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生物可吸收依维莫司洗脱支架治疗初发冠状动脉疾病患者的 3 年临床随访结果:ABSORB 试验。

Three-year results of clinical follow-up after a bioresorbable everolimus-eluting scaffold in patients with de novo coronary artery disease: the ABSORB trial.

机构信息

Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

EuroIntervention. 2010 Sep;6(4):447-53. doi: 10.4244/EIJ30V6I4A76.

Abstract

AIMS

Multimodality imaging of the first-in-man trial using a fully resorbable everolimus-eluting scaffold (BVS, Abbott Vascular, Santa Clara, CA, USA) demonstrated at two years the bioresorption of the device while preventing restenosis. Nevertheless, the long-term safety and efficacy of this novel therapy remain to be documented.

METHODS AND RESULTS

The ABSORB trial completed in July 2006 at four clinical sites in Europe and New Zealand the enrolment of 30 patients with a single de novo native coronary artery lesion. The major clinical endpoint was ischaemia-driven major adverse cardiac events (ID-MACE) defined as a composite of cardiac death, myocardial infarction, or ischaemia-driven target lesion revascularisation. Clinical follow-up was available in 29 patients since one patient withdrew consent. At 46 days, one patient experienced a single episode of chest pain and underwent a diagnostic optical coherence tomography and subsequently a target lesion revascularisation with slight troponin rise after the procedure. At 3-year the hierarchical ID-MACE of 3.4% remained unchanged. Clopidogrel therapy was discontinued in all but one patient. There has been no stent thrombosis reported. Two non-cardiac deaths were reported; one from duodenal perforation, the other from Hodgkin disease. Two patients underwent non-ischaemia driven target vessel revascularisation.

CONCLUSIONS

Three-year clinical results have demonstrated a sustained low MACE rate (3.4%) without any late complication such as stent thrombosis.

摘要

目的

使用完全可吸收依维莫司洗脱支架(BVS,雅培血管,圣克拉拉,CA,美国)对首例人体试验进行多模态成像,在两年时显示出设备的生物吸收,同时预防再狭窄。然而,这种新型治疗的长期安全性和疗效仍有待记录。

方法和结果

ABSORB 试验于 2006 年 7 月在欧洲和新西兰的四个临床地点完成,共招募了 30 名患有单一初发原生冠状动脉病变的患者。主要临床终点是缺血驱动的主要不良心脏事件(ID-MACE),定义为心脏死亡、心肌梗死或缺血驱动的靶病变血运重建的复合事件。由于一名患者撤回同意,29 名患者可进行临床随访。在 46 天时,一名患者经历了一次胸痛发作,随后进行了光学相干断层扫描诊断,并随后在轻微肌钙蛋白升高后进行了靶病变血运重建。在 3 年时,3.4%的分层 ID-MACE 保持不变。除了一名患者外,所有患者均停用了氯吡格雷治疗。未报告支架血栓形成。报告了两例非心脏死亡;一例来自十二指肠穿孔,另一例来自霍奇金病。两名患者进行了非缺血驱动的靶血管血运重建。

结论

3 年的临床结果显示,MACE 发生率持续较低(3.4%),没有任何晚期并发症,如支架血栓形成。

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