de Hemptinne Quentin, Picard Fabien, Ly Hung Q, Ibrahim Reda, Asgar Anita W, de Guise Pierre, Doucet Serge, Dorval Jean-François, Marquis-Gravel Guillaume, Levi Michael, L-L'allier Philippe, Tanguay Jean-François
a Department of Medicine , Montreal Heart Institute, Université de Montréal , Montreal , Canada.
Acta Cardiol. 2018 Jun;73(3):276-281. doi: 10.1080/00015385.2017.1380767. Epub 2017 Sep 28.
Bioresorbable vascular scaffolds (BVS) implantation in selected patients with stable angina has been demonstrated feasible and safe. However, limited data are currently available on long-term outcomes after BVS implantation for ST-elevation myocardial infarction (STEMI). Therefore, we sought to assess the safety, efficacy and long-term results of BVS implantation in STEMI patients.
Retrospective review of all STEMI patients treated with the Absorb BVS (Abbott Vascular, Santa Clara, CA) or conventional drug eluting stent (DES) between 1 April 2013 and 30 March 2014. Primary outcomes were procedural success, device thrombosis and device-oriented composite endpoint (DOCE) including cardiac death, target vessel myocardial infarction and target lesion revascularization. The study included 54 BVS patients and 121 DES patients.
Patients were slightly younger in the BVS group (60 vs. 63 years old, p = .03). Other baseline characteristics were comparable between the two groups. Procedural success was achieved in all patients. Median follow-up was 901 days and 849 days for BVS and DES patients, respectively (p = .01). The cumulative incidence of DOCE was not significantly different between the BVS and DES groups (7.5% vs. 9.1%, hazard ratio [HR]: 0.74 [95% confidence interval (CI): 0.26-2.2], p = NS). Rate of probable/definite device thrombosis were not statistically different between both groups (3.7% vs. 3.3%, p = NS).
The results of this single-centre retrospective study, one of the first assessing long-term safety and efficacy of BVS in STEMI, seems reassuring with similar long-term results as compared with patients treated with conventional DES.
已证实,在选定的稳定型心绞痛患者中植入生物可吸收血管支架(BVS)是可行且安全的。然而,目前关于BVS植入治疗ST段抬高型心肌梗死(STEMI)后的长期预后的数据有限。因此,我们试图评估STEMI患者植入BVS的安全性、有效性和长期结果。
回顾性分析2013年4月1日至2014年3月30日期间接受Absorb BVS(雅培血管,加利福尼亚州圣克拉拉)或传统药物洗脱支架(DES)治疗的所有STEMI患者。主要结局为手术成功率、器械血栓形成和器械相关复合终点(DOCE),包括心源性死亡、靶血管心肌梗死和靶病变血运重建。该研究纳入了54例BVS患者和121例DES患者。
BVS组患者年龄稍小(60岁对63岁,p = 0.03)。两组间其他基线特征具有可比性。所有患者均实现了手术成功。BVS组和DES组患者的中位随访时间分别为901天和849天(p = 0.01)。BVS组和DES组DOCE的累积发生率无显著差异(7.5%对9.1%,风险比[HR]:0.74[95%置信区间(CI):0.26 - 2.2],p = 无显著性差异)。两组间可能/确定的器械血栓形成率无统计学差异(3.7%对3.3%,p = 无显著性差异)。
这项单中心回顾性研究是首批评估BVS在STEMI中远期安全性和有效性的研究之一,其结果令人安心,与接受传统DES治疗的患者相比,长期结果相似。