Lim Sang-Yup, Park Hyun-Woong, Chung Woo-Young, Kim Song-Yee, Kim Ki-Seok, Bae Jang-Whan, Youn Tae-Jin
Korea University Ansan Hospital, Ansan, Korea.
J Invasive Cardiol. 2012 Jun;24(6):270-3.
We evaluated the clinical and angiographic outcomes of silicon carbide-coated cobalt chromium PROKinetic bare-metal stent in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
Patients with acute STEMI (2.75-5.00 mm vessels; lesion length ≤30 mm by visual estimation) were treated with PRO-Kinetic stents at 5 centers in Korea. The primary endpoint was the rate of major adverse cardiac events (MACE), defined as all-cause death, new myocardial infarction, and target lesion revascularization (TLR) at 6-month follow-up. Follow-up angiography was recommended after the completion of the 6-month clinical followup.
A total of 64 patients (56.6 ± 12.9 years old, 56 male) were enrolled in the study. Procedural success was achieved in 100% of the lesions. The mean stent size was 3.51 ± 0.67 mm and the mean stent length was 20.3 ± 4.4 mm. There was 1 case of in-hospital death due to cardiac tamponade. During the 6-month clinical follow-up, 4 patients (6.3%) received TLR. Therefore, the total rate of MACE was 7.8%. Angiographic follow-up data were available for 42 patients (65.6%) and the in-stent late lumen loss was 1.02 ± 0.62 mm and in-segment late lumen loss was 0.99 ± 0.64 mm. Binary restenosis occurred in 53% of reference vessel diameters (RVDs) ≤3.0 mm, 25% of RVDs between 3.0 and 3.5 mm, and 0% of RVDs >3.5 mm (P=.006).
The use of the PRO-Kinetic stent seems to be safe and feasible in primary PCI for acute STEMI, and shows favorable clinical and angiographic outcomes in large (>3.0 mm) coronary arteries, but not in small arteries.
我们评估了碳化硅涂层钴铬合金PROKinetic裸金属支架在接受直接经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）患者中的临床和血管造影结果。
在韩国的5个中心，对急性STEMI患者（血管直径2.75 - 5.00 mm；目测病变长度≤30 mm）使用PRO-Kinetic支架进行治疗。主要终点是6个月随访时的主要不良心脏事件（MACE）发生率，定义为全因死亡、新发心肌梗死和靶病变血运重建（TLR）。在6个月临床随访结束后建议进行随访血管造影。
共有64例患者（年龄56.6±12.9岁，男性56例）纳入研究。所有病变的手术成功率均为100%。平均支架尺寸为3.51±0.67 mm，平均支架长度为20.3±4.4 mm。有1例患者因心脏压塞在住院期间死亡。在6个月的临床随访期间，4例患者（6.3%）接受了TLR。因此，MACE的总发生率为7.8%。42例患者（65.6%）有血管造影随访数据，支架内晚期管腔丢失为1.02±0.62 mm，节段内晚期管腔丢失为0.99±0.64 mm。参考血管直径（RVD）≤3.0 mm的患者中53%发生了二元再狭窄，RVD在3.0至3.5 mm之间的患者中25%发生了二元再狭窄，RVD>3.5 mm的患者中0%发生了二元再狭窄（P = 0.006）。
PRO-Kinetic支架在急性STEMI的直接PCI中似乎是安全可行的，并且在大（>3.0 mm）冠状动脉中显示出良好的临床和血管造影结果，但在小动脉中并非如此。
