摘要
虽然有聚合物涂层的冠状动脉支架可负载足够的药物,且可使所携药物足量释放,但目前关于该类支架的可能不良反应尚未可知。本研究比较了置入以聚合物为基础的紫杉醇洗脱支架(PES)与非聚合物基础PES的患者其临床、血管造影以及血管内超声(IVUS)的资料。
Although polymer coating of coronary stents enables sufficient loading and release of incorporated drugs, it has also been associated with potentially negative effects. This study compared the clinical, angiographic, and intravascular ultrasound (IVUS) outcomes of patients treated with polymer-versus nonpolymer-based paclitaxel-eluting stents (PESs). Sixty-five consecutive patients (70 de novo lesions) treated with polymer-based PESs (TAXUS, 1 μg/mm2 of paclitaxel; Boston Scientific Corp.) and 65 consecutive patients (65 de novo lesions) treated with nonpolymer-based PESs (V-Flex Plus, 2.7 μg/mm2 of paclitaxel; Cook, Inc.) were enrolled in the study. Six-month angiographic follow-up was performed on 54 lesions of the polymer-based PES group and 51 lesions of the nonpolymer-based PES group. IVUS at angiographic follow-up was performed in 61 of the first 70 included lesions. At 6-month IVUS follow-up, mean intimal hyperplasia cross-sectional area was 2.36±1.60 mm2 in the nonpolymer-based PES group versus 0.62±0.41 mm2 in the polymer-based PES group (p=0.003). Implantation of polymer-based PESs resulted in significantly lower in-stent late lumen loss (0.22±0.27 vs 0.74±0.61 mm, respectively, p < 0.001). In-stent binary restenosis rate was 5%versus 20%, respectively (p < 0.001). Target lesion revascularization rate was 9%after implantation of polymer-based PES versus 18%(p=0.128) after implantation of nonpolymer-based PES, and the major adverse cardiac event rate was 9%versus 23%, respectively (p=0.032). In conclusion, polymer-based PESs result in superior angiographic and IVUS follow-up findings compared with nonpolymer-based PESs.
