Wang Bin, Han Ya-ling, Jing Quan-min, Wang Shou-li, Ma Ying-yan, Wang Geng, Luan Bo, Li Yi, Wang Zu-lu, Wang Dong-mei
Department of Cardiology, General Hospital of Shenyang Military Command, Shenyang 110016, China.
Zhonghua Yi Xue Za Zhi. 2010 Aug 10;90(30):2099-102.
To assess the therapeutic effect and safety of drug eluting stent for the patients with anterior wall myocardial infarction by left anterior descending artery occluded abruptly.
From January 2004 to December 2008, 302 patients with anterior wall myocardial infarction in 12 hours from chest pain to treatment were treated. But only 189 patients were recruited and randomly divided into drug eluting stent group (n = 95) and bare metal stent group (n = 94). The occurrence of cardiac death, stent thrombosis, reinfarction, target vessel revascularization and re-hospitalization because of heart function failure was compared.
There was no difference in cardiac death [3/95 (3%) vs 7/94 (7%), P = 0.206], reinfarction [1/95 (1%) vs 5/94 (5%), P = 0.112] and re-hospitalization because of heart function failure [8 (8%) vs 5 (5%), P = 0.434]. Compared with those in bare metal stent group, the patients in drug eluting stent group has a lower rate of target vessel revascularization [2 (2%) vs 13 (14%), P = 0.009] and composite therapeutic effect endpoints [12 (13%) vs 25 (27%), P = 0.011]. There was no difference in safety endpoint or stent thrombosis [1 (1%) vs 4 (4%), P = 0.204].
In patients with anterior wall myocardial infarction by left anterior descending artery occluded abruptly, drug eluting stent decreases the rate of target vessel revascularization. But it has no increased stent thrombosis.
评估药物洗脱支架对因左前降支急性闭塞所致前壁心肌梗死患者的治疗效果及安全性。
选取2004年1月至2008年12月间胸痛发作12小时内接受治疗的302例前壁心肌梗死患者。但仅189例患者被纳入研究并随机分为药物洗脱支架组(n = 95)和裸金属支架组(n = 94)。比较两组患者心源性死亡、支架内血栓形成、再梗死、靶血管血运重建以及因心力衰竭再次住院的发生率。
两组在心源性死亡[3/95(3%) vs 7/94(7%),P = 0.206]、再梗死[1/95(1%) vs 5/94(5%),P = 0.112]以及因心力衰竭再次住院[8(8%) vs 5(5%),P = 0.434]方面无差异。与裸金属支架组相比,药物洗脱支架组患者的靶血管血运重建率[2(2%) vs 13(14%),P = 0.009]和综合治疗效果终点发生率[12(13%) vs 25(27%),P = 0.011]更低。在安全性终点或支架内血栓形成方面两组无差异[1(1%) vs 4(4%),P = 0.204]。
对于因左前降支急性闭塞所致前壁心肌梗死患者,药物洗脱支架可降低靶血管血运重建率,但未增加支架内血栓形成的发生率。