Interventional Cardiology Unit, University Hospital of Saint Paul, Barcelona, Spain.
EuroIntervention. 2011 Feb;6(7):831-7. doi: 10.4244/EIJV6I7A143.
To evaluate outcomes of the endothelial progenitor cell (EPC) capture stent in patients on chronic anti-vitamin K (AVK) regimen, requiring percutaneous coronary intervention (PCI).
Between February 2007 and February 2008, 78 consecutive patients under chronic AVK treatment undergoing PCI were enrolled in the registry and received an EPC capture stent. The incidence of comorbid conditions was analysed by the Charlson index. Dual antiplatelet therapy (DAT, aspirin and clopidogrel) was prescribed for one month only together with the AVK treatment, after PCI. Major adverse clinical events (MACE) rate, included death, acute myocardial infarction (MI) or target lesion revascularisation (TLR), incidence of stent thrombosis and rate of haemorrhagic events were collected. A?Charlson index >3 was present in 89% of patients. At 14±8 months the cumulative rate of MACE was 22%: 10 deaths (six cardiac deaths), and six TLR. No MI or definitive/probable stent thromboses occurred during follow-up. Four major haemorrhagic episodes occurred during follow-up, all of them after the first month.
Patients on AVK treatment represent a highly comorbid population with a high event rate after PCI. The strategy of PCI with an EPC capture stent and short duration of DAT may be used in patients who need a short-term DAT.
评估内皮祖细胞(EPC)捕获支架在需要经皮冠状动脉介入治疗(PCI)的慢性抗维生素 K(AVK)治疗患者中的疗效。
2007 年 2 月至 2008 年 2 月,连续登记了 78 例接受慢性 AVK 治疗并行 PCI 的患者,这些患者均接受了 EPC 捕获支架治疗。采用 Charlson 指数分析合并症的发生率。PCI 后,患者仅接受 1 个月的双联抗血小板治疗(DAT,阿司匹林和氯吡格雷)联合 AVK 治疗。主要不良临床事件(MACE)发生率包括死亡、急性心肌梗死(MI)或靶病变血运重建(TLR)、支架血栓形成发生率和出血事件发生率。89%的患者 Charlson 指数>3。14±8 个月时,MACE 的累积发生率为 22%:10 例死亡(6 例心源性死亡)和 6 例 TLR。随访期间无 MI 或明确/可能的支架血栓形成。随访期间发生 4 例严重出血事件,均发生在第 1 个月之后。
接受 AVK 治疗的患者合并症较多,PCI 后事件发生率较高。对于需要短期 DAT 的患者,可采用 EPC 捕获支架和短期 DAT 的 PCI 策略。