Interventional Cardiology Division, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
Interventional Cardiology Division, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
Int J Cardiol. 2018 May 1;258:36-41. doi: 10.1016/j.ijcard.2018.01.115. Epub 2018 Jan 31.
We aimed to evaluate the mid-term outcomes of a novel thin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI), as compared with durable-polymer everolimus-eluting stents (EES).
We compiled a multicenter registry of patients undergoing CTO recanalization followed by BP-SES or EES implantation. The primary endpoint was the incidence of target-lesion failure (TLF, a composite of cardiac death, target-vessel myocardial infarction, and target-lesion revascularization) at one year. Propensity score matching (PSM) was used to adjust for case mix.
Overall, 413 patients were included (BP-SES n = 242, EES n = 171). PSM resulted in 131 matched pairs, which represented the subject of the main analysis. Antegrade wire escalation was the most successful crossing technique (66% vs. 63%, p = 0.98) in both the BP-SES and EES groups, respectively. Procedural success rates were similar between groups (BP-SES 96% vs. EES 93%, p = 0.24). At one-year follow-up, there were no differences in the primary endpoint of TLF (5.7% vs. 8.3%, p = 0.44), and in cardiac death (0.9% vs. 2.8%, p = 0.32), target-vessel myocardial infarction (0.9% vs 1.9%, p = 0.57), target-lesion revascularization (3.7% vs 3.7%, p = 0.99), or stent thrombosis (0.9% vs. 1.9%, p = 0.57), in BP-SES vs. EES, respectively.
Patients undergoing CTO PCI with BP-SES suffer a low rate of TLF at one-year follow-up, which is similar to that of subjects treated with durable-polymer EES.
我们旨在评估一种新型薄壁生物可吸收聚合物西罗莫司洗脱支架(BP-SES)在慢性完全闭塞(CTO)经皮冠状动脉介入治疗(PCI)中的中期结果,与持久性聚合物依维莫司洗脱支架(EES)相比。
我们编纂了一项多中心注册研究,纳入了接受 CTO 再通后植入 BP-SES 或 EES 的患者。主要终点是一年时的靶病变失败(TLF,包括心脏死亡、靶血管心肌梗死和靶病变血运重建)发生率。采用倾向评分匹配(PSM)调整病例组合。
总体而言,纳入了 413 名患者(BP-SES 组 242 名,EES 组 171 名)。PSM 产生了 131 对匹配对,这是主要分析的对象。正向导丝升级是最成功的穿越技术(分别为 66%和 63%,p=0.98),在 BP-SES 和 EES 组中。两组的手术成功率相似(BP-SES 组为 96%,EES 组为 93%,p=0.24)。在一年随访时,TLF 的主要终点(5.7%对 8.3%,p=0.44)、心脏死亡(0.9%对 2.8%,p=0.32)、靶血管心肌梗死(0.9%对 1.9%,p=0.57)、靶病变血运重建(3.7%对 3.7%,p=0.99)和支架血栓形成(0.9%对 1.9%,p=0.57)在 BP-SES 与 EES 组之间无差异。
接受 CTO PCI 的患者植入 BP-SES 后一年时的 TLF 发生率较低,与接受持久性聚合物 EES 治疗的患者相似。