Heart Institute (InCor), University of São Paulo Medical School (USP), São Paulo, Brazil.
EuroIntervention. 2012 May 15;8(1):117-9. doi: 10.4244/EIJV8I1A18.
The long-term clinical performance of drug-eluting stents (DES) coated with biodegradable polymers is poorly known.
A total of 274 coronary patients were randomly allocated to paclitaxel-eluting stents, sirolimus-eluting stents, or bare metal stents (2:2:1 ratio). The two DES used the same biodegradable polymers and were identical except for the drug. At three years, the pooled DES population had similar rates of cardiac death or myocardial infarction (9.0% vs. 7.1; p=0.6), but lower risk of repeat interventions (10.0% vs. 29.9%; p<0.01) than controls with bare stents. The cumulative 3-year incidence of definite or probable stent thrombosis in the pooled DES group was 2.3% (first year: 1.8%; second year: 0.4%; third year: zero). There were no significant differences in outcomes between paclitaxel- and sirolimus-eluting stents.
The biodegradable-polymer coated DES releasing either paclitaxel or sirolimus were effective in reducing the 3-year rate of re-interventions.
带生物可降解聚合物涂层的药物洗脱支架（DES）的长期临床性能尚不清楚。
共 274 例冠状动脉疾病患者被随机分配到紫杉醇洗脱支架、西罗莫司洗脱支架或裸金属支架（2:2:1 比例）组。两种 DES 使用相同的生物可降解聚合物，除药物外其他均相同。三年时，联合 DES 人群的心脏死亡或心肌梗死发生率相似（9.0%比 7.1%；p=0.6），但再次介入治疗的风险较低（10.0%比 29.9%；p<0.01），优于裸支架对照组。联合 DES 组 3 年累计确定或可能的支架血栓形成发生率为 2.3%（第一年：1.8%；第二年：0.4%；第三年：0）。紫杉醇洗脱支架和西罗莫司洗脱支架的结局无显著差异。
释放紫杉醇或西罗莫司的带生物可降解聚合物涂层的 DES 可有效降低 3 年再介入率。
