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在中国人群中比较超薄支架、可生物降解聚合物西罗莫司洗脱支架和持久性聚合物依维莫司洗脱支架:随机 BIOFLOW VI 试验。

Comparison of the Ultrathin Strut, Biodegradable Polymer Sirolimus-eluting Stent With a Durable Polymer Everolimus-eluting Stent in a Chinese Population: The Randomized BIOFLOW VI Trial.

机构信息

Fu Wai Hospital, National Center for Cardiovascular Diseases, Beijing, China.

Fu Wai Hospital, National Center for Cardiovascular Diseases, Beijing, China.

出版信息

Clin Ther. 2020 Apr;42(4):649-660.e9. doi: 10.1016/j.clinthera.2020.02.014. Epub 2020 Apr 5.

Abstract

PURPOSE

The BIOFLOW-VI (Biotronik-Safety and Clinical Performance of the Drug Eluting Orsiro Stent in the Treatment of Subjects With De Novo Coronary Artery Lesions-VI) study evaluates the angiographic efficacy, clinical safety, and effectiveness of the ultrathin strut, biodegradable polymer sirolimus-eluting stent (BP-SES) compared with a durable polymer everolimus-eluting stent (DP-EES). This randomized controlled clinical trial was designed to enable approval of new drug-eluting stents in China.

METHODS

A total of 440 eligible patients from 11 sites with up to 2 de novo native coronary artery lesions were randomly assigned to receive either BP-SES (n = 220) or DP-EES (n = 220) from July 2014 to September 2016 in this prospective, multicenter, noninferiority trial.

FINDINGS

The primary end point of 9-month in-stent late lumen loss (LLL) was 0.05 (0.02) mm in the BP-SES group versus 0.07 (0.02) mm in the DP-EES group, with a mean difference of -0.02 mm (95% CI, -0.06 to 0.03; P = 0.44; P < 0.0001). At 1 year, the target lesion failure rate (cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization) was similar between the 2 groups (BP-SES 2.3% vs DP-EES 1.4%; P = 0.50). No definite or probable stent thrombosis had occurred in any of the 2 treatment arms.

IMPLICATIONS

The randomized BIOFLOW-VI trial showed that BP-SES was noninferior to DP-EES with regard to the primary end point of 9-month in-stent LLL in a Chinese population. ClinicalTrials.gov Identifier: NCT02870985.

摘要

目的

BIOFLOW-VI(Biotronik- 新型药物洗脱支架 Orsiro 在治疗初发冠状动脉病变患者中的安全性和临床疗效 VI 期研究)旨在评估超薄支架、生物可降解聚合物西罗莫司洗脱支架(BP-SES)与持久性聚合物依维莫司洗脱支架(DP-EES)相比在治疗初发冠状动脉病变患者中的血管造影疗效、临床安全性和有效性。该随机对照临床试验旨在推动新型药物洗脱支架在中国的获批。

方法

2014 年 7 月至 2016 年 9 月,这项前瞻性、多中心、非劣效性临床试验共纳入 11 个中心的 440 例符合条件的患者,这些患者最多有 2 条初发的原生冠状动脉病变,被随机分配接受 BP-SES(n=220)或 DP-EES(n=220)治疗。

结果

BP-SES 组 9 个月时支架内晚期管腔丢失(LLL)的主要终点为 0.05(0.02)mm,DP-EES 组为 0.07(0.02)mm,两组间平均差值为-0.02mm(95%CI,-0.06 至 0.03;P=0.44;P<0.0001)。1 年时,两组的靶病变失败率(心源性死亡、靶血管心肌梗死和缺血驱动的靶病变血运重建)相似(BP-SES 组 2.3%,DP-EES 组 1.4%;P=0.50)。两组均未发生明确或可能的支架血栓。

结论

在中国人中,随机 BIOFLOW-VI 试验显示,BP-SES 在 9 个月时支架内 LLL 的主要终点方面非劣效于 DP-EES。临床试验注册号:NCT02870985。

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