佐他莫司和西罗莫司支架在老年冠心病患者介入治疗中的对比研究

目的 比较佐他莫司支架和西罗莫司支架治疗老年冠心病的临床效果. 方法回顾性分析2006年8月至2007年5月我院对635例老年冠心病患者连续支架植入治疗的临床资料.其中植入佐他莫司(佐他莫司组)支架334例,西罗莫司(西罗莫司组)支架301例.比较两组治疗成功率、主要心脏不良事件等临床情况,并进行对比分析. 结果两组基线临床特点佐他莫司组高脂血症和左主干病变少于西罗莫司组,佐他莫司组再狭窄病变、支架长度、支架最大释放压和后扩张比率均小于西罗莫司组.两组介入成功率均为100%.主要心脏不良事件发生率与佐他莫司组比较(分别为4.5%(15例)与4.3%(13例)],差异无统计学意义,其中心原性死亡、非致死性心肌梗死和靶血管重建率两组比较,差异无统计学意义.支架内血栓发生率佐他莫司组和西罗莫司组分别为0.3%(1例)和0.7%(2例),差异无统计学意义.早期、晚期支架内血栓发生率两组比较,差异无统计学意义.7个月随访,佐他莫司组和两罗莫司组支架内和血管段再狭窄率[分别为5.9%(4/68)和3.5%(3/36),7.4%(5/65)和4.7%(4/86)]比较,差异无统计学意义.但支架内和血管段的晚期丢失佐他莫司组均大于西罗莫司组,分别为(0.48±0.12)mm与(0.24±0.09)mm和(0.44±0.13)mm与(0.26±0.09)mm,均P< 0.01. 结论7个月随访结果证实,佐他莫司和西罗莫司支架对于老年冠心病患者具有相似的疗效.

Comparison of zotarolimus-eluting and sirolimus-eluting stents in elderly patients with coronary artery disease

Objective To compare the clinic effect between zotarolimus-eluting Endeavor and sirolimus-eluting stents Cypher for daily practice in Chinese elderly patients with coronary artery disease. Methods From October 2006 to May 2007, the data of 635 consecutive patients ≥ 60 years old in whom Endeavor E group, n=334 or Cypher C group, n=301 were implanted in our center were analyzed. And clinical and angiographic follow-up were performed in the next 7 months. Results On baseline, there was more hyperlipidemia, left main disease, restenosis and postdilation, longer stent length and larger stent deployed pressure in C group. Compared E with C group following the next 7 months, there were no differences of major adverse cardiac event MACE 4.5% vs. 4.3%, cardiac death 0. 6% vs. 0% , non-fatal myocardial infarction 0. 6 % vs. 2.0% and target vessel revascularization TVR,3.3% vs. 2. 3%, all P > 0.05. There were no differences of the incidence of stent thrombosis total: 0. 3% vs. 0. 7% , early: 0. 3% vs. 0. 3% and late- 0% vs. 0.3% according to Academic Research Consortium ARC standard definitions definite + probable. The 7 months angiographic follow-up indicated that there were no differences of in-stent or in-segment restenosis rate 5. 9% vs. 3. 5% and 7. 4% vs. 4. 7% , but in-stent and in-segment late loss were significantly larger in E group than in C group[0. 48 ± 0.12mm vs. 0. 24 ± 0. 09mm and 0.21 ± 0.09mm vs. 0. 23 ± 0. 11 mm, both P< 0. 01] . Conclusions Both of Endeavor and Cypher stents have similar effects on reducing the incidence of MACE and the risk of restenosis both in-stent and in-segment binary restenosis for elderly patients in daily practice.