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未经选择的患者使用 PROMUS Element 铂铬、依维莫司洗脱支架的临床结果:PE PROVE 研究的最终 5 年结果。

Clinical outcomes in unselected patients treated with the PROMUS Element platinum-chromium, everolimus-eluting stent: Final five-year results from the PE PROVE Study.

机构信息

Hospital La Paz, Madrid, Spain.

Centre Hospitalier Universitaire Sart Tilman, Liege, Belgium.

出版信息

Catheter Cardiovasc Interv. 2019 Feb 15;93(3):398-403. doi: 10.1002/ccd.27835. Epub 2018 Oct 20.

Abstract

OBJECTIVES

The goal of this analysis was to evaluate the final 5-year safety and effectiveness of the PROMUS Element platinum-chromium everolimus-eluting stent in unselected patients treated in routine clinical practice.

BACKGROUND

The prospective, open-label PROMUS Element™ European Post-Approval Surveillance Study (PE-PROVE) enrolled 1,010 "real-world" patients who received the PROMUS Element stent. Adverse event rates were low at 1-year, and the incidence of stent thrombosis was 0.6%.

METHODS

The primary endpoint was target vessel failure (TVF; overall and PE stent-related), a composite of cardiac death, myocardial infarction (MI) related to the target vessel, or target vessel revascularization (TVR) at 1-year post-implantation. Five-year clinical outcomes were evaluated in overall as well as high-risk patient subgroups.

RESULTS

The overall 5-year TVF rate was 14.9%, with 7.0% being related to the study stent. Cardiac death, MI and TVR related to the study stent occurred in 0.5%, 3.2%, and 5.7%, respectively. Stent thrombosis through 5-year follow-up was 1.0%. The rates of overall and study stent related TVF were numerically higher in patients with medically treated diabetes, long lesions (≥28 mm), and small diameter vessels (≤2.5 mm) compared to the overall study population. Additionally, favorable stent thrombosis rates through 5 years were reported for the PROMUS Element stent in these high-risk subgroups.

CONCLUSIONS

The final 5-year data from the PE-PROVE study demonstrate favorable outcomes and low rates of adverse events with the PE stent when used in "real-world" patients with coronary artery disease.

摘要

目的

本分析旨在评估 PROMUS Element 铂铬依维莫司洗脱支架在常规临床实践中治疗的未经选择患者的最终 5 年安全性和有效性。

背景

前瞻性、开放性标签的 PROMUS Element™欧洲上市后监测研究(PE-PROVE)纳入了 1010 名接受 PROMUS Element 支架治疗的“真实世界”患者。一年时不良事件发生率较低,支架血栓形成发生率为 0.6%。

方法

主要终点是靶血管失败(TVF;总体和 PE 支架相关),包括心脏死亡、与靶血管相关的心肌梗死(MI)和靶血管血运重建(TVR),在植入后 1 年时评估。在总体和高危患者亚组中评估了 5 年的临床结果。

结果

总体 5 年 TVF 发生率为 14.9%,其中 7.0%与研究支架相关。心脏死亡、MI 和与研究支架相关的 TVR 分别发生 0.5%、3.2%和 5.7%。通过 5 年随访发现支架血栓形成率为 1.0%。与总体研究人群相比,接受药物治疗的糖尿病患者、长病变(≥28mm)和小血管直径(≤2.5mm)患者的总体和研究支架相关 TVF 发生率呈数值升高。此外,在这些高危亚组中,通过 5 年还报告了有利的 PROMUS Element 支架的支架血栓形成率。

结论

PE-PROVE 研究的最终 5 年数据表明,当用于患有冠状动脉疾病的“真实世界”患者时,PE 支架具有良好的结果和较低的不良事件发生率。

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