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Eur Heart J:超薄药物洗脱支架 vs 传统二代药物洗脱支架的长期效益!

2021-06-06 Nebula MedSci原创

采用超薄药物洗脱支架治疗的患者可长期获益~

当代第二代薄支柱药物洗脱支架(DES)被认为是经皮冠状动脉介入治疗患者血运重建的标准选择。之前的一项荟萃分析对10项随机对照试验(RCT)进行汇总分析(共纳入16658位患者)显示,与传统的第二代薄支柱DES相比,超薄支柱DES的1年靶血管治疗失败(TLF)风险降低了16%。但是,这种益处是否能持续较长时间尚不清楚,新的试验数据可能会提供这些结果的相关信息。

因此,本研究旨在对超薄-支状DES(支状厚度≤70μm)与传统的第二代薄-支状DES的最新临床试验结果进行汇总对比分析。

研究人员对所有比较了超薄支柱DES和传统的第二代薄支柱DES的随机对照试验进行了随机效应荟萃分析。预先指定的主要终点是长期TLF(包括心源性死亡、心肌梗死[MI]或临床驱动的靶血管血运重建[CD-TLR])。次要终点包括TLF成分、支架内血栓形成(ST)和全因死亡率。

两组各终点指标的相对风险比

共纳入了16项符合条件的随机试验,共包含了20701名患者。加权平均随访时间为2.5年。与传统的第二代薄-支柱DES相比,采用超薄-支柱DES治疗患者的CD-TLR发生率减少了25% (相对风险[RR] 0.75, 95% CI 0.62-0.92, P=0.005)、长期TLF发生率减少了15% (RR 0.85, 95% CI 0.76-0.96, P=0.008)。

此外,采用不同类型支架治疗的患者之间的心肌梗死、ST、心源性死亡或全因死亡率的风险没有显著差异。

综上所述,在平均随访2.5年时间内,与传统的第二代薄支柱DES相比,采用超薄支柱DES治疗的患者的CD-TLR发生率显著降低,使得总TLF的发生风险也随之降低;但心肌梗死、ST、心源性死亡和全因死亡率的风险无明显差异。

原始出处:

Madhavan Mahesh V,Howard James P,Naqvi Azim et al. Long-term follow-up after ultrathin vs. conventional 2nd-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials.[J] .Eur Heart J, 2021, undefined: undefined. https://doi.org/10.1093/eurheartj/ehab280

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    2021-06-08 zhaojie88
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    2021-06-08 slcumt
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    2021-06-06 粪兜小医生

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