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一种新型可生物降解聚合物涂层西罗莫司洗脱支架:HELIOS 注册研究的 1 年结果。

A novel biodegradable polymer-coated sirolimus-eluting stent: 1-year results of the HELIOS registry.

机构信息

Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China.

Department of Cardiology, Radboud University, Nijmegen, The Netherlands.

出版信息

Chin Med J (Engl). 2023 Aug 5;136(15):1848-1854. doi: 10.1097/CM9.0000000000002324.

Abstract

BACKGROUND

The HELIOS stent is a sirolimus-eluting stent with a biodegradable polymer and titanium oxide film as the tie-layer. The study aimed to evaluate the safety and efficacy of HELIOS stent in a real-world setting.

METHODS

The HELIOS registry is a prospective, multicenter, cohort study conducted at 38 centers across China between November 2018 and December 2019. A total of 3060 consecutive patients were enrolled after application of minimal inclusion and exclusion criteria. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, non-fatal target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR) at 1-year follow-up. Kaplan-Meier methods were used to estimate the cumulative incidence of clinical events and construct survival curves.

RESULTS

A total of 2998 (98.0%) patients completed the 1-year follow-up. The 1-year incidence of TLF was 3.10% (94/2998, 95% closed interval: 2.54-3.78%). The rates of cardiac death, non-fatal target vessel MI and clinically indicated TLR were 2.33% (70/2998), 0.20% (6/2998), and 0.70% (21/2998), respectively. The rate of stent thrombosis was 0.33% (10/2998). Age ≥60 years, diabetes mellitus, family history of coronary artery disease, acute myocardial infarction at admission, and device success were independent predictors of TLF at 1 year.

CONCLUSION

The 1-year incidence rates of TLF and stent thrombosis were 3.10% and 0.33%, respectively, in patients treated with HELIOS stents. Our results provide clinical evidence for interventional cardiologists and policymakers to evaluate HELIOS stent.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, NCT03916432.

摘要

背景

HELIOS 支架是一种载有西罗莫司的药物洗脱支架,其具有生物可降解聚合物和氧化钛薄膜作为结合层。本研究旨在评估 HELIOS 支架在真实环境中的安全性和有效性。

方法

HELIOS 注册研究是一项在中国 38 个中心进行的前瞻性、多中心、队列研究,于 2018 年 11 月至 2019 年 12 月期间开展。经过最小纳入和排除标准筛选后,共纳入了 3060 例连续患者。主要终点是靶病变失败(TLF),定义为 1 年随访时的心脏死亡、非致命性靶血管心肌梗死(MI)和临床指示的靶病变血运重建(TLR)的复合终点。Kaplan-Meier 法用于估计临床事件的累积发生率并构建生存曲线。

结果

共有 2998 例(98.0%)患者完成了 1 年随访。TLF 的 1 年发生率为 3.10%(94/2998,95%置信区间:2.54-3.78%)。心脏死亡、非致命性靶血管 MI 和临床指示 TLR 的发生率分别为 2.33%(70/2998)、0.20%(6/2998)和 0.70%(21/2998)。支架血栓形成的发生率为 0.33%(10/2998)。年龄≥60 岁、糖尿病、冠心病家族史、入院时发生急性心肌梗死和器械成功率是 1 年时 TLF 的独立预测因素。

结论

在接受 HELIOS 支架治疗的患者中,TLF 和支架血栓形成的 1 年发生率分别为 3.10%和 0.33%。我们的结果为介入心脏病学家和政策制定者评估 HELIOS 支架提供了临床证据。

临床试验注册

ClinicalTrials.gov,NCT03916432。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a8b/10405989/4c8ec05841b3/cm9-136-1848-g001.jpg

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