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铂铬依维莫司洗脱支架在中国:新发冠状动脉病变中铂铬依维莫司洗脱支架的前瞻性随机研究。

PLATINUM China: a prospective, randomized investigation of the platinum chromium everolimus-eluting stent in de novo coronary artery lesions.

作者信息

Gao Runlin, Han Yaling, Yang Yuejin, Zhang Jian, Hou Yuqing, Wang Haichang, Li Hui, Fang Quan, Yu Bo, Xu Bo, Allocco Dominic J, Dawkins Keith D

机构信息

Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Catheter Cardiovasc Interv. 2015 Mar;85 Suppl 1:716-23. doi: 10.1002/ccd.25859. Epub 2015 Feb 18.

Abstract

OBJECTIVES

The PLATINUM China clinical trial evaluated the safety and effectiveness of the thin-strut, everolimus-eluting, platinum-chromium PROMUS™ Element™ stent (PtCr-EES) (Boston Scientific, Marlborough, MA) for the treatment of patients in China.

BACKGROUND

Clinical outcomes from the PtCr-EES have not been evaluated in patients from China, nor has it been directly compared with the second-generation stainless steel paclitaxel-eluting TAXUS Liberté stent (PES) in a randomized head-to-head trial. Methods In this prospective, multicenter, single-blind, superiority trial, patients with a single de novo atherosclerotic coronary artery lesion were randomized 1:3 to receive either the PES or PtCr-EES. The primary endpoint was in-stent late loss at 9 months.

RESULTS

Among 127 PES and 373 PtCr-EES patients (71.2% male; mean age 57.3 years), the primary endpoint of 9-month in-stent late loss was 0.40 ± 0.45 mm for PES versus 0.11 ± 0.36 mm for PtCr-EES (P < 0.001). In-stent % diameter stenosis was 22.20 ± 16.00% for PES versus 11.06 ± 13.86% for PtCr-EES (P < 0.001) at 9 months. The 1-year rate of death/MI was 1.6% (2/127) for PES versus 0% (0/371) for PtCr-EES (P = 0.06) and target vessel revascularization was 4.7% (6/127) for PES versus 2.7% (10/371) for PtCr-EES (P = 0.26). No stent thromboses occurred at 12 months in either group.

CONCLUSIONS

In the largest prospective angiographic evaluation conducted to date with this stent, the PROMUS Element PtCr-EES was superior to the TAXUS Liberté PES for the primary endpoint of late loss at 9 months, with low rates of clinical events at 1 year. Clinical follow-up will continue to 2 years.

摘要

目的

PLATINUM中国临床试验评估了薄支柱、依维莫司洗脱、铂铬材质的PROMUS™ Element™支架(PtCr-EES)(波士顿科学公司,马尔伯勒,马萨诸塞州)在中国患者治疗中的安全性和有效性。

背景

尚未在中国患者中评估PtCr-EES的临床疗效,也未在随机头对头试验中直接将其与第二代不锈钢紫杉醇洗脱TAXUS Liberté支架(PES)进行比较。方法 在这项前瞻性、多中心、单盲、优效性试验中,将患有单一新发动脉粥样硬化性冠状动脉病变的患者按1:3随机分组,分别接受PES或PtCr-EES治疗。主要终点是9个月时的支架内晚期管腔丢失。

结果

在127例接受PES治疗的患者和373例接受PtCr-EES治疗的患者中(男性占71.2%;平均年龄57.3岁),PES组9个月时支架内晚期管腔丢失的主要终点为0.40±0.45 mm,而PtCr-EES组为0.11±0.36 mm(P<0.001)。9个月时,PES组的支架内直径狭窄百分比为22.20±16.00%,而PtCr-EES组为11.06±13.86%(P<0.001)。PES组1年的死亡/心肌梗死发生率为1.6%(2/127),而PtCr-EES组为0%(0/371)(P=0.06),PES组的靶血管血运重建率为4.7%(6/127),而PtCr-EES组为2.7%(10/371)(P=0.26)。两组在12个月时均未发生支架内血栓形成。

结论

在迄今为止对该支架进行的最大规模前瞻性血管造影评估中,PROMUS Element PtCr-EES在9个月晚期管腔丢失这一主要终点方面优于TAXUS Liberté PES,且1年时临床事件发生率较低。临床随访将持续至2年。

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