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铂铬依维莫司洗脱支架治疗小血管和长病变的两年安全性和有效性

Two-year safety and effectiveness of the platinum chromium everolimus-eluting stent for the treatment of small vessels and longer lesions.

作者信息

Teirstein Paul S, Meredith Ian T, Feldman Robert L, Rabinowitz A Charles, Cannon Louis A, Lee Tommy C, Dens Joseph, Dubois Christophe L, Mooney Michael R, Pompili Vincent J, Saito Shigeru, Allocco Dominic J, Dawkins Keith D, Stone Gregg W

机构信息

Scripps Clinic, Division of Cardiovascular Diseases, La Jolla, California.

出版信息

Catheter Cardiovasc Interv. 2015 Feb 1;85(2):207-15. doi: 10.1002/ccd.25565. Epub 2014 Jul 4.

Abstract

OBJECTIVES

To report 1- and 2-year clinical outcomes of patients receiving platinum chromium everolimus-eluting stents (PtCr-EES) in the prospective, single-arm PLATINUM small vessel (SV) and long lesion (LL) studies.

BACKGROUND

Small vessel diameter and long lesion length are independently associated with increased risk of adverse cardiac events after drug-eluting stent implantation.

METHODS

The PLATINUM SV study enrolled 94 patients with coronary artery lesions in vessels ≥2.25 mm to <2.50 mm in diameter and ≤28 mm in length. The PLATINUM LL study enrolled 102 patients with lesions >24 to ≤34 mm long in vessels ≥2.50 to ≤4.25 mm in diameter. The primary endpoint for both studies was target lesion failure (TLF) at 1 year compared to a prespecified performance goal based on outcomes with the TAXUS Express paclitaxel-eluting stent in small vessels and long lesions.

RESULTS

One-year TLF rates with the PtCr-EES were significantly (P < 0.001) lower than the predetermined performance goals: 2.4% versus 21.1% in the SV cohort and 3.2% versus 19.4% in the LL cohort. Cumulative rates of TLF to 2 years were 4.7% in the SV cohort and 8.8% in the LL cohort. No myocardial infarction or ARC definite/probable stent thromboses occurred in either cohort through 2-year follow-up.

CONCLUSIONS

The clinical efficacy and safety outcomes observed in these small vessel and long lesion cohorts support the use of the PtCr-EES in the treatment of small diameter vessels and long lesions.

摘要

目的

在一项前瞻性单臂PLATINUM小血管(SV)和长病变(LL)研究中,报告接受铂铬依维莫司洗脱支架(PtCr-EES)患者的1年和2年临床结局。

背景

小血管直径和长病变长度与药物洗脱支架植入术后不良心脏事件风险增加独立相关。

方法

PLATINUM SV研究纳入了94例冠状动脉病变患者,病变血管直径≥2.25 mm至<2.50 mm,长度≤28 mm。PLATINUM LL研究纳入了102例病变长度>24至≤34 mm的患者,病变血管直径≥2.50至≤4.25 mm。两项研究的主要终点均为1年时的靶病变失败(TLF),并与基于TAXUS Express紫杉醇洗脱支架在小血管和长病变中的结局预先设定的性能目标进行比较。

结果

PtCr-EES的1年TLF率显著低于预定性能目标(P<0.001):SV队列中分别为2.4%和21.1%,LL队列中分别为3.2%和19.4%。SV队列至2年的TLF累积率为4.7%,LL队列为8.8%。在2年随访期间,两个队列均未发生心肌梗死或ARC明确/可能的支架血栓形成。

结论

在这些小血管和长病变队列中观察到的临床疗效和安全性结局支持使用PtCr-EES治疗小直径血管和长病变。

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