Lemmert Miguel E, van Mieghem Nicolas M, van Geuns Robert-Jan, Diletti Roberto, van Bommel Rutger J, van Domburg Ron T, de Jaegere Peter P, Regar Evelyn, Zijlstra Felix, Boersma Eric, Daemen Joost
Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.
Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.
Int J Cardiol. 2017 Aug 1;240:103-107. doi: 10.1016/j.ijcard.2017.03.054. Epub 2017 Mar 20.
A new-generation everolimus eluting platinum-chromium stent (EePCS), offering improved radial strength, radiopacity and conformability compared to everolimus-eluting cobalt-chromium stents (EeCCS), was evaluated with regard to safety and efficacy in an all-comer cohort.
A total of 1000 consecutive all-comer patients (including acute coronary syndrome, multivessel disease, calcified lesions) treated with an EePCS (Promus Premier™, Boston Scientific, Natick, Massachusetts) from May 2013 to October 2014 were compared to 1000 consecutive patients treated with an EeCCS (Xience Prime™, Abbott Vascular, Santa Clara, California) from April 2012 to May 2013. Patients were clinically followed for 1year.
Mean age was 66±12years with diabetes in 20.7%, previous infarction in 22.7%, and ACS as the indication in 71.2% of patients. The mean number of stents per patient was 1.8±1.13. Total stented length was 35±25mm. Lesion classification was B2/C in 73.9% of patients. At 1year the primary endpoint of major adverse cardiac events (all-cause mortality, myocardial infarction [MI], ischemia-driven target vessel revascularization [TVR]) was reached in 11.7% in the EePCS cohort and 10.9% in the EeCCS cohort (adjusted HR 1.01 [0.77-1.33]; p=0.95). No significant differences were noted in the individual clinical endpoints all-cause mortality (6.8% versus 6.4%), MI (2.2% versus 2.3%), and TVR (4.3% versus 3.7%) in the respective EePCS and EeCCS cohorts. Stent thrombosis occurred in 0.8% and 1.0% respectively.
In all-comer patients undergoing percutaneous coronary intervention, the use of EePCS was associated with similar 1-year clinical outcome as compared to EeCCS.
新一代依维莫司洗脱铂铬合金支架(EePCS)与依维莫司洗脱钴铬合金支架(EeCCS)相比,具有更高的径向支撑力、显影性和顺应性。本研究在所有患者队列中评估了EePCS的安全性和有效性。
将2013年5月至2014年10月连续接受EePCS(Promus Premier™,波士顿科学公司,马萨诸塞州纳蒂克)治疗的1000例所有患者(包括急性冠状动脉综合征、多支血管病变、钙化病变)与2012年4月至2013年5月连续接受EeCCS(Xience Prime™,雅培血管公司,加利福尼亚州圣克拉拉)治疗的1000例患者进行比较。对患者进行为期1年的临床随访。
患者平均年龄为66±12岁,20.7%患有糖尿病,22.7%有既往心肌梗死病史,71.2%的患者以急性冠状动脉综合征为适应症。每位患者的支架平均数量为1.8±1.13个。支架总长度为35±25mm。73.9%的患者病变分类为B2/C型。1年后,EePCS队列中主要不良心脏事件(全因死亡率、心肌梗死[MI]、缺血驱动的靶血管血运重建[TVR])的主要终点发生率为11.7%,EeCCS队列为10.9%(校正风险比1.01[0.77-1.33];p=0.95)。在各自的EePCS和EeCCS队列中,全因死亡率(6.8%对6.4%)、MI(2.2%对2.3%)和TVR(4.3%对3.7%)等个体临床终点未发现显著差异。支架血栓形成发生率分别为0.8%和1.0%。
在接受经皮冠状动脉介入治疗的所有患者中,与EeCCS相比,使用EePCS的1年临床结局相似。