Zhu Jinzhou, Zhang Qi, Chen Lianglong, Zhang Chenyun, Zhou Xuchen, Yuan Yong, Zhang Ruiyan
Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025.
Department of Cardiology, Union Hospital, Fujian Medical University, Fuzhou 350005, Fujian.
Acta Cardiol Sin. 2017 Jan;33(1):28-33. doi: 10.6515/acs20160131b.
The safety and efficacy of a China-made polymer-free paclitaxel-eluting microporous stent (Yinyi) at 1-year has been previously reported. However, limited evidence exists regarding the long-term performance of this novel drug-eluting stent (DES). This study investigated the 3-year efficacy and safety of the Yinyi stent in the setting of safety and efficacy registry of the Yinyi stent (SERY-I) clinical trial.
Between June 2008 and August 2009, a total of 1045 patients undergoing percutaneous coronary intervention (PCI) were implanted with ≥ 1 Yinyi stents at 27 medical centers in mainland China. Thereafter, clinical follow-up was performed for a period of 3 years after enrollment. The primary endpoint was the cumulative rate of composite major adverse cardiac events (MACE) including target lesion revascularization (TLR), the combined incidence of cardiac death, and non-fatal myocardial infarction; the second endpoint was the incidence of stent thrombosis.
Overall, 1376 lesions were treated successfully with 1713 Yinyi stents, and 1019 (98.7%) patients received dual antiplatelet therapy for at least 12 months. At 3 years, a total of 13 (1.33%) patients had suffered cardiac death. The incidence of non-fatal myocardial infarction and TLR was 9 (0.92%) and 58 (5.92%) among the patients. Stent thrombosis occurred in 13 (1.33%) patients, and the rate of Academic Research Consortium (ARC) definite or probable stent thrombosis was 0.82%.
Given the limitations that SERY-I was a single arm, nonrandomized study and only telephone follow-up was performed without angiographic analysis, the safety and efficacy of Yinyi stent observed in this extended follow-up Registry needs further verification.
此前已有关于国产无聚合物紫杉醇洗脱微孔支架(银翼)1年安全性和有效性的报道。然而,关于这种新型药物洗脱支架(DES)长期性能的证据有限。本研究在银翼支架安全性和有效性注册研究(SERY - I)临床试验中,调查了银翼支架3年的有效性和安全性。
2008年6月至2009年8月期间,中国大陆27个医疗中心共有1045例行经皮冠状动脉介入治疗(PCI)的患者植入了≥1枚银翼支架。此后,在入组后进行了为期3年的临床随访。主要终点是复合主要不良心脏事件(MACE)的累积发生率,包括靶病变血运重建(TLR)、心源性死亡和非致死性心肌梗死的合并发生率;次要终点是支架血栓形成的发生率。
总体而言,1713枚银翼支架成功治疗了1376处病变,1019例(98.7%)患者接受了至少12个月的双联抗血小板治疗。3年时,共有13例(1.33%)患者发生心源性死亡。患者中非致死性心肌梗死和TLR的发生率分别为9例(0.92%)和58例(5.92%)。13例(1.33%)患者发生支架血栓形成,学术研究联盟(ARC)明确或可能的支架血栓形成率为0.82%。
鉴于SERY - I是一项单臂、非随机研究,且仅进行了电话随访而未进行血管造影分析,在本次延长随访注册研究中观察到的银翼支架的安全性和有效性需要进一步验证。