冠状动脉长病变患者置入雷帕霉素洗脱支架和紫杉醇洗脱支架2年临床观察Two-year clinical outcome after successful implantation of sirolimus-eluting and paclitaxel-eluting stents in patients with long coronary lesions: results from a real-world single center registry
尹栋,窦克非,杨跃进,徐波,陈珏,刘海波,姚民,秦学文,吴永健,李建军,乔树宾,尤士杰,袁晋青,戴军,陈纪林,高润霖,陈在嘉
摘要(Abstract):
目的评价冠状动脉长病变患者成功置入Firebird雷帕霉素洗脱支架和Taxus紫杉醇洗脱支架2年后的有效性和安全性。方法本研究入选了2004年4月至2006年10月期间,在阜外心血管病医院行择期经皮冠状动脉介入治疗(PCI)的冠状动脉长病变患者826例。入选患者分为Firebird组(666例)和Taxus组(160例)。随访资料包括术后30天、1年和2年的死亡、心肌梗死、血栓、靶病变血运重建和靶血管血运重建。本研究比较了两组间各种临床事件的累积发生率差异。同时通过倾向性评分调整后的Cox比例风险模型比较两组间的2年临床随访结果。结果两组病变长度[(45.62±15.25)mm比(44.09±13.67)mm]及置入支架长度[(51.22±16.64)mm比(49.63±15.86)mm]相似(P>0.05)。术后2年,Firebird组靶病变血运重建率(3.46%比10.00%,P=0.0005)、靶血管血运重建率(5.42%比11.25%,P=0.008)及MACE发生率(10.99%比20.00%,P=0.002)方面显著低于Taxus组。两组患者术后2年支架肯定或可能血栓形成的发生率差异均无统计学意义。经倾向性评分调整后,与Taxus组相比,应用Firebird支架治疗的患者在术后2年时MACE风险降低(危险比0.622,95%CI:0.401~0.965,P=0.034),而其他临床事件的风险比差异无统计学意义。结论对于冠状动脉长病变患者而言,使用Firebird雷帕霉素洗脱支架MACE发生率较低,而靶病变血运重建率和靶血管血运重建率方面不劣于Taxus紫杉醇洗脱支架,且风险有下降趋势。
关键词(KeyWords): 冠心病;药物洗脱支架;治疗结果
基金项目(Foundation):
作者(Author): 尹栋,窦克非,杨跃进,徐波,陈珏,刘海波,姚民,秦学文,吴永健,李建军,乔树宾,尤士杰,袁晋青,戴军,陈纪林,高润霖,陈在嘉
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