摘要
目的观察冠心病患者应用国产雷帕霉素洗脱支架后临床不良心血管事件(major adverse cardia cevent,MACE)包括心源性死亡、再发非致死性心肌梗死、再次血运重建的发生率。方法2003年11月至2006年12月,共入选267例患者,国产雷帕霉素(Firebird,上海微创公司)支架组145例,进口雷帕霉素(Cypher,美国强生公司)支架组122例。术后严格要求患者服用阿司匹林和噻氯匹定或氯吡格雷至少12个月。通过门诊或电话随访术后患者MACE的发生率,部分患者进行了冠状动脉造影复查。结果随访(31±11)个月,失访患者9例(Firebird组6例、Cypher组3例),失访率3.37%。随访期间总的MACE的发生率在Firebird组10.79%、Cypher组11.76%,两组无显著性差异(P=0.95),两组冠状动脉介入治疗(PCI)术后<1年及>1年MACE分别为5.04%、7.02%和5.04%、8.08%,P<0.05;Firebird支架和Cypher支架的血栓发生率分别为1.44%、1.68%,P>0.05。两组冠状动脉造影再狭窄率分别为17.6%(6/34)、19%(8/42),无显著性差异。结论远期临床随访结果表明,国产Firebird支架与Cypher支架临床心血管事件、支架内血栓的发生率均较低,两组无显著性差异,两者的安全性与有效性相似。延长联合抗血小板治疗时间很有必要。
Objective To observe the major adverse cardiac events （MACE including cardiac death, non - fatal myocardial infarction or target vessel revascularization） rate in patients implanted with rapamycin - eluting stents （Firebird）. Method From November 2003 to December 2006, a total of 267 consecutive patients with coronary artery disease were randomized to Firebird （n = 145, Firebird group） and Cypher（ n = 122, Cypher group） stent treatment. Fully antiplatelet therapy was performed for 12 months after percutaneous coronary intervention. Follow - up was done by telephone or interview at clinic. A small proportion of patients was followed up by angiography. Results 258 patients were followed up for （31±11 ） months, with 9 patients（3.37 % ） lost to follow - up, including 6 in Firebird stents group and 3 in Cypher stents group. MACE was 10.79% , 11.76% in Firebird and Cypher group, respectively. There was no difference of MACE between the two groups（ P = 0.95）. There were no difference with restenosis after PCI between the two groups, which were 17.6 % （6/34） and 19 % （8/42） in Firebird and Cypher groups, respectively. Conclusion There were a lower MACE incident rate in Firebird group and Cypher stenting group, and no statistical difference between the two groups. Firebird stent is an alternative one for PCI wit the same efficacy and safety . It is important that standard antiplatelet therapy shoule be prolnged.
出处
《浙江临床医学》
2008年第6期746-747,共2页
Zhejiang Clinical Medical Journal
关键词
药物洗脱支架
临床心血管事件
支架内血栓
Drug- eluting stent
Clinical major adverse cardiac events
Stent thrornbosisd3osis
