Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2012 Dec;13(12):775-82. doi: 10.2459/JCM.0b013e32834102d8.
Chrono Carbostent (CID, Saluggia, Italy) is characterized by a peculiar coating with Carbofilm which could reduce the risk of thrombosis as compared to other bare metal stents (BMS). This feature should be particularly useful in the setting of primary or rescue percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).
We tested the efficacy and safety of this stent in patients with STEMI undergoing primary or rescue PCI. Inclusion criteria included the diagnosis of STEMI, a coronary anatomy suitable for stenting and no contraindications to dual antiplatelet therapy for at least 1 month. The primary endpoint was the composite of the following major adverse cardiac events (MACEs) at 12 months: death, recurrence of myocardial infarction and target vessel revascularization.
One hundred and seven STEMI patients treated with Chrono Carbostent implantation were enrolled. Eighty-three (77%) patients underwent primary and 24 (23%) rescue PCI. A total of 148 stents were successfully implanted. Cardiogenic shock was present in 12 (11%) patients and in-hospital mortality was 6.5%. Cumulatively, the rate of MACEs at 12 months was 17.7% (deaths 7.4%, target lesion revascularization 9.3%).
In unselected patients with STEMI treated by urgent PCI, the Chrono Carbostent showed a low rate of events in those patients surviving the acute phase of myocardial infarction. Unfortunately, and especially for patients in cardiogenic shock, survival continued to be relatively independent of interventional treatment, even when successfully completed, thus strictly linking prognosis of STEMI to severity of clinical presentation.
Chrono Carbostent（CID，意大利萨卢贾）的特点是具有 Carbofilm 涂层，与其他裸金属支架（BMS）相比，可降低血栓形成的风险。这一特点在急性 ST 段抬高型心肌梗死（STEMI）患者行直接或补救性经皮冠状动脉介入治疗（PCI）时尤为有用。
我们测试了该支架在 STEMI 患者行直接或补救性 PCI 中的疗效和安全性。纳入标准包括诊断为 STEMI、适合支架置入的冠状动脉解剖结构以及至少 1 个月内无双联抗血小板治疗禁忌证。主要终点为 12 个月时以下主要不良心脏事件（MACEs）的复合事件：死亡、心肌梗死复发和靶血管血运重建。
共纳入 107 例接受 Chrono Carbostent 植入的 STEMI 患者。83 例（77%）患者行直接 PCI，24 例（23%）患者行补救性 PCI。共成功植入 148 枚支架。12 例（11%）患者发生心原性休克，住院期间死亡率为 6.5%。累计 12 个月时 MACEs 发生率为 17.7%（死亡 7.4%，靶病变血运重建 9.3%）。
在接受紧急 PCI 治疗的 STEMI 患者中，Chrono Carbostent 在急性心肌梗死存活患者中事件发生率较低。不幸的是，尤其是对于心原性休克患者，即使介入治疗成功，其生存情况仍与临床严重程度相关，与预后无关。
