架日本上市后监测注册研究(J-PMS)的一年结果

Assessment of sirolimus-eluting coronary stent implantation with aspirin plus low dose ticlopidine administration: one year results from CYPHER Stent Japan Post-Marketing Surveillance Registry (J-PMS).

作者信息

Ikari Yuji, Kotani Junichi, Kozuma Ken, Kyo Eishou, Nakamura Masato, Yokoi Hiroyoshi

机构信息

Tokai University School of Medicine, Isehara, Japan.

出版信息

Circ J. 2009 Jun;73(6):1038-44. doi: 10.1253/circj.cj-08-0732. Epub 2009 Apr 14.

Abstract

BACKGROUND

Clinical data of sirolimus-eluting stent (SES) implantation are under investigation in Japan.

METHODS AND RESULTS

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.

CONCLUSIONS

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.

摘要

背景

西罗莫司洗脱支架(SES)植入的临床数据正在日本进行研究。

方法与结果

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。

结论

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。

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