新型氮氧化钛生物有效支架与国产雷帕霉素药物洗脱支架在老年冠状动脉血运重建临床应用的对比研究

Comparison of the effect of coronary revascularization between titanium nitric-oxide biological availability stent and sirolimus-eluting stent in elderly patients

摘要:

目的对比研究氮氧化钛生物有效性支架(Titan2-BAS)与国产雷帕霉素药物洗脱支架(SES)在老年冠状动脉血运重建临床应用中的疗效。方法共入选125例老年冠心病患者,男75例,女50例。根据植入的支架不同分为A组(Titan2-BAS)79例,B组(SES)46例,均采用经桡动脉或尺动脉途径冠脉血运重建。A组阿司匹林与氯吡格雷治疗1～3个月,B组至少12个月。计算A、B两组支架病变的通过率、早期支架内血栓发生率及随访主要不良心脏事件(MACE,指死亡、急性心肌梗死、靶血管重建等)发生率。结果(1)A组病变内径(3.1±0.3)mm,长度为(25±3.6)mm,B组病变内径(3.1±0.4)mm,长度为(24±4.2)mm,两组无显著差异。(2)A组129处>75%狭窄病变共植入Titan2-BAS146枚,1枚支架未能通过病变(右冠状动脉),通过率99.3%;B组72处病变共植入SES82枚,通过率100%,两组无显著差异。(3)随访1～17个月,平均5.3个月。两组均无死亡病例;A组无急、晚期血栓。B组1例术后2d出现支架内血栓;A组1例术后3个月行靶血管重建,B组无靶血管重建;综合以上,两组MACE发生率无显著差异(1.3%对2.2%)。结论Titan2-BAS与SES在老年冠状动脉血运重建方面的近期及远期疗效相近,Titan2-BAS不增加MACE发生率。

Abstract:

Objective To compare the effect of coronary revascularization between titanium nitric-oxide biological availability stent (Titan2-BAS) and sirolimus-eluting stent (SES) in elderly patients. Methods One hundred and twenty-five patients with coronary artery diseases were enrolled,including 75 males and 50 females. The patients were categorized into Titan2-BAS group (group A,n=79) and SES group (n=46). All the stents were implanted through transulnar or transradial approach. Patients in group A received aspirin and clopidogrel for 1 to 3 months,while patients in group B received the same medications for at least 12 months. The success rate of stent implantation,incidence of in-stent thrombosis in early period and incidence of major adverse cardiac events(MACE)during follow-up visit,including death,acute myocardial infarction,and criminal artery reestablishment were observed in both groups. Results (1) The lesion was averagely (25±3.6) mm long and (3.1±0.3) mm internal diameter in group A,and (24±4.2) mm long and (3.1±0.4) mm internal diameter in group B,with no significant difference between the two groups. (2) In group A,146 Titan2-BAS were implanted in 129 narrowed lesions,and 1 stent implantation failed. In group B,82 SES were implanted in 72 lesions. The success rate of stent implantation were 99.3% in group A and 100% in group B,with no significant difference between the two groups. (3) All subjects survived,and were followed up for 1-17 months (average 5.8 months). One patient presented in-stent thrombosis on the second day after stent implantation in group B,whereas no thrombosis developed in group A. One patient was submitted to revascularization in the third month after stent implantation in group A,while no revascularization was performed in group B. In general,there was no difference between group A and B in the incidence of MACE(1.3% vs 2.2%). Conclusion Concerning coronary revascularization,the short and long-term efficacy of Titan2-BAS is similar to that of SES in elderly patients with coronary artery disease. Titan2-BAS adds no extra risk of MACE.?更多