Department of Cadre Ward, The First Hospital of Jilin University, Changchun, Jilin, 130021, People's Republic of China.
Department of Cardiology, Harbin Yinghua Hospital, Harbin, Heilongjiang, 150199, People's Republic of China.
Int J Nanomedicine. 2024 Nov 11;19:11689-11700. doi: 10.2147/IJN.S482608. eCollection 2024.
Polymer-free sirolimus-eluting stent (PF-SES) possess multiple properties improving targeted drug elution and in-stent reendothelialization without the presence of polymers. The long-term clinical performance comparison between PF-SES and the latest generation polymer-coated sirolimus-eluting stents (SES), particularly regarding intravascular imaging assessment and in the type 2 diabetes mellitus (DM) population, remains unexplored.
We conducted a retrospective study involving 2646 diabetes patients meeting coronary artery disease (CAD) criteria underwent coronary stents in the real-world. All patients were divided into the PF-SES group and the SES group. Optical coherence tomography (OCT) was used to evaluate the imaging characteristics of in-stent reendothelialization. Patient information between the two groups was systematically compared in hospital and at 5-year follow-up.
In terms of basic characteristics, the proportion of current smoker and stable angina patients in the PF-SES group was significantly higher than that in the SES group. The PF-SES group exhibited significantly higher rate of left anterior descending (LAD) lesion and more stents per patients compared to the SES group. The value of minimum lumen area (MLA), neointimal area (NA) and neointimal thickness (NT) were higher in the PF-SES group. Additionally, the occurrence rates of heterogeneous, lipid layer, intimal tears, thrombi, and micro-vessels were notably lower in the PF-SES group compared to the SES group. A higher all-cause mortality was observed in the SES cohort.
PF-SES could effectively improve in-stent reendothelialization in patients with type 2 DM, with positive effects on survival rate and may, therefore, be considered as an alternative treatment option for improving clinical long-term outcomes.
无聚合物涂层的西罗莫司洗脱支架（PF-SES）具有多种特性，可以改善靶向药物洗脱和支架内再内皮化，而无需聚合物的存在。PF-SES 与最新一代聚合物涂层西罗莫司洗脱支架（SES）的长期临床性能比较，特别是在血管内影像学评估和 2 型糖尿病（DM）患者中，仍有待探索。
我们进行了一项回顾性研究，纳入了 2646 名符合冠状动脉疾病（CAD）标准的糖尿病患者，这些患者在真实世界中接受了冠状动脉支架植入术。所有患者均分为 PF-SES 组和 SES 组。采用光学相干断层扫描（OCT）评估支架内再内皮化的影像学特征。系统比较两组患者住院期间和 5 年随访时的资料。
在基本特征方面，PF-SES 组中当前吸烟者和稳定型心绞痛患者的比例明显高于 SES 组。PF-SES 组左前降支（LAD）病变的比例和每位患者的支架数量均明显高于 SES 组。PF-SES 组最小管腔面积（MLA）、新生内膜面积（NA）和新生内膜厚度（NT）值较高。此外，PF-SES 组的异质性、脂质层、内膜撕裂、血栓和微血管的发生率明显低于 SES 组。SES 组的全因死亡率较高。
PF-SES 可有效改善 2 型糖尿病患者的支架内再内皮化，对生存率有积极影响，因此可考虑作为改善临床长期预后的替代治疗选择。
