佐他莫司洗脱支架与依维莫司洗脱支架5年临床疗效比较

Comparison of 5-year outcomes of zotarolimus-eluting stents and everolimus-eluting stents

目的比较佐他莫司和依维莫司两类药物洗脱支架的长期临床安全性和有效性。方法纳入2011年1月至2012年12月于武汉亚洲心脏病医院接受经皮冠状动脉介入治疗的患者480例,根据置入支架类型,分为佐他莫司洗脱支架组(ZES组,244例)和依维莫司洗脱支架组(EES组,236例)。随访5年的临床疗效。初级终点是主要不良心血管事件,包括全因死亡、非致死性心肌梗死、靶血管再次血运重建。次级终点为支架内再狭窄及支架内闭塞。结果 5年随访结果显示,两组患者全因死亡率和非致死性急性心肌梗死发生率比较,差异均无统计学意义(均P>0.05)。EES组患者靶血管再次血运重建(5.1%比10.2%,P=0.040)、支架内再狭窄(5.9%比11.5%,P=0.036)和支架内闭塞(2.1%比6.1%,P=0.038)发生率均显著低于ZES组,差异均有统计学意义。结论 EES的5年临床安全性和有效性优于ZES。

Objective To compare 5-year clinical outcomes of the safety and efficacy of zotarolimus-eluting stent（ZES） and everolimus-eluting stent（EES）. Methods A total of 480 patients receiving either ZES（n=244） or EES（n=236） placement from January 2011 to December 2012 in Wuhan Asia Heart Hospital were included in this study. The primary end point of the study was 5-year all-cause mortality including acute myocardial infarction, and target vessel revascularization af ter the index EES/ZES placement. The secondary end points included subsequent in-stent restenosis and instent occlusion at 5 years. Results There were no signif icant diff erences in all-cause mortality and acute myocardial infarction outcomes between the ZES and the EES groups（P 〉 0.05）. Compared with patients receiving EES, patients receiving ZES had a significantly higher rate of 5-year target vessel revascularization（10.2% vs. 5.1%,P=0.040）, in-stent restenosis（11.5% vs. 5.9%, P=0.036）, and instent occlusion（6.1% vs. 2.1%,P=0.038）. Conclusions At 5 years, patients receiving EES generally had better or comparable long-term outcomes compared with patients receiving ZES.