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REMEDEE 注册研究的最终 5 年结果:COMBO 支架双重治疗的真实世界经验。

Final five-year results of the REMEDEE Registry: Real-world experience with the dual-therapy COMBO stent.

机构信息

Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Center, Amsterdam, The Netherlands.

Department of Cardiology, Icahn School of Medicine at Mount Sinai Hospital, New York, USA.

出版信息

Catheter Cardiovasc Interv. 2021 Sep;98(3):503-510. doi: 10.1002/ccd.29305. Epub 2020 Oct 8.

Abstract

OBJECTIVES

This final report from the REMEDEE Registry assessed the long-term safety and efficacy of the dual-therapy COMBO stent in a large unselected patient population.

BACKGROUND

The bio-engineered COMBO stent (OrbusNeich Medical BV, The Netherlands) is a dual-therapy pro-healing stent. Data of long-term safety and efficacy of the this stent is lacking.

METHODS

The prospective, multicenter, investigator-initiated REMEDEE Registry evaluated clinical outcomes after COMBO stent implantation in daily clinical practice. One thousand patients were enrolled between June 2013 and March 2014.

RESULTS

Five-year follow-up data were obtained in 97.2% of patients. At 5-years, target lesion failure (TLF) (composite of cardiac death, target-vessel myocardial infarction, or target lesion revascularization) was present in 145 patients (14.8%). Definite or probable stent thrombosis (ST) occurred in 0.9%, with no additional case beyond 3-years of follow-up. In males, 5-year TLF-rate was 15.6 versus 12.6% in females (p = .22). Patients without diabetes mellitus (DM) had TLF-rate of 11.4%, noninsulin-treated DM 22.7% (p = .001) and insulin-treated DM 41.2% (p < .001). Patients presenting with non-ST segment elevation acute coronary syndrome (NSTE-ACS) had higher incidence of TLF compared to non-ACS (20.4 vs. 13.3%; p = .008), while incidence with STE-ACS was comparable to non-ACS (10.7 vs. 13.3%; p = .43).

CONCLUSION

Percutaneous coronary intervention with the dual-therapy COMBO stent in unselected patient population shows low rates of TLF and ST to 5 years. Remarkably, no case of ST was noted beyond 3 years.

摘要

目的

这项来自 REMEDEE 登记研究的最终报告评估了双重治疗 COMBO 支架在大型未选择患者人群中的长期安全性和疗效。

背景

生物工程 COMBO 支架(荷兰 OrbusNeich Medical BV)是一种双重治疗促进愈合的支架。缺乏该支架长期安全性和疗效的数据。

方法

前瞻性、多中心、研究者发起的 REMEDEE 登记研究评估了 COMBO 支架植入后在日常临床实践中的临床结局。2013 年 6 月至 2014 年 3 月期间,共纳入 1000 例患者。

结果

97.2%的患者获得了 5 年随访数据。5 年时,145 例患者(14.8%)出现了靶病变失败(TLF,包括心脏死亡、靶血管心肌梗死或靶病变血运重建)。确定或可能的支架血栓形成(ST)发生率为 0.9%,随访 3 年以上无额外病例。男性 5 年 TLF 发生率为 15.6%,女性为 12.6%(p =.22)。无糖尿病(DM)患者的 TLF 发生率为 11.4%,未接受胰岛素治疗的 DM 患者为 22.7%(p =.001),接受胰岛素治疗的 DM 患者为 41.2%(p <.001)。非 ST 段抬高型急性冠脉综合征(NSTE-ACS)患者的 TLF 发生率高于非 ACS 患者(20.4%比 13.3%;p =.008),而 ST 段抬高型 ACS 患者的 TLF 发生率与非 ACS 患者相似(10.7%比 13.3%;p =.43)。

结论

在未选择的患者人群中,经皮冠状动脉介入治疗使用双重治疗 COMBO 支架 5 年内的 TLF 和 ST 发生率较低。值得注意的是,3 年后未发现 ST 病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/616f/8518525/ee98f84354e7/CCD-98-503-g001.jpg

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