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糖尿病患者应用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的临床转归。

Clinical outcome of biodegradable polymer sirolimus-eluting stent and durable polymer everolimus-eluting stent in patients with diabetes.

机构信息

Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan.

出版信息

Cardiovasc Diabetol. 2020 Oct 1;19(1):162. doi: 10.1186/s12933-020-01145-x.

DOI:10.1186/s12933-020-01145-x
PMID:33004019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7531093/
Abstract

BACKGROUND

Diabetes mellitus is a risk for increased incidence of adverse clinical events after percutaneous coronary intervention. However, the difference in the incidence of adverse clinical events according to stent type in patients with diabetes remains to be elucidated. In the present study, we aimed to compare the clinical outcomes between patients treated with the biodegradable polymer sirolimus-eluting stents (BP-SES) and the durable polymer everolimus-eluting stents (DP-EES) among patients with diabetes.

METHODS

Among 631 lesions in 510 consecutive patients treated with either BP-SES or DP-EES, 165 lesions in 141 patients with diabetes mellitus and stable angina pectoris were identified and classified into the BP-SES group (48 lesions in 44 patients) and the DP-EES group (117 lesions in 100 patients). The incidence of adverse clinical events after stent implantation was compared between the 2 groups.

RESULTS

There was no significant difference in the prevalence of conventional risk factors, lesion characteristics, and procedural characteristics between the 2 groups. During median 386 [334-472] days follow-up, the incidence of target lesion revascularization (11.4 vs. 2.0%, p = 0.003) and device-oriented clinical endpoint (13.6 vs. 6.0%, p = 0.035) in the BP-SES group was significantly greater than that in the DP-EES group. A univariate model demonstrated that the BP-SES usage was significantly associated with the higher incidence of target lesion revascularization (odds ratio, 6.686; 95% confidence interval, 1.234-36.217; p = 0.028).

CONCLUSION

BP-SES was associated with the greater incidence of TLR than the DP-EES in patients with diabetes mellitus. Further studies with larger cohorts and longer follow-up are required to confirm the present results.

摘要

背景

糖尿病是经皮冠状动脉介入治疗后不良临床事件发生率增加的一个危险因素。然而,糖尿病患者中不同支架类型发生不良临床事件的差异仍需阐明。本研究旨在比较糖尿病患者使用生物可降解聚合物西罗莫司洗脱支架(BP-SES)和永久性聚合物依维莫司洗脱支架(DP-EES)的临床结局。

方法

在 510 例连续接受 BP-SES 或 DP-EES 治疗的 631 个病变中,确定并分类了 141 例糖尿病合并稳定型心绞痛患者的 165 个病变,分为 BP-SES 组(44 例患者中的 48 个病变)和 DP-EES 组(100 例患者中的 117 个病变)。比较两组支架植入术后不良临床事件的发生率。

结果

两组患者的常规危险因素、病变特征和手术特征无显著差异。在中位 386[334-472]天的随访期间,BP-SES 组的靶病变血运重建(11.4%比 2.0%,p=0.003)和器械定向临床终点(13.6%比 6.0%,p=0.035)的发生率明显高于 DP-EES 组。单变量模型表明,BP-SES 的使用与靶病变血运重建发生率升高显著相关(优势比,6.686;95%置信区间,1.234-36.217;p=0.028)。

结论

与 DP-EES 相比,BP-SES 与糖尿病患者的 TLR 发生率增加相关。需要进一步的研究,以更大的队列和更长的随访时间来证实目前的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/8be7f00629b0/12933_2020_1145_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/2117163669c6/12933_2020_1145_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/b8082574cd9a/12933_2020_1145_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/8be7f00629b0/12933_2020_1145_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/2117163669c6/12933_2020_1145_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/b8082574cd9a/12933_2020_1145_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4fe/7531093/8be7f00629b0/12933_2020_1145_Fig3_HTML.jpg

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