Department of Cardiology, Academic Medical Center, University of Amsterdam, B2-137 Meibergdreef 9, PO Box 22660, 1105 AZ Amsterdam, The Netherlands.
Eur Heart J. 2010 May;31(9):1055-64. doi: 10.1093/eurheartj/ehp476. Epub 2009 Nov 18.
The purpose of this study was to evaluate the Genous(TM) endothelial progenitor cell capturing stent vs. the Taxus Liberté paclitaxel-eluting stent in patients with de novo coronary lesions with a high-risk of coronary restenosis.
We randomly assigned 193 patients with lesions carrying a high risk of restenosis to have the Genous stent or the Taxus stent implanted. Lesions were considered high risk of restenosis if one of the following applied: chronic total occlusion, lesion length >23 mm, vessel diameter <2.8 mm, or any lesion in a diabetic patient. At 1-year, the rate of the primary end point, target vessel failure (TVF), was 17.3% in the Genous stent group when compared with 10.5% in the Taxus stent group [risk difference (RD) 6.8%, 95% CI -3.1 to 16.7%], a difference predominantly due to a higher incidence of repeat revascularization in patients treated with the Genous stent. In contrast, no stent thrombosis was observed in the Genous stent group compared to 4 stent thromboses in the Taxus stent group (RD -4.2%; 95% CI -10.3 to 0.3%). Repeat angiography between 6 and 12 months in a subgroup of patients showed a significantly higher late loss in the Genous stent compared with the Taxus stent (1.14 +/- 0.64 and 0.55 +/- 0.61 mm).
In patients with lesions carrying a high risk of restenosis, the Genous stent resulted in a non-significant higher rate of TVF compared with the Taxus stent mainly due to more repeat revascularizations in the Genous stent group. There were four stent thromboses with Taxus stent, none with the Genous stent.
本研究旨在评估 Genous(TM)内皮祖细胞捕获支架与 Taxus Liberté 紫杉醇洗脱支架在伴有高再狭窄风险的初发冠状动脉病变患者中的疗效。
我们将 193 例存在高再狭窄风险的病变患者随机分为植入 Genous 支架或 Taxus 支架组。如果存在以下任何一种情况,则认为病变具有高再狭窄风险:慢性完全闭塞、病变长度>23mm、血管直径<2.8mm 或任何糖尿病患者的病变。在 1 年时,Genous 支架组的主要终点——靶血管失败(TVF)发生率为 17.3%,而 Taxus 支架组为 10.5%[风险差异(RD)6.8%,95%CI-3.1 至 16.7%],这一差异主要是由于 Genous 支架组患者再次血运重建的发生率较高。相比之下,Genous 支架组未观察到支架血栓形成,而 Taxus 支架组有 4 例支架血栓形成(RD-4.2%,95%CI-10.3 至 0.3%)。在患者亚组中进行的 6 至 12 个月时的重复血管造影显示,Genous 支架的晚期管腔丢失明显高于 Taxus 支架(1.14±0.64 和 0.55±0.61mm)。
在伴有高再狭窄风险的病变患者中,与 Taxus 支架相比,Genous 支架导致 TVF 的发生率非显著升高,主要是由于 Genous 支架组再次血运重建的比例较高。Taxus 支架组发生了 4 例支架血栓形成,而 Genous 支架组无支架血栓形成。