不同药物洗脱支架治疗老年急性心肌梗死疗效观察

目的探讨老年ST段抬高型急性心肌梗死患者应用雷帕霉素洗脱支架与紫杉醇洗脱支架经皮冠状动脉介入治疗的安全性及有效性。方法 129例≥65岁ST段抬高型急性心肌梗死患者,随机分为雷帕霉素组68例和紫杉醇组61例,分别应用雷帕霉素洗脱支架与紫杉醇洗脱支架经皮冠状动脉介入治疗,分析2组患者冠状动脉靶血管特点、手术成功率及术后12个月主要不良心脏事件及术后9个月晚期管腔丢失和支架内再狭窄情况。结果手术成功率100%,2组术后9个月晚期管腔丢失和支架内再狭窄发生率差异均无统计学意义(P>0.05);2组术后12个月病死率及心肌梗死、靶血管重建、主要不良心脏事件、支架内血栓形成的发生率差异均无统计学意义(P>0.05)。结论老年ST段抬高型急性心肌梗死患者使用雷帕霉素或紫杉醇支架经皮冠状动脉介入治疗近期治疗效果和安全性均较可靠。

Effect of drug-eluting stents on the elderly patients with acute ST-segment elevation myocardial infarction

Objective To compare the efficacy and safety of primary percutaneous coronary intervention(PCI) with sirolimus-eluting stents and paclitaxel-eluting stents for the elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 129 STEMI patients aged 65 years or older underwent primary PCI were randomly divided into sirolimus group(n=68,sirolimus-eluting stents) and paclitaxel group(n=61,paclitaxel-eluting stents).Target vessel features,operation success rate,incidence of major adverse cardiac events in postoperative 12 months,the late luminal loss and restenosis in postoperative 9 months were assessed.Results The operation success rate was 100%.There were no significant differences in late luminal loss and restenosis in postoperative 9 months between two groups(P>0.05).There were no significant differences in fatality rate,incidences of reinfarction,target vessel revascularization,major adverse cardiac events and stent thrombosis in postoperative 12 months between two groups(P>0.05).Conclusion Sirolimus-eluting stents and paclitaxel-eluting stents may have similar short-term efficacy and safety in the elderly patients with STEMI.