Bikkina Mahesh, Koneru Jayanth
St Joseph Regional Medical Center, Paterson, Seton Hall University, NJ, USA.
Med Devices (Auckl). 2011;4:117-24. doi: 10.2147/MDER.S11749. Epub 2011 Aug 17.
The root cause of coronary artery disease is atherosclerosis, ie, intraluminal narrowing (stenosis) of the arteries that supply blood to tissues of the heart. The introduction of the drug-eluting stent over the past decade has revolutionized the field of interventional cardiology. It is used extensively in clinical practice for the treatment of coronary artery disease. The first drug-eluting stent to receive US Food and Drug Administration approval was the sirolimus-eluting stent. Recently, two other stent analogs of sirolimus were approved, ie, the zotarolimus-eluting stent and the everolimus-eluting stent. However, concern has arisen in recent years about the long-term safety and efficacy of drug-eluting stents, due to the occurrence of late adverse clinical events, such as stent thrombosis. This review focuses on clinical studies that have been performed with the sirolimus-eluting stent or its analogs. We discuss the pharmacology, safety, and various therapeutic options that exist when choosing stents for coronary artery disease. Our aim is to provide a thorough review of the long-term efficacy and safety of sirolimus drug-eluting stents, and also to discuss currently approved and promising investigational drug-eluting stents, in an effort to provide insight into how these stents are currently evolving and generate further investigation in this area.
冠状动脉疾病的根本原因是动脉粥样硬化，即供应心脏组织血液的动脉管腔内狭窄（狭窄）。在过去十年中，药物洗脱支架的引入彻底改变了介入心脏病学领域。它在临床实践中被广泛用于治疗冠状动脉疾病。第一个获得美国食品药品监督管理局批准的药物洗脱支架是西罗莫司洗脱支架。最近，另外两种西罗莫司支架类似物也获得了批准，即佐他莫司洗脱支架和依维莫司洗脱支架。然而，近年来，由于出现了晚期不良临床事件，如支架血栓形成，人们对药物洗脱支架的长期安全性和有效性产生了担忧。本综述重点关注使用西罗莫司洗脱支架或其类似物进行的临床研究。我们讨论了药理学、安全性以及在为冠状动脉疾病选择支架时存在的各种治疗选择。我们的目的是对西罗莫司药物洗脱支架的长期疗效和安全性进行全面综述，并讨论目前已批准和有前景的研究性药物洗脱支架，以期深入了解这些支架目前的发展情况，并推动该领域的进一步研究。
