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使用安普利莫司洗脱支架或佐他莫司洗脱支架治疗的复杂真实世界糖尿病患者的临床结局:一项单中心注册研究。

Clinical outcomes of complex real-world diabetic patients treated with amphilimus sirolimus-eluting stents or zotarolimus-eluting stents: A single-center registry.

作者信息

Rozemeijer Rik, Benedetto Daniela, Kraaijeveld Adriaan O, Voskuil Michiel, Stein Mèra, Timmers Leo, Rittersma Saskia Z, Agostoni Pierfrancesco, Doevendans Pieter A, Stella Pieter R

机构信息

Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.

Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Cardiology, Sint Antonius Hospital, Nieuwegein, The Netherlands.

出版信息

Cardiovasc Revasc Med. 2018 Jul;19(5 Pt A):521-525. doi: 10.1016/j.carrev.2017.10.011. Epub 2017 Oct 26.

Abstract

OBJECTIVE

To assess clinical outcomes of Amphilimus Sirolimus-Eluting Stents (A-SES) as compared to Zotarolimus-Eluting Stents (ZES) in complex real-world diabetic patients.

BACKGROUND

Patients with diabetes mellitus represent one of the most challenging scenarios with high rates of restenosis and stent thrombosis in the current era of drug-eluting stents. Hence, we assessed the safety of A-SES versus ZES in complex diabetic patients.

METHODS

In this observational study, we analyzed all consecutive patients with diabetes mellitus referred to our center from November 2012 to November 2014. The primary outcome was target-lesion failure at 1-year follow-up.

RESULTS

A total of 165 consecutive diabetic patients underwent percutaneous coronary intervention with A-SES or ZES for stable coronary artery disease in our tertiary center. Using the Kaplan Meier method the cumulative incidence of target-lesion failure was 6.7% (5.9% A-SES versus 7.5% ZES, p=0.19) at 1-year follow-up. Event-free survival at 1year follow-up was similar (89.4% A-SES vs. 83.3% ZES, p=0.29). Interestingly, we did not find any cases of definite-, and only one case of probable stent thrombosis in this high risk cohort.

CONCLUSION

In this real-world registry, A-SES and ZES seems to be associated with promising 1-year clinical safety outcomes following PCI in a contemporary cohort of high-risk diabetic patients. Our results should be considered hypothesis generating, as the clinical safety of A-SES has to be confirmed in a large trial.

摘要

目的

评估在复杂的现实世界糖尿病患者中,与佐他莫司洗脱支架(ZES)相比,安普利莫司西罗莫司洗脱支架(A-SES)的临床疗效。

背景

在当前药物洗脱支架时代,糖尿病患者是面临再狭窄和支架血栓形成高发生率的最具挑战性的情况之一。因此,我们评估了A-SES与ZES在复杂糖尿病患者中的安全性。

方法

在这项观察性研究中,我们分析了2012年11月至2014年11月期间转诊至我们中心的所有连续性糖尿病患者。主要结局是1年随访时的靶病变失败。

结果

在我们的三级中心,共有165例连续性糖尿病患者接受了A-SES或ZES经皮冠状动脉介入治疗以治疗稳定型冠状动脉疾病。使用Kaplan Meier方法,1年随访时靶病变失败的累积发生率为6.7%(A-SES为5.9%,ZES为7.5%,p = 0.19)。1年随访时的无事件生存率相似(A-SES为89.4%,ZES为83.3%,p = 0.29)。有趣的是,在这个高风险队列中,我们未发现任何明确的支架血栓形成病例,仅发现1例可能的支架血栓形成病例。

结论

在这个现实世界注册研究中,在当代高风险糖尿病患者队列中,PCI术后A-SES和ZES似乎与有前景的1年临床安全性结局相关。由于A-SES的临床安全性必须在大型试验中得到证实,我们的结果应被视为产生假设。

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