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e-HEALING 注册研究中糖尿病患者应用 Genous™ 生物可降解雷帕霉素洗脱支架的 12 个月随访结果

Twelve-month outcomes after coronary stenting with the Genous™ bio-engineered R Stent™ in diabetic patients from the e-HEALING registry.

机构信息

Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands.

出版信息

J Interv Cardiol. 2011 Aug;24(4):285-94. doi: 10.1111/j.1540-8183.2010.00624.x. Epub 2011 Jan 31.

DOI:10.1111/j.1540-8183.2010.00624.x
PMID:21281358
Abstract

OBJECTIVES

We compared 12-month outcomes, regarding ischemic events, repeat intervention, and ST, between diabetic and nondiabetic patients treated with the Genous™ EPC capturing R stent™ during routine nonurgent percutaneous coronary intervention (PCI) using data from the multicenter, prospective worldwide e-HEALING registry.

BACKGROUND

Diabetic patients have an increased risk for restenosis and stent thrombosis (ST).

METHODS

In the 4,996 patient e-HEALING registry, 273 were insulin requiring diabetics (IRD), 963 were non-IRD (NIRD), and 3,703 were nondiabetics. The 12-month primary outcome was target vessel failure (TVF), defined as target vessel-related cardiac death or myocardial infarction (MI) and target vessel revascularization. Secondary outcomes were the composite of cardiac death, MI or target lesion revascularization (TLR), and individual outcomes including ST. Cumulative event rates were estimated with the Kaplan-Meier method and compared with a log-rank test.

RESULTS

TVF rates were respectively 13.4% in IRD, 9.0% in NIRD, and 7.9% in nondiabetics (P < 0.01). This was mainly driven by a higher mortality hazard in IRD (P < 0.001) and NIRD (P = 0.07), compared with nondiabetics. TLR rates were comparable in NIRD and nondiabetics, but significantly higher in IRD (P = 0.04). No difference was observed in ST.

CONCLUSION

The 1-year results of the Genous stent in a real-world population of diabetics show higher TVF rates in diabetics compared with nondiabetics, mainly driven by a higher mortality hazard. IRD is associated with a significant higher TLR hazard. Definite or probable ST in all diabetic patients was comparable with nondiabetics. (J Interven Cardiol 2011;24:285-294).

摘要

目的

我们比较了 12 个月的结果,包括缺血事件、再次介入和 ST,比较了在常规非紧急经皮冠状动脉介入治疗(PCI)中使用 Genous™EPC 捕获 R 支架™治疗的糖尿病和非糖尿病患者,这些数据来自多中心、前瞻性全球 e-HEALING 登记处。

背景

糖尿病患者再狭窄和支架血栓形成(ST)的风险增加。

方法

在 4996 例患者的 e-HEALING 登记处中,273 例为胰岛素依赖型糖尿病(IRD),963 例为非胰岛素依赖型糖尿病(NIRD),3703 例为非糖尿病患者。12 个月的主要结果是靶血管失败(TVF),定义为靶血管相关的心脏死亡或心肌梗死(MI)和靶血管血运重建。次要结果是心脏死亡、MI 或靶病变血运重建(TLR)的复合终点,以及包括 ST 在内的个别终点。累积事件发生率用 Kaplan-Meier 法估计,并与对数秩检验进行比较。

结果

IRD、NIRD 和非糖尿病患者的 TVF 发生率分别为 13.4%、9.0%和 7.9%(P<0.01)。这主要是由于 IRD(P<0.001)和 NIRD(P=0.07)的死亡率风险较高。NIRD 和非糖尿病患者的 TLR 发生率相当,但 IRD 显著较高(P=0.04)。未观察到 ST 差异。

结论

在真实世界的糖尿病患者人群中,Genous 支架的 1 年结果显示,与非糖尿病患者相比,糖尿病患者的 TVF 发生率较高,主要是由于死亡率风险较高。IRD 与 TLR 风险显著增加相关。所有糖尿病患者的明确或可能 ST 与非糖尿病患者相当。

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