Hiremath Shirish, Chandra Praveen, Desai Devang, Sivakumar R, Selvamani S, Srinivasan Anand, Paulose Madhu, Jose Sajy, Kalmath B C, Magarkar Vilas P, Pathak Abhijeet, Mhetre Tushar
Ruby Hall Clinic and Research Centre, Pune, India.
Max Hospital, New Delhi, India.
Indian Heart J. 2014 Nov-Dec;66(6):691-5. doi: 10.1016/j.ihj.2014.12.009. Epub 2014 Dec 23.
This study aims to assess the safety and efficacy of a biodegradable polymer-coated Rapamycin-Eluting Stent (Excel) used in conjunction with six-month dual antiplatelet therapy in daily practice.
The polymeric material of cardiac stents has been reported to adversely affect the safety profile of the drug-eluting stents and is also suspected to cause serious long-term complications. It has been proposed that the biodegradable polymer coatings may reduce such late-stage adverse effects.
This is a prospective, multi-center registry of 654 patients from across 9 cardiology centers in India, who were enrolled and exclusively treated with Excel stents between February 2008 and May 2010. The recommended antiplatelet regimen included clopidogrel and aspirin for 6 months period, followed by lifelong aspirin therapy.
The study population included 46.94% diabetics, 24.31% smokers, 48.93% hypertensives and 14.98% hyperlipidemics. The cumulative rates of major adverse cardiac events were 0.153% at discharge and 1.38% at 12 months. The mean percentage of stenosis was 88.24 ± 9.17% No events occurred between 6 and 12 months.
This multi-center registry study on "real world, all comers" has, thus, showed that EXCEL™ stent which is PLA-coated biodegradable Rapamycin-Eluting Stent exhibited high efficacy and safety profile in treatment of patients undergoing PCI as evidenced by significantly lower rates of MACE and no case of stent thrombosis. There was no event even after DAPT was discontinued after 6 months.
本研究旨在评估在日常实践中,一种可生物降解聚合物涂层的雷帕霉素洗脱支架(Excel)联合六个月双重抗血小板治疗的安全性和有效性。
据报道,心脏支架的聚合物材料会对药物洗脱支架的安全性产生不利影响,并且还怀疑会导致严重的长期并发症。有人提出,可生物降解的聚合物涂层可能会减少此类后期不良反应。
这是一项前瞻性、多中心注册研究,纳入了来自印度9个心脏病中心的654例患者,他们在2008年2月至2010年5月期间入组并仅接受了Excel支架治疗。推荐的抗血小板治疗方案包括氯吡格雷和阿司匹林治疗6个月,之后进行终身阿司匹林治疗。
研究人群包括46.94%的糖尿病患者、24.31%的吸烟者、48.93%的高血压患者和14.98%的高脂血症患者。出院时主要不良心脏事件的累积发生率为0.153%,12个月时为1.38%。平均狭窄百分比为88.24±9.17%。6至12个月之间未发生事件。
因此,这项针对“现实世界中的所有患者”的多中心注册研究表明,EXCEL™支架是一种聚乳酸涂层的可生物降解雷帕霉素洗脱支架,在治疗接受经皮冠状动脉介入治疗的患者中显示出高疗效和安全性,主要不良心血管事件发生率显著较低且无支架血栓形成病例证明了这一点。即使在6个月后停用双重抗血小板治疗后也未发生事件。