国产Firebird支架在急性冠状动脉综合征急诊介入治疗中的作用

Efficacy of domestic Firebird drug-eluting stent in the emergent intervention for acute coronary syndrome

目的:探讨国产雷帕霉素药物洗脱支架(Firebird)在急性冠状动脉综合征(ACS)急诊经皮冠状动脉介入治疗(PCI)中应用的安全性和有效性。方法:选择2004年1月至2007年9月间的ACS患者118例,于发病12h内行急诊PCI治疗,于梗死相关血管的靶病变处置入Firebird支架。记录1个月和6个月随访终点时的主要心脏不良事件(包括死亡、再发心肌梗死、靶血管再成形等)发生率、支架内血栓发生率、支架内再狭窄发生率。结果:118例患者急诊PCI治疗均获得成功。118支梗死相关血管的125处罪犯病变共置入140枚Firebird支架,12例患者出现无复流现象,1例应用主动脉内气囊反搏术,6例出现心室颤动,18例出现一过性室性心动过速。10例出现一过性低血压,术后2例发生穿刺部位血肿。仅1例患者于术后第3天因再发急性心肌梗死死亡,1个月随访终点时主要心脏不良事件为0.8%。6个月随访终点时有28例接受了冠状动脉造影复查(造影随访率23.9%),无支架内再狭窄发生,无主要心脏不良事件。结论:Firebird支架在ACS急诊PCI中应用与普通支架一样有较高的安全性和有效性,并可以明显降低再狭窄率。

Objective To explore the safety and efficacy of the domestic Firebird rapamycin-eluting stent in percutaneous coronary intervention （PCI） for acute coronary syndrome （ACS）. Methods From January 2004 through September 2007, emergent PCI was performed on 118 patients with ACS within 12 hours of symptom onset to place Fircbird stents. At one- and six-month follow-ups, the incidence rates of major adverse cardiac events （MACEs; death, recurrent myocardial infarction, and revascularization） and in-stent thrombosis or restenosis were documented. Results Emergent PCI was successful in all the patients. 140 Firebird stents were placed in 125 culprit lesions locating at 118 infarct-related vessels. No-reflow phenomenon occurred in 12 patients, so did ventricular fibrillation in 6, transient ventricular tachycardia in 18, transient hypotension in 10, postosurgical hematoma at the puncture site in 2. One patient needed placement of an intra-aortie balloon pump and one died from recurrent myocardial infarction on day 3. The incidence rate of MACEs was 0.8% in a one-month follow-up. No MACEs and no in-stent restenosis were found in 28 patients undergoing coronary angiography in a six-month follow-up. Conclusions Firebird drug-eluting stent has the similar safety and efficacy with the conventional stent in emergent PCI for ACS. It can markedly reduce the incidence rate of restenosis.