Division of Cardiology, Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Am J Cardiol. 2013 Nov 1;112(9):1335-41. doi: 10.1016/j.amjcard.2013.06.012. Epub 2013 Aug 14.
This study was designed to prospectively evaluate the safety and efficacy of the 38-mm Resolute zotarolimus-eluting stent (R-ZES). Drug-eluting stents with long lengths are needed to ensure coverage of long lesions in some patients. Patients recruited from the RESOLUTE US and RESOLUTE Asia studies were implanted with at least one 38-mm R-ZES. Up to 2 lesions (in separate vessels) could be implanted with length ≤35 mm and a reference vessel diameter of 3.0 to 4.2 mm. The primary end point was 1-year target lesion failure, defined as cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. The 1-year target lesion failure rate using 1 vessel per patient was compared with a performance goal (19%) derived from historical data. There were 223 patients enrolled (n = 269 lesions). The mean age was 60.9 ± 10.9 years, 79% were men, and 38% had diabetes. Target lesion failure rate using a single-vessel analysis was 4.5%, and the upper limit of the 1-sided 95% confidence interval (7.5%) was less than the performance goal of 19%. A secondary analysis using all lesions resulted in a target lesion failure rate of 5.4% (upper limit of 1-sided 95% confidence interval, 8.6%). Baseline characteristics and clinical outcomes were similar between patients with and without diabetes. The rate of probable or definite stent thrombosis was 0.9%. In conclusion, the 38-mm length of the R-ZES was found to be safe and effective with a low rate of target lesion failure and stent thrombosis and no differences in outcomes between patients with and without diabetes.
这项研究旨在前瞻性评估 38 毫米 Resolute 佐他莫司洗脱支架(R-ZES)的安全性和有效性。在某些患者中,需要使用长长度的药物洗脱支架来确保覆盖长病变。从 RESOLUTE US 和 RESOLUTE Asia 研究中招募的患者植入了至少一个 38 毫米 R-ZES。可以在长度≤35 毫米和参考血管直径为 3.0 至 4.2 毫米的情况下植入最多 2 个病变(在不同血管中)。主要终点是 1 年的靶病变失败率,定义为心脏死亡、靶血管心肌梗死或临床驱动的靶病变血运重建。每个患者 1 个血管的 1 年靶病变失败率与从历史数据得出的性能目标(19%)进行了比较。共纳入 223 例患者(n=269 个病变)。平均年龄为 60.9±10.9 岁,79%为男性,38%患有糖尿病。单支血管分析的靶病变失败率为 4.5%,单侧 95%置信区间上限(7.5%)小于 19%的性能目标。使用所有病变的二次分析导致靶病变失败率为 5.4%(单侧 95%置信区间上限为 8.6%)。有和没有糖尿病的患者之间的基线特征和临床结局相似。可能或确定的支架血栓形成率为 0.9%。总之,R-ZES 的 38 毫米长度被发现是安全有效的,靶病变失败率和支架血栓形成率低,且有和没有糖尿病的患者之间的结局没有差异。