Division of Cardiology, Department of Internal Medicine, Inje University Busan Baik Hospital, South Korea.
Clin Cardiol. 2010 Jun;33(6):340-4. doi: 10.1002/clc.20744.
The aim of this study was to evaluate and compare the clinical and angiographic outcomes of 3 drug-eluting stents (DES) in patients with large vessel diameter and single coronary artery lesions.
The efficacy of 3 DESs may be similar.
A total of 411 consecutive patients who visited 3 university hospitals from June 2004 to December 2007 and had a single coronary lesion which was treated with the use of a DES that was 3.5 mm in diameter were enrolled in this study. Patients were divided into 3 stent groups: Paclitaxel-eluting stent (PES, n = 105), Sirolimus-eluting stent (SES, n = 259), and Zotarolimus-eluting stent (ZES, n = 47). The study end point was a composite of major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), and ischemia-driven target-vessel revascularization (TVR) for 12 months.
Baseline characteristics were not different. Late loss was higher in the ZES group than the other stents (0.5 +/- 0.4 mm in SES vs 0.3 +/- 0.5 mm in PES, 0.7 +/- 0.5 mm in ZES, P = 0.001). The total MACE-free survival rate was not significantly different between the SES group and the PES group (98.8% in SES vs 97.1% in PES, P = 0.252) or the PES group and the ZES group (97.1% in PES vs 93.6% in ZES, P = 0.301). However, the SES group showed a significantly better MACE-free survival rate compared with the ZES group (98.8% in SES vs 93.6% in ZES, P = 0.018).
Clinical and angiographic outcomes of DES in a large vessel diameter and single coronary artery is excellent and SES appears to show better angiographic and clinical outcomes than ZES.
本研究旨在评估和比较 3 种药物洗脱支架（DES）在大血管直径和单支冠状动脉病变患者中的临床和血管造影结果。
3 种 DES 的疗效可能相似。
本研究共纳入 411 例 2004 年 6 月至 2007 年 12 月期间在 3 所大学医院就诊的连续患者，这些患者均患有单支冠状动脉病变，采用直径为 3.5mm 的 DES 进行治疗。患者被分为 3 个支架组：紫杉醇洗脱支架（PES，n=105）、西罗莫司洗脱支架（SES，n=259）和佐他莫司洗脱支架（ZES，n=47）。研究终点是 12 个月时主要不良心脏事件（MACE）的复合终点，包括心脏死亡、心肌梗死（MI）和缺血驱动的靶血管血运重建（TVR）。
基线特征无差异。ZES 组的晚期丢失高于其他支架（SES 组为 0.5±0.4mm，PES 组为 0.3±0.5mm，ZES 组为 0.7±0.5mm，P=0.001）。SES 组与 PES 组（SES 组为 98.8%，PES 组为 97.1%，P=0.252）或 PES 组与 ZES 组（PES 组为 97.1%，ZES 组为 93.6%，P=0.301）之间的总 MACE 无事件生存率无显著差异。然而，SES 组的 MACE 无事件生存率明显优于 ZES 组（SES 组为 98.8%，ZES 组为 93.6%，P=0.018）。
大血管直径和单支冠状动脉病变的 DES 的临床和血管造影结果非常出色，SES 似乎显示出比 ZES 更好的血管造影和临床结果。
