西罗莫司洗脱支架与紫杉醇洗脱支架用于冠状动脉血运重建的比较

查看全文 作　　者：Windecker [1]S.;Remondino A.;Eberli F. R.;姜朝晖 机构地区：[1]Dr.Department of Cardiology, University Hospital Bern, 3010 Bern, Switzerland 出　　处：《世界核心医学期刊文摘(心脏病学分册)》索引2006年第2卷第1期,共1页 摘　　要：Background:Sirolimus-eluting stents and paclitaxel-eluting stents, as compared with bare-metal stents, reduce the risk of restenosis. It is unclear whether there are differences in safety and efficacy between the two types of drug-eluting stents. Methods:We conducted a randomized, controlled, single-blind trial comparing sirolimus-eluting stents with paclitaxel-eluting stents in 1012 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events(death from cardiac causes, myocardial infarction, and ischemia-driven revascularization of the target lesion) by nine months. Follow-up angiography was completed in 540 of 1012 patients(53.4 percent). Results:The two groups had similar baseline clinical and angiographic characteristics. The rate of major adverse cardiac events at nine months was 6.2 percent in the sirolimus-stent group and 10.8 percent in the aclitaxel-stent group(hazard ratio, 0.56; 95 percent confidence interval, 0.36 to 0.86; P=0.009). The difference was driven by a lower rate of target-lesion revascularization in the sirolimus-stent group than in the paclitaxel-stent group(4.8 percent vs. 8.3 percent; hazard ratio, 0.56; 95 percent confidence interval, 0.34 to 0.93; P=0.03). Rates of death from cardiac causes were 0.6 percent in the sirolimus stent group and 1.6 percent in the paclitaxel-stent group(P=0.15); the rates of myocardial infarction were 2.8 percent and 3.5 percent, respectively(P=0.49); and the rates of angiographic restenosis were 6.6 percent and 11.7 percent, respectively(P=0.02). Conclusions:As compared with paclitaxel-eluting stents, the use of sirolimus-eluting stents results in fewer major adverse cardiac events, primarily by decreasing the rates of clinical and angiographic restenosis. 关 键 词：药物洗脱支架 冠状动脉血运重建 紫杉醇 冠状动脉造影检查 经皮冠状动脉介入 不良心脏事件 西罗莫司 心源性死亡 金属支架 单盲试验