Okuno Shota, Ishihara Takayuki, Iida Osamu, Asai Mitsutoshi, Masuda Masaharu, Okamoto Shin, Nanto Kiyonori, Kanda Takashi, Tsujimura Takuya, Matsuda Yasuhiro, Hata Yosuke, Mano Toshiaki
Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan.
Circ Rep. 2020 Dec 15;3(1):18-25. doi: 10.1253/circrep.CR-20-0120.
There are limited data comparing clinical outcomes between biodegradable polymer and durable polymer drug-eluting stents (BP-DES and DP-DES, respectively) in patients with end-stage renal disease (ESRD). This study enrolled 229 ESRD patients who underwent successful percutaneous coronary intervention (PCI) for 400 lesions with 472 DES, with 2-year clinical outcomes compared between the BP-DES and DP-DES groups. The primary outcome measure was the incidence of target lesion revascularization (TLR), whereas secondary outcome measures were the occurrence of cardiac death (CD), myocardial infraction (MI), stent thrombosis (ST), target vessel revascularization (TVR), non-TVR, and major adverse cardiac events (MACE), defined as a composite of CD, MI, and TVR. Multivariate analysis was used to identify predictors of TLR occurrence. The 2-year incidence of TLR did not differ significantly between the BP-DES and DP-DES groups (P=0.274). In addition, there were no significant differences in the 2-year incidence of CD (P=0.144), MI (P=0.812), ST (P=0.241), TVR (P=0.434), non-TVR (P=0.375), or MACE (P=0.841) between the 2 groups. Multivariate analysis showed that diabetes (P=0.021) was independently associated with TLR occurrence. BP-DES and DP-DES had comparable safety and efficacy profiles over a 2-year follow-up period after PCI in ESRD patients.
关于终末期肾病(ESRD)患者中,比较生物可降解聚合物药物洗脱支架和耐用聚合物药物洗脱支架(分别为BP-DES和DP-DES)临床结局的数据有限。本研究纳入了229例接受了400处病变、472枚DES成功经皮冠状动脉介入治疗(PCI)的ESRD患者,比较了BP-DES组和DP-DES组的2年临床结局。主要结局指标为靶病变血运重建(TLR)发生率,次要结局指标为心源性死亡(CD)、心肌梗死(MI)、支架血栓形成(ST)、靶血管血运重建(TVR)、非TVR以及主要不良心脏事件(MACE,定义为CD、MI和TVR的复合事件)的发生情况。采用多因素分析来确定TLR发生的预测因素。BP-DES组和DP-DES组之间TLR的2年发生率无显著差异(P=0.274)。此外,两组之间CD的2年发生率(P=0.144)、MI(P=0.812)、ST(P=0.241)、TVR(P=0.434)、非TVR(P=0.375)或MACE(P=0.841)均无显著差异。多因素分析显示,糖尿病(P=0.021)与TLR发生独立相关。在ESRD患者PCI术后2年的随访期内,BP-DES和DP-DES具有相当的安全性和有效性。