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Sirolimus-eluting stents for treatment of drug-eluting versus bare-metal stents restenosis: 42-month clinical outcomes from a Chinese single center

摘要Background Restenosis of bare-metal stents (BMS) and drug-eluting stents (DES) has been increasingly treated with sirolimus-eluting stents (SES),but the long-term outcomes are unknown.Methods In our study,388 consecutive patients (144 DES restenosis and 244 BMS restenosis) with 400 lesions (147 DES restenosis and 253 BMS restenosis) treated with SES were included.The rates of target lesion revascularization (TLR) and major adverse cardiac events (MACE) at 42 months were analyzed.Results At the mean follow-up of 42 months,the rates of death (3.5% vs.3.3%,P=1.000) and myocardial infarction (2.8% vs.1.2%,P=0.431) in the DES group and BMS group were comparable.Compared with the BMS group,ischemia-driven TLR occurred with a higher frequency in the DES group (18.8% vs.10.7%,P=0.024).This translated into an increased rate of MACE in the DES group (22.2% vs.14.0%,P=0.034).Stent thrombosis occurred with a similar frequency in both groups (2.8% vs.1.6%,P=0.475).Multivariate analysis showed that DES restenosis (OR=1.907,95%Cl 1.108-3.285,P=0.020) and smoking (OR=2.069; 95% C/ 1.188-3.605; P=0.010) were independent predictors of MACE.Conclusions Although SES implantation appears to be safe and effective,it was associated with higher TLR recurrence for DES than BMS restenosis.

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作者 YAN Rong-qiang [1] CHEN Ji-lin [1] GAO Li-jian [1] YANG Yue-jin [1] LI Jian-jun [1] QIAO Shu-bin [1] XU Bo [1] YAO Min [1] QIN Xue-wen [1] LIU Hai-bo [1] WU Yong-jian [1] YUAN Jin-qing [1] CHEN Jue [1] YOU Shi-jie [1] DAI Jun [1] GAO Run-lin [1] 学术成果认领
作者单位 State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China [1]
分类号 Q492.4
栏目名称
DOI 10.3760/cma.j.issn.0366-6999.2012.19.007
发布时间 2012-12-20
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中华医学杂志(英文版)

中华医学杂志(英文版)

2012年125卷19期

3398-3403页

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