Jinnouchi Hiroyuki, Kuramitsu Shoichi, Shinozaki Tomohiro, Hiromasa Takashi, Kobayashi Yohei, Morinaga Takashi, Yamaji Kyohei, Soga Yoshimitsu, Shirai Shinichi, Ando Kenji
Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan.
Department of Biostatistics, School of Public Health, the University of Tokyo, Tokyo, Japan.
Catheter Cardiovasc Interv. 2016 Nov;88(5):E132-E138. doi: 10.1002/ccd.26360. Epub 2015 Dec 28.
Biolimus-eluting stents (BES) have similar efficacy and safety compared with cobalt chromium everolimus-eluting stents (CoCr-EES), whereas it is unclear whether the same applies to small vessel disease. We sought compare clinical outcomes between BES and CoCr-EES in patients with small vessel disease.
A total of 1,132 patients treated only with BES (612 patients) or EES (520 patients) in small vessel disease (stent size 2.5-mm) were retrospectively analyzed. We assessed the cumulative 2-year incidence of major adverse cardiovascular events (MACE), defined as a composite of cardiac death, myocardial infarction (MI), definite stent thrombosis (ST), and clinically driven target lesion revascularization (CD-TLR). The cumulative 2-year incidence of MACE was similar between the two groups (12.1% vs. 11.8%, P = 0.77). The cumulative incidence of cardiac death, CD-TLR, and definite ST were also not significantly different between both groups (3.2% vs. 3.6%, P = 0.78; 8.3% vs. 8.4%, P = 1.00; 0.33% vs. 0.21%, P = 0.66, respectively). After multivariate adjusting, the adjusted risk of BES group relative to CoCr-EES group for MACE was not significantly different (hazard ratio [HR]: 0.78, 95% confidential interval [CI]: 0.53-1.15, P = 0.20). Similarly, no significant difference in the adjusted risks for cardiac death and CD-TLR were observed between the two groups (HR: 0.62, 95% CI: 0.28-1.37, P = 0.24; HR: 0.81, 95% CI: 0.51-1.29, P = 0.38).
Two-year clinical outcomes of BES are similar to those of CoCr-EES in patients with small vessel disease. The use of BES is acceptable for small coronary artery disease. © 2015 Wiley Periodicals, Inc.
与钴铬依维莫司洗脱支架(CoCr-EES)相比,生物雷帕霉素洗脱支架(BES)具有相似的疗效和安全性,然而对于小血管疾病是否同样如此尚不清楚。我们试图比较BES和CoCr-EES在小血管疾病患者中的临床结局。
对1132例仅接受BES(612例患者)或EES(520例患者)治疗的小血管疾病(支架尺寸2.5毫米)患者进行回顾性分析。我们评估了主要不良心血管事件(MACE)的累积2年发生率,MACE定义为心脏死亡、心肌梗死(MI)、明确的支架血栓形成(ST)和临床驱动的靶病变血运重建(CD-TLR)的复合事件。两组的MACE累积2年发生率相似(12.1%对11.8%,P = 0.77)。两组之间心脏死亡、CD-TLR和明确ST的累积发生率也无显著差异(分别为3.2%对3.6%,P = 0.78;8.3%对8.4%,P = 1.00;0.33%对0.21%,P = 0.66)。多因素调整后,BES组相对于CoCr-EES组的MACE调整风险无显著差异(风险比[HR]:0.78,95%置信区间[CI]:0.53 - 1.15,P = 0.20)。同样,两组之间心脏死亡和CD-TLR的调整风险也无显著差异(HR:0.62,95% CI:0.28 - 1.37,P = 0.24;HR:0.81,95% CI:0.51 - 1.29,P = 0.38)。
在小血管疾病患者中,BES的2年临床结局与CoCr-EES相似。对于小冠状动脉疾病,使用BES是可接受的。© 2015威利期刊公司。