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新型薄壁钴铬冠状动脉支架系统的临床安全性和疗效:真实世界 Coroflex Blue 注册研究结果。

Clinical safety and efficacy of a novel thin-strut cobalt-chromium coronary stent system: results of the real world Coroflex Blue Registry.

机构信息

Department of Cardiology, Charité-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.

出版信息

Catheter Cardiovasc Interv. 2010 Jan 1;75(1):78-85. doi: 10.1002/ccd.22208.

Abstract

OBJECTIVES

The aim of this registry was to evaluate the clinical efficacy and safety of the Coroflex Blue cobalt-chromium stent in real-world practice.

BACKGROUND

The development of cobalt-chromium bare-metal stents (BMS) with thinner struts has lead to better deliverability and lower target-lesion revascularization rates compared with stainless steel BMS.

METHODS

The Coroflex Blue Registry was an international, prospective, multicenter registry enrolling patients with symptomatic ischemic heart disease attributable to single de novo or restenotic nonstented lesions of a single vessel amenable for percutaneous stenting. The primary end point was clinically driven target-lesion revascularisation (TLR) 6 months after enrolment, secondary endpoints were technical/procedural success, in-hospital outcome, definite stent thrombosis and major adverse cardiac events (death, myocardial infarction, or TLR) after 6 months.

RESULTS

The registry included 2,315 patients (mean age 64.3 +/- 11.1 years, 19.8% diabetes, 37.3% acute myocardial infarction). Although a complex lesion cohort with 60.3% Typ B(2)/C-lesions, the technical success rate was 99.1% and the procedural success rate 98.5%. The incidence of TLR after 6 months was 5.5% and the cumulative 6-month acute/subacute stent thrombosis rate was 1.6%. After 6 months cumulative event-free survival was 90.8% in all patients and 87% in patients with acute PCI for acute myocardial infarction.

CONCLUSIONS

This registry demonstrates the safety and efficacy of the Coroflex Blue cobalt-chromium stent platform in real-world practice. In the era of drug-eluting stents (DES), these results raise the serious question if the use of DES for primary prevention of restenosis and TLR is really justified.

摘要

目的

本注册研究旨在评估 Coroflex Blue 钴铬支架在真实世界实践中的临床疗效和安全性。

背景

与不锈钢 BMS 相比,具有更薄支架的钴铬裸金属支架(BMS)具有更好的可输送性和更低的靶病变血运重建率。

方法

Coroflex Blue 注册研究是一项国际性、前瞻性、多中心注册研究,纳入了因单一初发或再狭窄非支架病变导致有症状缺血性心脏病的患者,这些病变适合经皮支架置入。主要终点是 6 个月时临床驱动的靶病变血运重建(TLR),次要终点是技术/程序成功、住院结局、明确支架血栓形成和 6 个月后主要不良心脏事件(死亡、心肌梗死或 TLR)。

结果

该注册研究共纳入 2315 例患者(平均年龄 64.3±11.1 岁,19.8%患有糖尿病,37.3%发生急性心肌梗死)。尽管病变复杂,60.3%为 B2/C 型病变,但技术成功率为 99.1%,程序成功率为 98.5%。6 个月时 TLR 的发生率为 5.5%,6 个月时急性/亚急性支架血栓形成的累积发生率为 1.6%。所有患者 6 个月时累积无事件生存率为 90.8%,急性心肌梗死行急诊 PCI 的患者为 87%。

结论

本注册研究表明 Coroflex Blue 钴铬支架平台在真实世界实践中的安全性和有效性。在药物洗脱支架(DES)时代,这些结果提出了一个严重的问题,即是否真的有必要将 DES 用于原发性预防再狭窄和 TLR。

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