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在真实临床实践中,生物可降解聚合物涂层超薄(60μm)西罗莫司洗脱支架的 3 年结果。

Three-Year Outcomes of Biodegradable Polymer-Coated Ultra-Thin (60 µm) Sirolimus-Eluting Stents in Real-World Clinical Practice.

机构信息

Department of Cardiology, Heart and General Hospital, Rajasthan, India.

出版信息

Ann Acad Med Singap. 2019 May;48(5):150-155.

Abstract

INTRODUCTION

Although drug-eluting stents (DES) have outclassed the use of bare metal stents, the safety and efficacy of DES at long-term follow-up has still been conflicting because of increased occurrence of late or very late restenosis and stent thrombosis after DES implantation. Hence, the present study was aimed to evaluate the 3-year safety and clinical performance of biodegradable polymer-coated ultra-thin (60 µm) sirolimus-eluting stent (SES) in real-world patients with coronary artery disease (CAD).

MATERIALS AND METHODS

This was a physician-initiated, retrospective, single-centre, observational study that included 237 consecutive patients who had previously undergone implantation of only Supraflex SES (Sahajanand Medical Technologies Pvt Ltd, Surat, India) for the treatment of CAD. Follow-up was received after 1 year and 3 years of stent implantation. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR). Stent thrombosis was considered as a safety endpoint.

RESULTS

The mean age of patients was 64.1 ± 10.2 years, and 192 (81.0%) patients were male. The average stent length and diameter were 24.4 ± 9.0 mm and 3.1 ± 0.4 mm, respectively. The cumulative MACE rate at 3 years follow-up was 6.5% which included 4 (1.8%) cardiac deaths, 6 (2.8%) MI, and 4 (1.8%) TLR. There were 2 (0.9%) cases of stent thrombosis.

CONCLUSION

Treatment of patients with CAD in real-world clinical practice was associated with sustained clinical safety and low rates of restenosis, stent thrombosis and MACE up to 3 years after Supraflex SES implantation.

摘要

介绍

尽管药物洗脱支架(DES)已经优于裸金属支架的应用,但由于 DES 植入后晚期或极晚期再狭窄和支架血栓形成的发生率增加,DES 的长期安全性和疗效仍存在争议。因此,本研究旨在评估在真实世界的冠心病患者中使用可生物降解聚合物涂层超薄(60μm)西罗莫司洗脱支架(SES)的 3 年安全性和临床疗效。

材料和方法

这是一项由医生发起的回顾性、单中心、观察性研究,共纳入 237 例连续患者,他们之前仅接受 Supraflex SES(印度苏拉特的 Sahajanand Medical Technologies Pvt Ltd 公司)植入治疗冠心病。在支架植入后 1 年和 3 年进行随访。主要终点是主要不良心脏事件(MACE),包括心脏死亡、心肌梗死(MI)和靶病变血运重建(TLR)的复合终点。支架血栓形成被视为安全性终点。

结果

患者的平均年龄为 64.1±10.2 岁,192 例(81.0%)为男性。平均支架长度和直径分别为 24.4±9.0mm 和 3.1±0.4mm。3 年随访时累积 MACE 发生率为 6.5%,包括 4 例(1.8%)心脏死亡、6 例(2.8%)MI 和 4 例(1.8%)TLR。有 2 例(0.9%)支架血栓形成。

结论

在真实世界的临床实践中,治疗冠心病患者与持续的临床安全性相关,在 Supraflex SES 植入后 3 年内再狭窄、支架血栓形成和 MACE 的发生率较低。

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