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支架内捕获内皮祖细胞治疗 ST 段抬高型急性心肌梗死患者:1 年随访。

Endothelial progenitor cell capture stent implantation in patients with ST-segment elevation acute myocardial infarction: one year follow-up.

机构信息

National University Hospital, Singapore.

出版信息

EuroIntervention. 2010 Jan;5(6):698-702. doi: 10.4244/eijv5i6a115.

DOI:10.4244/eijv5i6a115
PMID:20142221
Abstract

AIMS

The Genous endothelial progenitor cell (EPC) capture stent is a bioengineered R stent coated with immobilised antibodies on its stent struts to allow for the capture of circulating EPCs to promote rapid endothelisation. We assessed the impact of this stent in the primary percutaneous coronary intervention (PCI) of patients with acute ST-elevation myocardial infarction (STEMI) and examined its long term clinical outcomes.

METHODS AND RESULTS

All patients with acute STEMI without cardiogenic shock who underwent primary PCI between January 2005 and April 2007 and received the stent were enrolled in the study. The study endpoints were major adverse cardiac events (MACE) defined as death, MI and target vessel revascularisation (TVR) at 30 days, six months and one year. A total of 321 enrolled patients received 357 EPC capture stents during the study period. The cohort comprises 81.0% males with mean age of 54.6+/-11.6 years. The mean stent length used was 20.98+/-5.50 mm and mean stent size was 2.99+/-0.32 mm. Ninety-four percent of patients achieved Thrombolysis in Myocardial Infarction (TIMI) 3 flow post-procedurally. The cumulative MACE rate was 8.1% at 30 days, 10.0% at six months and 12.2% at one year. There was one patient who developed acute stent thrombosis and another two with subacute stent thromboses. No late thrombosis or late cardiac mortality was observed in our cohort. The need for TVR was 4.4% at one year.

CONCLUSIONS

The use of EPC capture stents in patients who underwent primary PCI for STEMI is safe and showed good clinical outcomes, with low rates of TVR and no late stent thrombosis.

摘要

目的

Genous 内皮祖细胞(EPC)捕获支架是一种生物工程 R 支架,其支架支柱上固定有抗体,以捕获循环中的 EPC,从而促进快速内皮化。我们评估了该支架在急性 ST 段抬高型心肌梗死(STEMI)患者的直接经皮冠状动脉介入治疗(PCI)中的作用,并检查了其长期临床结果。

方法和结果

所有在 2005 年 1 月至 2007 年 4 月期间接受直接 PCI 治疗且植入支架的急性 STEMI 且无心源性休克的患者均被纳入研究。研究终点为 30 天、6 个月和 1 年时的主要不良心脏事件(MACE),定义为死亡、心肌梗死和靶血管血运重建(TVR)。在研究期间,共有 321 名患者接受了 357 个 EPC 捕获支架。该队列包括 81.0%的男性,平均年龄为 54.6+/-11.6 岁。使用的支架平均长度为 20.98+/-5.50mm,支架平均直径为 2.99+/-0.32mm。94%的患者在术后达到心肌梗死溶栓治疗(TIMI)3 级血流。30 天时的累积 MACE 发生率为 8.1%,6 个月时为 10.0%,1 年时为 12.2%。有 1 例患者发生急性支架内血栓形成,另有 2 例发生亚急性支架内血栓形成。我们的队列中没有观察到迟发性血栓形成或迟发性心脏死亡。1 年内需要 TVR 的比例为 4.4%。

结论

在接受直接 PCI 治疗的 STEMI 患者中使用 EPC 捕获支架是安全的,且显示出良好的临床结果,TVR 发生率低,且无迟发性支架内血栓形成。

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