Lee Hyun Jong, Park Taek Kyu, Song Young Bin, Choi Young Jin, Yu Cheol Woong, Yang Jeong Hoon, Hahn Joo-Yong, Choi Seung-Hyuk, Choi Rak Kyeong, Choi Jin-Ho, Park Jin Sik, Kim Je Sang, Kim Tae Hoon, Jang Ho Joon, Lee Sang Hoon, Shim Won Heum, Roh Young Moo, Gwon Hyeon-Cheol
Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Int J Cardiol. 2015 Mar 15;183:190-7. doi: 10.1016/j.ijcard.2015.01.036. Epub 2015 Jan 28.
There are limited data about long-term outcomes for biodegradable polymer biolimus-eluting stent (BES) versus durable polymer everolimus-eluting stent (EES) in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). We sought to compare the two-year efficacy and safety of BES versus EES in AMI patients.
A total of 707 consecutive patients with ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction who underwent PCI with BES (n=171) or EES (n=536) between July 2008 and June 2012 were enrolled in this study. The efficacy endpoint (target vessel failure; a composite of cardiac death, target vessel-related myocardial infarction, and target vessel revascularization) and the safety endpoint (a composite of all cause death, myocardial infarction, and stent thrombosis) at two years were compared in crude and propensity score-matched cohorts.
After two years, target vessel failure occurred in 13 patients treated with BES and 49 patients treated with EES (7.6% versus 9.1%; adjusted hazard ratio [HR], 1.09; 95% confidence interval [CI], 0.58-2.04; p=0.78). The rates of composite safety endpoint at two years were not different between two groups (BES 7.6% versus EES 10.8%; adjusted HR, 0.87; 95% CI, 0.47-1.62; p=0.66). The rates of stent thrombosis did not differ between two groups (BES 0.6% versus EES 1.3%; adjusted HR, 0.63; 95% CI, 0.06-6.20; p=0.69). These findings were substantiated by similar results in the propensity score-matched cohort.
In the treatment of patients with AMI, BES showed similar efficacy and safety compared to those of EES for up to two years.
对于接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者，关于生物可降解聚合物生物雷帕霉素洗脱支架（BES）与耐用聚合物依维莫司洗脱支架（EES）的长期预后数据有限。我们旨在比较BES与EES在AMI患者中的两年疗效和安全性。
本研究纳入了2008年7月至2012年6月期间连续707例接受PCI治疗的ST段抬高型心肌梗死和非ST段抬高型心肌梗死患者，其中171例使用BES，536例使用EES。在粗队列和倾向评分匹配队列中比较了两年时的疗效终点（靶血管失败；包括心源性死亡、靶血管相关心肌梗死和靶血管血运重建的复合终点）和安全性终点（全因死亡、心肌梗死和支架血栓形成的复合终点）。
两年后，接受BES治疗的13例患者和接受EES治疗的49例患者发生靶血管失败（7.6%对9.1%；调整后风险比[HR]，1.09；95%置信区间[CI]，0.58 - 2.04；p = 0.78）。两组两年时复合安全性终点发生率无差异（BES为7.6%，EES为10.8%；调整后HR，0.87；95%CI，0.47 - 1.62；p = 0.66）。两组支架血栓形成发生率无差异（BES为0.6%，EES为1.3%；调整后HR，0.63；95%CI，0.06 - 6.20；p = 0.69）。倾向评分匹配队列中的类似结果证实了这些发现。
在AMI患者的治疗中，BES在长达两年的时间里显示出与EES相似的疗效和安全性。
