雷帕霉素药物洗脱支架在急性心肌梗死择期介入治疗中应用的近远期疗效观察

Evaluation of Short and Long-term Outcomes of Rapamyxin Eluting Stent Using in Delayed Percutaneous Coronaryintervention in Patients of Acute Myocadial Infarction

目的探讨雷帕霉素药物洗脱支架(Cypher支架)在急性心肌梗死择期介入治疗中应用的安全性及近、远期临床疗效。方法对2003年9月-2004年12月期间55例急性心肌梗死患者于梗死后5-14 d(平均8．6±3．1d)行。PCI,术后随访15～29个月观察有无心绞痛、急性心肌梗死、再次血管重建和死亡事件等。结果55例患者72处靶病变,共置入71个Cypher支架及11个普通金属裸支架,支架置入成功率为100％,术中和住院期间无死亡,住院期间无主要心脏不良事件。随访期间,无死亡病例,无慢性充血性心力衰竭心功能Ⅲ一Ⅳ级(NYHA分级)病例,1例发生急性左心衰,1例发生心绞痛进行了靶病变重建,2例发生急性心肌梗死,主要心脏不良事件发生率7．3％,靶病变重建率1．8％。结论雷帕霉素药物洗脱支架应用于急性心肌梗死择期介入治疗中安全、有效, 具有良好的近远期临床效果。

Objective To investigate the short and long-term clinical outcome of Cypher stent in patients of Acute Myocadial Infarction （AMI） with Delayed Percutaneous Coronaryintervention （PCI）. Methods From September 2003 to december 2004,PCI was performed after AMI 5-14 clays in 55 patients. All patientswere followed up for 15 - 29 months for major adverse cardiac event（MACE） such as angina pectoris, myocadial infarction , sudden death and target lession revascularization （TLR）. Results 55 patients were treated with 71 Cypher stents and 11 BES. Success rate of stent implantation was 100%. There was no MACE during the procedure and hospitalzation. During the follow-up period one patient occurred acute heart failure, one patient occurred angina pectoris and TLR was performed , AMI occurred in two patients, with a MACE rate of 7.3% ,TLR rate was 1.8%. Conclusion The treatment of rapamyxin eluting stent e using in Delayed Percutaneous Coronaryintervention is safe and effective in patients of AMI.