Hougaard Mikkel, Thayssen Per, Kaltoft Anne, Tilsted Hans-Henrik, Maeng Michael, Lassen Jens Flensted, Thuesen Leif, Okkels Jensen Lisette
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Catheter Cardiovasc Interv. 2014 Jun 1;83(7):1035-42. doi: 10.1002/ccd.25279. Epub 2013 Dec 5.
We used the Western Denmark Heart Registry to assess one-year and long-term all-cause mortality and stent failure following Percutaneous Coronary Intervention (PCI) with drug-eluting stents (DES) or bare-metal stents (BMS).
The use of DES compared with BMS during PCI has reduced the risk of restenosis in native coronary artery lesions. In saphenous vein grafts (SVG) the outcome after DES compared with BMS is insufficiently described.
From January 1, 2002 to December 31, 2010 all patients with PCI of SVG lesions were identified among 3.0 million inhabitants. Stent failure was defined as clinically driven target lesion revascularization, graft occlusion without intervention, or stent thrombosis.
The study cohort consisted of 529 patients with 755 SVG lesions (348 DES patients with 510 lesions and 181 BMS patients with 245 lesions). Mean age did not differ between patients with DES-treated lesions compared to patients with BMS-treated lesions (67.5 ± 9.1 years vs. 67.6 ± 9.3 years; P = 0.85). The median follow-up time was 3.0 years (25th-75th percentile: 1.4-5.1 years). One-year (n = 27 (8.2%) vs. n = 12 (6.7%), log rank P = 0.60) and 3-year cumulative mortality (n = 31 (18.8%) vs. n = 59 (21.8%), log rank P = 0.64) did not differ significantly between DES- and BMS-treated patients. One-year cumulative stent failure was seen in 39 (6.6%) DES-treated lesions vs. 24 (10.8%) BMS-treated lesions (P = 0.088), and 3-year cumulative stent failure in 48 (15.4%) vs. 34 (18.8%) lesions (P = 0.25), respectively.
In SVG lesions, DES showed no long-term benefit compared to BMS in rates of all-cause mortality or stent failure.
我们利用丹麦西部心脏注册中心评估药物洗脱支架（DES）或裸金属支架（BMS）经皮冠状动脉介入治疗（PCI）后一年及长期的全因死亡率和支架失败情况。
与BMS相比，PCI期间使用DES降低了原发性冠状动脉病变的再狭窄风险。在大隐静脉移植物（SVG）中，DES与BMS相比的结果描述不足。
在300万居民中确定了2002年1月1日至2010年12月31日期间所有接受SVG病变PCI的患者。支架失败定义为临床驱动的靶病变血运重建、未经干预的移植物闭塞或支架血栓形成。
研究队列包括529例患者，共755处SVG病变（348例DES治疗患者有510处病变，181例BMS治疗患者有245处病变）。DES治疗病变患者与BMS治疗病变患者的平均年龄无差异（67.5±9.1岁对67.6±9.3岁；P=0.85）。中位随访时间为3.0年（第25-75百分位数：1.4-5.1年）。DES治疗患者与BMS治疗患者的一年（n = 27（8.2%）对n = 12（6.7%），对数秩检验P = 0.60）和三年累积死亡率（n = 31（18.8%）对n = 59（21.8%），对数秩检验P = 0.64）无显著差异。DES治疗病变的一年累积支架失败率为39处（6.6%），而BMS治疗病变为24处（10.8%）（P = 0.088），三年累积支架失败率分别为48处（15.4%）和34处（18.8%）（P = 0.25）。
在SVG病变中，与BMS相比，DES在全因死亡率或支架失败率方面未显示出长期益处。
