North Shore Hospital, Auckland, New Zealand.
Circ Cardiovasc Interv. 2010 Dec;3(6):556-64. doi: 10.1161/CIRCINTERVENTIONS.110.946426. Epub 2010 Nov 9.
Drug-eluting stents reduce restenosis and reintervention rates but are complicated by stent thrombosis, which may be related to polymer coating. The NEVO sirolimus-eluting coronary stent (NEVO SES) is designed to improve long-term percutaneous coronary intervention safety by combining sirolimus release from reservoirs with bioabsorbable polymer to reduce spatial and temporal polymer exposure.
NEVO ResElution-I was a prospective randomized study in 394 patients with coronary artery disease comparing the NEVO SES with the TAXUS Liberté paclitaxel-eluting coronary stent (TAXUS Liberté PES) stent. The primary end point was in-stent angiographic late loss at 6 months. Six months after percutaneous coronary intervention (PCI), the primary end point favored NEVO SES (0.13±0.31 mm versus 0.36±0.48 mm, P<0.001 for noninferiority and superiority). The study was not powered for clinical end points and showed no significant difference for NEVO SES versus TAXUS Liberté PES: death: 0.5 versus 1.6%, P=0.36; myocardial infarction: 2.0 versus 2.6%, P=0.75; target lesion revascularization: 1.5 versus 3.2%, P=0.33; major adverse cardiac events: 4.0 versus 7.4%, P=0.19. No stent thrombosis was observed with NEVO SES, whereas 2 cases occurred in TAXUS Liberté PES. Intravascular ultrasound showed lower percent volume obstruction for NEVO SES (5.5±11% versus 11.5±9.7%, P=0.016).
This trial proved the superiority of NEVO SES over TAXUS Liberté PES for the primary angiographic end point of in-stent late loss. No stent thrombosis occurred in the NEVO SES group.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00606333.
药物洗脱支架可降低再狭窄和再介入率,但存在支架血栓形成的并发症,这可能与聚合物涂层有关。NEVO 西罗莫司洗脱冠状动脉支架(NEVO SES)旨在通过将西罗莫司从储库中释放出来并结合可生物吸收的聚合物来减少空间和时间上的聚合物暴露,从而提高长期经皮冠状动脉介入治疗的安全性。
NEVO ResElution-I 是一项前瞻性随机研究,纳入 394 例冠心病患者,比较 NEVO SES 与紫杉醇洗脱冠状动脉支架(TAXUS Liberté PES)的疗效。主要终点是 6 个月时的支架内血管造影晚期丢失。经皮冠状动脉介入治疗(PCI)后 6 个月,主要终点有利于 NEVO SES(0.13±0.31mm 对 0.36±0.48mm,非劣效性和优效性 P<0.001)。该研究未针对临床终点进行统计学效能分析,并且未显示 NEVO SES 与 TAXUS Liberté PES 之间有显著差异:死亡:0.5%对 1.6%,P=0.36;心肌梗死:2.0%对 2.6%,P=0.75;靶病变血运重建:1.5%对 3.2%,P=0.33;主要不良心脏事件:4.0%对 7.4%,P=0.19。NEVO SES 未观察到支架血栓形成,而 TAXUS Liberté PES 发生 2 例。血管内超声显示 NEVO SES 的血管内体积阻塞百分比较低(5.5±11%对 11.5±9.7%,P=0.016)。
该试验证明 NEVO SES 在支架内晚期丢失的主要血管造影终点上优于 TAXUS Liberté PES。NEVO SES 组未发生支架血栓形成。