植入金属裸支架治疗急性冠脉综合征患者的长期疗效与安全性随访研究

Long-term Safety and Efficacy of Bare Metal Stent Implantation in Patients with Acute Coronary Syndromes

目的探讨植入金属裸支架(BMS)治疗急性冠脉综合征(ACS)患者的长期疗效和安全性。方法选择2000—2005年北华大学附属医院住院植入BMS随访资料完整的ACS患者491例为研究对象,均行经皮冠状动脉介入治疗植入BMS。经住院冠状动脉造影随访、门诊随访或电话随访,记录主要终点事件。结果平均随访(95±39)个月,随访期间累积171例发生主要心脏不良事件(MACE),MACE发生率为34.83%,年均MACE发生率为4.38%。死亡68例(13.85%),靶病变血管重建71例(14.46%),靶血管重建28例(5.70%),晚期支架内血栓(LST)和极晚期支架内血栓(VLST)0例,心力衰竭2例(0.41%),冠状动脉旁路移植2例(0.41%)。发生支架内再狭窄106例(21.59%),支架节段内再狭窄60例(12.22%),支架内再狭窄合并支架节段内再狭窄127例(25.87%)。结论植入BMS治疗ACS患者,远期MACE、LST、VLST发生率较低,安全性较好。

Objectives To investigate the long-term efficacy and safety of baremetal stent（BMS） implantation in patients with acute coronary syndrome（ACS）.Methods A total of 491 ACS patients who underwent BMS implantation at the Affiliated Hospital of Beihua University between 2000 and 2005,for whom complete follow-up data were available,were enrolled in this study.Percutaneous coronary intervention was performed to implant the BMS.The following primary endpoints were recorded by the hospital：coronary angiography follow-up,outpatient follow-up,or telephone follow-up.Results The average follow-up time was（95±39） months.During the follow-up period,there were 171 cases of major cardiac adverse events（MACE）.The incidence of MACE was 34.83%,and the average annual MACE rate was 4.38%.There were 68 death cases（13.85%）;71 cases（14.46%） of target lesion revascularization;28 cases（5.70%） of target vessel revascularization;0 cases of late stent thrombosis（LST） and very late stent thrombosis（VLST）;2 cases（0.41%） of heart failure;and 2 cases（0.41%） of coronary artery bypass graft.In-stent restenosis occurred in 106 cases（21.59%）;stent segment restenosis developed in 60 cases（12.22%）;and both types of restenosis occurred in 127 cases（25.87%）.Conclusion The incidence of MACE,LST and VLST were lower in patients with ACS who underwent BMS implantation;the treatment thus has a favorable safety profile.