Koch Karel T, Grundeken Maik J, Vos Nicola S, IJsselmuiden Alexander J J, van Geuns Robert-Jan, Wessely Rainer, Dengler Thomas, La Manna Alessio, Silvain Johanne, Montalescot Gilles, Spaargaren René, Tijssen Jan G P, Amoroso Giovanni
Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
EuroIntervention. 2015 Jul;11(3):264-71. doi: 10.4244/EIJY15M02_08.
The aim of APPOSITION III was to evaluate the feasibility and performance of the STENTYS Self-Apposing¨ stent (STENTYS S.A., Paris, France) in the setting of primary percutaneous coronary intervention (PCI).
APPOSITION III was an international, prospective, multicentre registry. The study population consisted of 965 patients. The rate of the primary endpoint major adverse cardiac events (MACE), defined as the composite of cardiac death, recurrent target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularisation (CD-TLR), at one year was 9.3%. One-year cardiac death rate was 2.0%, TV-MI rate was 1.3%, CD-TLR rate was 7.4% and definite/probable stent thrombosis (ST) rate was 3.5% (definite ST 2.8%). An interim safety analysis of in-hospital outcomes in the first 400 patients showed higher event rates if post-dilation was not performed, and post-dilations became highly recommended in the remaining cohort. Patients undergoing post-dilation eventually showed a numerically lower one-year MACE rate (8.4% vs. 11.3%, p=0.137). One-year TV-MI (0.8% vs. 2.5%, p=0.027) and definite ST (1.9% vs. 5.0%, p=0.010) rates were significantly lower if post-dilation was performed, with the divergence occurring at <30 days.
The use of the STENTYS Self-Apposing¨ stent in the setting of primary PCI was feasible and associated with acceptable cardiovascular event rates which improved when post-dilation was performed.
APPOSITION III研究旨在评估STENTYS自贴式支架(STENTYS S.A.,法国巴黎)在直接经皮冠状动脉介入治疗(PCI)中的可行性和性能。
APPOSITION III是一项国际前瞻性多中心注册研究。研究人群包括965例患者。主要终点主要不良心脏事件(MACE)定义为心源性死亡、复发性靶血管心肌梗死(TV-MI)和临床驱动的靶病变血运重建(CD-TLR)的复合事件,1年时发生率为9.3%。1年心源性死亡率为2.0%,TV-MI发生率为1.3%,CD-TLR发生率为7.4%,明确/可能的支架血栓形成(ST)发生率为3.5%(明确ST为2.8%)。对前400例患者的院内结局进行的中期安全性分析显示,如果不进行后扩张,事件发生率较高,因此强烈建议在其余队列中进行后扩张。接受后扩张的患者最终1年MACE发生率在数值上较低(8.4%对11.3%,p = 0.137)。如果进行后扩张,1年TV-MI(0.8%对2.5%,p = 有关027)和明确ST(1.9%对5.0%,p = 0.010)发生率显著较低,差异出现在<30天时。
在直接PCI中使用STENTYS自贴式支架是可行的,且心血管事件发生率可接受,进行后扩张时发生率有所改善。