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Endeavor 佐他莫司洗脱支架植入后 5 年的临床随访:ENDEAVOR I,首例人体研究。

Five-year clinical follow-up after implantation of the Endeavor zotarolimus-eluting stent: ENDEAVOR I, first-in-human study.

机构信息

Monash Medical Centre and Monash University, 246 Clayton Road, Clayton, Melbourne, Australia.

出版信息

Catheter Cardiovasc Interv. 2009 Dec 1;74(7):989-95. doi: 10.1002/ccd.22206.

Abstract

OBJECTIVE

To evaluate the 5-year clinical outcomes of patients treated with the Endeavor zotarolimus-eluting stent (ZES) in the ENDEAVOR I first-in-human study.

BACKGROUND

ENDEAVOR I was a prospective, nonrandomized, multicenter study of the Endeavor ZES in 100 consecutive patients with symptomatic coronary artery disease (CAD) due to de novo, stenotic lesions in native coronary arteries.

METHODS

Patients with single or multivessel CAD were eligible to participate, but only one lesion per patient was treated. The lesion had to have > or = 50% stenosis, be < or = 15 mm in length, and located in a vessel with a reference diameter of 3.0-3.5 mm. Major adverse cardiac events (MACE), target lesion revascularization (TLR), target vessel failure (TVF), and stent thrombosis were evaluated 5 years after stent implantation.

RESULTS

The cumulative incidence of MACE was 2.0% at 1 year, 3.0% at 2 years, 6.1% at 3 years, 7.2% at 4 years, and 7.2% at 5 years. At 5 years, there were seven patients who had eight events; four noncardiac (cancer) deaths, three cases of TLR, of which one presented as a non-Q-wave MI because of a stent thrombosis at 10 days after the index procedure. There were no late or very late stent thromboses by any definition. TVF at 5 years was 5.2%.

CONCLUSIONS

Use of the Endeavor ZES to treat symptomatic CAD due to de novo lesions in native coronary arteries resulted in sustained clinical benefits to 5 years, with low rates of MACE, TLR, TVF, and stent thrombosis.

摘要

目的

评估在 ENDEAVOR I 首例人体研究中接受 Endeavor 佐他莫司洗脱支架(ZES)治疗的患者的 5 年临床结果。

背景

ENDEAVOR I 是一项前瞻性、非随机、多中心研究,评估了 100 例有症状的冠心病(CAD)患者接受 Endeavor ZES 的效果,这些患者的 CAD 是由原发冠状动脉的新发病变、狭窄病变引起的。

方法

符合条件的患者为单支或多支 CAD,但每位患者仅限治疗一处病变。病变必须有≥50%狭窄,长度<15mm,且位于参考直径为 3.0-3.5mm 的血管内。主要不良心脏事件(MACE)、靶病变血运重建(TLR)、靶血管失败(TVF)和支架血栓形成在支架植入 5 年后进行评估。

结果

1 年时的 MACE 累积发生率为 2.0%,2 年时为 3.0%,3 年时为 6.1%,4 年时为 7.2%,5 年时为 7.2%。5 年时,有 7 名患者发生了 8 次事件;其中 4 例为非心脏性(癌症)死亡,3 例为 TLR,其中 1 例在指数手术后 10 天因支架血栓形成导致非 Q 波 MI。任何定义下均未发生晚期或极晚期支架血栓形成。5 年时 TVF 为 5.2%。

结论

在治疗原发冠状动脉新发病变引起的有症状 CAD 方面,使用 Endeavor ZES 治疗可带来持续 5 年的临床获益,其 MACE、TLR、TVF 和支架血栓形成发生率较低。

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