阮洁,蒋萍,苏晞

• 1:武汉亚洲心脏病医院心内科

摘要(Abstract)：

目的比较佐他莫司和依维莫司两类药物洗脱支架的长期临床安全性和有效性。方法纳入2011年1月至2012年12月于武汉亚洲心脏病医院接受经皮冠状动脉介入治疗的患者480例,根据置入支架类型,分为佐他莫司洗脱支架组(ZES组,244例)和依维莫司洗脱支架组(EES组,236例)。随访5年的临床疗效。初级终点是主要不良心血管事件,包括全因死亡、非致死性心肌梗死、靶血管再次血运重建。次级终点为支架内再狭窄及支架内闭塞。结果 5年随访结果显示,两组患者全因死亡率和非致死性急性心肌梗死发生率比较,差异均无统计学意义(均P>0.05)。EES组患者靶血管再次血运重建(5.1%比10.2%,P=0.040)、支架内再狭窄(5.9%比11.5%,P=0.036)和支架内闭塞(2.1%比6.1%,P=0.038)发生率均显著低于ZES组,差异均有统计学意义。结论 EES的5年临床安全性和有效性优于ZES。

关键词(KeyWords)： 药物洗脱支架;佐他莫司;依维莫司;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 阮洁,蒋萍,苏晞

参考文献(References)：

• [1]Garg S,Serruys PW.Coronary stents:current status.J Am Coll Cardiol,2010,56(10 Suppl):S1-S42.
• [2]Kandzari DE,Leon MB,Meredith I,et al.Final 5-year outcomes from the Endeavor zotarolimus-eluting stent clinical trial program:comparison of safety and efficacy with firstgeneration drug-eluting and bare-metal stents.JACC Cardiovasc Interv,2013,6(5):504-512.
• [3]Leon MB,Nikolsky E,Cutlip DE,et al.Improved late clinical safety with zotarolimus-eluting stents compared with paclitaxeleluting stents in patients with de novo coronary lesions:3-year follow-up from the ENDEAVOR IV(randomized comparison of zotarolimus-and paclitaxel-eluting stents in patients with coronary artery disease)trial.JACC Cardiovasc Interv,2010,3(10):1043-1050.
• [4]Fajadet J,Wijns W,Laarman GJ,et al.Randomized,doubleblind,multicenter study of the Endeavor zotarolimus-eluting phosphorylcholine-encapsulated stent f or treatment of native coronary artery lesions:clinical and angiographic results of the ENDEAVOR II trial.Circulation,2006,114(8):798-806.
• [5]Leon MB,Mauri L,Popma JJ,et al.A randomized comparison of the Endeavor zotarolimus-eluting stent versus the TAXUS paclitaxel-eluting stent in de novo native coronary lesions 12-month outcomes from the ENDEAVOR IV trial.J Am Coll Cardiol,2010,55(6):543-554.
• [6]Kedhi E,Gomes ME,Lagerqvist B,et al.Clinical impact of second-generation everolimus-eluting stent compared with firstgeneration drug-eluting stents in diabetes mellitus patients:insights from a nationwide coronary intervention register.JACC Cardiovasc Interv,2012,5(11):1141-1149.
• [7]Otsuka F,Vorpahl M,Nakano M,et al.Pathology of secondgeneration everolimus-eluting stents versus first-generation sirolimusand paclitaxel-eluting stents in humans.Circulation,2014,129(2):211-223.
• [8]Smits PC,Vlachojannis GJ,Mc Fadden EP,et al.Final 5-year follow-up of a randomized controlled trial of everolimus-and paclitaxel-eluting stents for coronary revascularization in daily practice:the COMPARE trial(a trial of everolimus-eluting stents and paclitaxel stents for coronary revascularization in daily practice).JACC Cardiovasc Interv,2015,8(9):1157-1165.
• [9]von Birgelen C,Sen H,Lam MK,et al.Third-generation zotarolimus-eluting and everolimus-eluting stents in all-comer patients requiring a percutaneous coronary intervention(DUTCH PEERS):a randomised,single-blind,multicentre,non-inferiority trial.Lancet,2014,383(9915):413-423.
• [10]Park KW,Lee JM,Kang SH,et al.Safety and effi cacy of secondgeneration everolimus-eluting Xience V stents versuszotarolimuseluting resolute stents in real-world practice:patient-related and stent-related outcomes f rom the multicenter prospective EXCELLENT and RESOLUTE-Korea registries.J Am Coll Cardiol,2013,61(5):536-544.
• [11]von Birgelen C,Basalus MW,Tandjung K,et al.A randomized controlled trial in second-generation zotarolimus-eluting Resolute stents versus everolimus-eluting Xience V stents in real-world patients:the TWENTE trial.J Am Coll Cardiol,2012,59(15):1350-1361.
• [12]Taniwaki M,Stefanini GG,Silber S,et al.4-year clinical outcomes and predictors of repeat revascularization in patients treated with new-generation drug-eluting stents:a report from the RESOLUTE All-Comers trial(a randomized comparison of a zotarolimus-eluting stent with an everolimus-eluting stent for percutaneous coronary intervention).J Am Coll Cardiol,2014,63(16):1617-1625.
• [13]Serruys PW,Silber S,Garg S,et al.Comparison of zotarolimuseluting and everolimus-eluting coronary stents.N Engl J Med,2010,363(2):136-146.
• [14]Velders MA,Boden H,van der Hoeven BL,et al.Longterm outcome of second-generation everolimus-eluting stents and Endeavor zotarolimus-eluting stents in a prospective registry of STelevation myocardial infarction patients.Euro Intervention,2013,8(10):1199-1206.
• [15]徐凯,韩雅玲,杨跃进,等.依维莫司洗脱支架在女性患者中的安全性和有效性:SEEDS多中心注册研究亚组分析.中国介入心脏病学杂志,2014,22(12):761-764.
• [16]王佳鑫,刘越,尹新华,等.新一代冠状动脉支架与支架内血栓的临床研究进展.中国介入心脏病学杂志,2013,21(1):51-52.
• [17]华琨,谷鸿秋.依维莫司和佐他莫司两种药物洗脱支架临床安全性和有效性的比较研究.实用临床医药杂志,2015,19(21):4-8.