Koh Angela S, Choi L M, Sim L L, Tan Jack W, Khin L W, Chua Terrance S J, Koh T H, Chia Stanley
Department of Cardiology, National Heart Centre Singapore, Singapore.
Acute Card Care. 2011 Dec;13(4):219-22. doi: 10.3109/17482941.2011.634011.
To determine clinical outcome and rates of target vessel revascularization (TVR) in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI who were treated with cobalt-chromium stents compared to stainless steel bare metal stents (BMS).
The newer generation cobalt chromium stents were reported to achieve lower rates of TVR compared with conventional BMS.
Consecutive STEMI cases admitted within 12 h of symptom onset and undergoing primary angioplasty and bare metal stent implantation 1 January 2002 and 31 December 2008 were identified. Primary outcomes were rates of clinically-driven TVR at six months as well as occurrence of major adverse cardiovascular events (MACE) either of all-cause death, repeat myocardial infarction or TVR at six months.
1030 cases with 1175 lesions (84% males) and median age of 58 years underwent primary PCI for STEMI in our registry. Overall procedural success rate was 98%. Stainless steel stents were inserted in 65% of the culprit lesions (stainless steel, n = 766 versus cobalt chromium, n = 264). Primary outcomes of TVR (3.5% in the stainless steel group and 3.4% in the cobalt chromium group, P = 0.93) and MACE (8.4% in the stainless steel group and 5.3% in the cobalt chromium group, P = 0.11) after six months were no different between the two groups. However, there were more deaths at 30 days in the stainless steel group compared to the cobalt chromium group (3.5% versus 0.4%, HR 4.04 (1.03-3.88), P = 0.04).
Both cobalt-chromium and stainless steel coronary stents were associated with similar and low risk of clinically-driven TVR.
确定接受钴铬合金支架治疗的ST段抬高型心肌梗死（STEMI）患者在接受直接经皮冠状动脉介入治疗（PCI）后的临床结局和靶血管血运重建（TVR）率，并与不锈钢裸金属支架（BMS）进行比较。
据报道，新一代钴铬合金支架的TVR率低于传统BMS。
确定2002年1月1日至2008年12月31日期间症状发作12小时内入院并接受直接血管成形术和裸金属支架植入的连续STEMI病例。主要结局为6个月时临床驱动的TVR率以及6个月时主要不良心血管事件（MACE）的发生率，MACE包括全因死亡、再次心肌梗死或TVR。
在我们的登记系统中，1030例患者共1175处病变（84%为男性）接受了STEMI的直接PCI，中位年龄为58岁。总体手术成功率为98%。65%的罪犯病变植入了不锈钢支架（不锈钢支架，n = 766；钴铬合金支架，n = 264）。两组6个月后的主要结局TVR（不锈钢组为3.5%，钴铬合金组为3.4%，P = 0.93）和MACE（不锈钢组为8.4%，钴铬合金组为5.3%，P = 0.11）无差异。然而，不锈钢组30天时的死亡人数多于钴铬合金组（3.5%对0.4%，HR 4.04（1.03 - 3.88），P = 0.04）。
钴铬合金冠状动脉支架和不锈钢冠状动脉支架在临床驱动的TVR方面具有相似的低风险。
