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急性冠状动脉综合征中钛一氧化氮涂层支架与依维莫司洗脱支架内膜覆盖情况的比较研究

Comparative study of neointimal coverage between titanium-nitric oxide-coated and everolimus-eluting stents in acute coronary syndromes.

作者信息

Sia Jussi, Nammas Wail, Collet Carlos, De Bruyne Bernard, Karjalainen Pasi P

机构信息

Department of Cardiology, Kokkola Central Hospital, Kokkola, Finland.

Heart Center, Satakunta Central Hospital, Pori, Finland.

出版信息

Rev Esp Cardiol (Engl Ed). 2023 Mar;76(3):150-156. doi: 10.1016/j.rec.2022.05.017. Epub 2022 Jun 2.

Abstract

INTRODUCTION AND OBJECTIVES

To evaluate by optical coherence tomography neointimal healing response after implantation of cobalt-chromium-based titanium-nitride-oxide-coated (TiNO) stents and platinum-chromium-based biodegradable-polymer-coated everolimus-eluting stents (EES) in patients with acute coronary syndrome.

METHODS

Patients were randomized (1:1) to receive either a TiNO-stent or EES. Optical coherence tomography images were obtained at 30-day (cohort A, n = 52) and 6-month (cohort B, n = 30) follow-up. The primary endpoint was the percentage of uncovered struts per patient.

RESULTS

In cohort A, the percentage of uncovered struts was lower with TiNO-stents vs EES (3.2% vs 19.6%, P <.001). The percentage of malapposed struts was 0.4% in the TiNO-group and 2.1% in the EES group (P <.001). In cohort B, the percentage of uncovered struts was also lower with TiNO-stents (0.0% vs 8.7%, (P <.001). The percentage of malapposed struts was 0% in the TiNO-stent group and 0.3% in the EES group, (P=.008). None of the patients had repeat revascularization during the 6 months of follow-up.

CONCLUSIONS

Following percutaneous intervention for acute coronary syndrome, TiNO stent implantation was associated with a lower percentage of uncovered and malapposed struts per patient, compared with EES, at early and mid-term follow-up. This study is registered under ClinicalTrials.gov, with number NCT02464397.

摘要

引言与目的

通过光学相干断层扫描评估急性冠脉综合征患者植入钴铬基氮化钛氧化物涂层(TiNO)支架和铂铬基生物可降解聚合物涂层依维莫司洗脱支架(EES)后的新生内膜愈合反应。

方法

患者被随机(1:1)分配接受TiNO支架或EES。在30天随访时(A组,n = 52)和6个月随访时(B组,n = 30)获取光学相干断层扫描图像。主要终点是每位患者未覆盖支架小梁的百分比。

结果

在A组中,TiNO支架未覆盖支架小梁的百分比低于EES(3.2%对19.6%,P <.001)。TiNO组贴壁不良支架小梁的百分比为0.4%,EES组为2.1%(P <.001)。在B组中,TiNO支架未覆盖支架小梁的百分比也较低(0.0%对8.7%,P <.001)。TiNO支架组贴壁不良支架小梁的百分比为0%,EES组为0.3%(P =.008)。在6个月的随访期间,没有患者进行再次血管重建。

结论

在急性冠脉综合征的经皮介入治疗后,与EES相比,在早期和中期随访中,TiNO支架植入与每位患者未覆盖和贴壁不良支架小梁的百分比更低相关。本研究已在ClinicalTrials.gov注册,编号为NCT02464397。

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