Reina Sofia Hospital, Department of Cardiology, University of Córdoba, Avenida Melendez Pidal 1. 14001 Cordoba, Spain.
Catheter Cardiovasc Interv. 2012 Dec 1;80(7):1165-70. doi: 10.1002/ccd.24281. Epub 2012 Apr 17.
To compare the efficacy of sirolimus- and everolimus-eluting stents in patients with bifurcation lesions treated with provisional side-branch stenting.
The efficacy of everolimus-eluting stents in bifurcation lesions has been poorly tested.
Patients with all types of Medina bifurcation lesions were randomly assigned to treatment with either a sirolimus- (n = 145) or everolimus-eluting stent (n = 148). We included patients with main vessel diameter over 2.5 mm and side branches over 2.25 mm. Patients with diffuse side-branch stenosis were excluded.
There were no significant differences between patients from the sirolimus and everolimus groups in terms of age, risk factors, clinical status, location of the bifurcation lesions or angiographic variables. Immediate results and in-hospital outcome were also similar in both groups of patients. In-hospital death occurred in two patients, one from each group. Target lesion revascularization was required in nine patients: four patients (2.7%) from the sirolimus group and five patients (3.4%) from the everolimus group. Late cardiac mortality occurred in two patients from the sirolimus group and in one patient from the everolimus group. Major cardiac event rates at 1 year were similar in both groups: nine patients (6.2%) in the sirolimus group and nine patients (6.1%) from the everolimus group (p: ns).
In patients with bifurcation lesions, no significant differences in clinical outcome at 1-year follow-up were observed between sirolimus- and everolimus-eluting stent groups.
比较在接受边支血管预扩张术的分叉病变患者中，使用西罗莫司洗脱支架和依维莫司洗脱支架的疗效。
依维莫司洗脱支架在分叉病变中的疗效尚未得到充分验证。
所有类型的 Medina 分叉病变患者被随机分为西罗莫司洗脱支架组（n = 145）或依维莫司洗脱支架组（n = 148）。纳入的患者主血管直径大于 2.5mm，边支血管直径大于 2.25mm。排除弥漫性边支狭窄的患者。
在年龄、危险因素、临床状况、分叉病变位置或血管造影变量方面，西罗莫司组和依维莫司组的患者之间无显著差异。两组患者的即刻结果和住院期间的结局也相似。住院期间死亡发生在两名患者中，每组各 1 例。需要靶病变血运重建的患者有 9 例：西罗莫司组 4 例（2.7%），依维莫司组 5 例（3.4%）。西罗莫司组有 2 例患者和依维莫司组有 1 例患者发生晚期心脏死亡。两组患者在 1 年内的主要心脏不良事件发生率相似：西罗莫司组 9 例（6.2%），依维莫司组 9 例（6.1%）（p：ns）。
在分叉病变患者中，在 1 年随访期间，西罗莫司洗脱支架组和依维莫司洗脱支架组的临床结局无显著差异。
