Beijk Marcel A, Damman Peter, Klomp Margo, Woudstra Pier, Silber Sigmund, Grisold Manfred, Ribeiro Expedito E, Suryapranata Harry, Wójcik Jaroslaw, Sim Kui Hian, Tijssen Jan G P, de Winter And Robbert J
Department of Cardiology, University of Amsterdam, Amsterdam, the Netherlands.
Coron Artery Dis. 2012 May;23(3):201-7. doi: 10.1097/MCA.0b013e328351550f.
The e-Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth (e-HEALING) registry was designed to capture clinical data on the use of the endothelial progenitor cell capture stent (ECS) in routine clinical practice. In this analysis, we investigated the 12-month clinical outcomes in patients treated with an ECS for a bifurcation lesion.
The worldwide, prospective, nonrandomized e-HEALING registry aimed to enroll 5000 patients treated for coronary artery disease with one or more ECS between October 2005 and October 2007. Clinical follow-up was obtained at 1, 6, and 12 months. The primary endpoint was target vessel failure (TVF), defined as the composite of cardiac death, myocardial infarction, and target vessel revascularization at 12 months.
A total of 573 patients were treated for at least one bifurcation lesion and were assessed in the current analysis. Baseline characteristics showed a median age of 65 years; 21% were diabetic patients and 36% had unstable angina. A total of 63% of the bifurcation lesions were located in the left artery descending and the mean stent length was 20.7±12.6 mm. At 12 months, TVF was 12.7% and target lesion revascularization was 7.5%. Definite or probable stent thrombosis occurred in 1.7% of the patients. Moreover, one or more stents per lesion [hazard ratio (HR): 2.79, 95% confidence interval (CI): 1.60-4.86, P<0.001], predilatation (HR: 0.39, 95% CI: 0.17-0.87, P=0.023), and lesions located in the right coronary artery (HR: 4.56, 95% CI: 1.07-19.5, P=0.041) were independent predictors of TVF.
In the e-HEALING registry, coronary bifurcation stenting with the ECS results in favorable clinical outcomes and low incidences of repeat revascularization and stent thrombosis.
电子健康内皮加速内膜生长抑制新生内膜增生(e-HEALING)注册研究旨在收集内皮祖细胞捕获支架(ECS)在常规临床实践中的使用情况的临床数据。在本分析中,我们调查了接受ECS治疗分叉病变患者的12个月临床结局。
全球前瞻性非随机e-HEALING注册研究旨在纳入2005年10月至2007年10月期间接受一个或多个ECS治疗冠状动脉疾病的5000例患者。在1、6和12个月时进行临床随访。主要终点是靶血管失败(TVF),定义为12个月时心源性死亡、心肌梗死和靶血管血运重建的复合终点。
共有573例患者至少接受了一处分叉病变的治疗,并纳入本分析进行评估。基线特征显示,中位年龄为65岁;21%为糖尿病患者,36%患有不稳定型心绞痛。共有63%的分叉病变位于左前降支,平均支架长度为20.7±12.6mm。12个月时,TVF为12.7%,靶病变血运重建率为7.5%。1.7%的患者发生明确或可能的支架血栓形成。此外,每个病变处一个或多个支架[风险比(HR):2.79,95%置信区间(CI):1.60-4.86,P<0.001]、预扩张(HR:0.39,95%CI:0.17-0.87,P=0.023)以及位于右冠状动脉的病变(HR:4.56,95%CI:1.07-19.5,P=0.041)是TVF的独立预测因素。
在e-HEALING注册研究中,使用ECS进行冠状动脉分叉支架置入术可带来良好的临床结局,且再次血运重建和支架血栓形成的发生率较低。