雷帕霉素洗脱支架与紫杉醇洗脱支架在急性心肌梗死直接经皮冠状动脉介入治疗中的疗效比较

目的 比较雷帕霉素洗脱支架(Firebird)与紫杉醇洗脱支架(Coroflex)在急性ST段抬高型心肌梗死直接经皮冠状动脉介入治疗中的有效性和安全性.方法 连续入选220例急性ST段抬高型心肌梗死患者,随机分入Firebird组(112例)和Coroflex组(108例),分析患者冠状动脉的靶血管特点、手术成功率及术后随访情况.主要终点为术后12个月主要不良心脏事件(包括死亡、心肌梗死和靶血管重建),次要终点为9个月晚期管腔丢失和支架内再狭窄.结果 手术成功率100％;术后9个月冠状动脉造影随访Firebird组与Coroflex组支架内晚期管腔丢失和支架内再狭窄的发生率差异无统计学意义(P＞0.05)；术后12个月Firebird组和Coroflex组死亡(2.7％ vs 1.8％,P＞0.05)、心肌梗死(2.7％ vs 1.8％,P＞0.05)、靶血管重建(2.7％ vs 2.8％,P＞0.05)、主要不良心脏事件(4.5％ vs3.7％,P ＞0.05)及支架内血栓形成(2.7％ vs 1.8％,P＞0.05)的发生率差异均无统计学意义.结论 Firebird支架与Coroflex支架在直接经皮冠状动脉介入治疗急性ST段抬高型心肌梗死中的近期疗效和安全性是一致的.

Efficacy comparison of primary percutaneous coronary intervention with sirolimus-eluting stent and paclitaxel-eluting stent for acute ST-segment elevation myocardial infarction

Objective This prospective random control study was performed to compare the efficacy and safety of primary percutaneous coronary intervention（PCI） with sirolimus-eluting stent（Firebird） and paclitaxel-eluting stent（Coroflex） for acute ST-segment elevation myocardial infarction（STEMI）. Methods Consecutive patients with STEMI who underwent primary PCI were randomly divided into Firebird group（n=112） and Coroflex group（n=108）.The primary endpoints were major adverse cardiac events（MACE,including death,reinfarction and target vessel revascularization） within 12 months.The second endpoints included late luminal loss and restenosis at 9 months. Results The rate of in-stent restenosis of Firebird and Coroflex group was 4.8% vs 3.4%（P0.05）,respectively.The late luminal loss of in-stent was（0.22±0.15） mm vs（0.23±0.17） mm（P0.05）,respectively.There were no significant difference in death（2.7% vs 1.8%,P0.05）,reinfarction（2.7% vs 1.8%,P0.05）,target vessel revascularization（2.7% vs 2.8%,P0.05）,MACE（4.5% vs 3.7%,P0.05） and stent thrombosis（2.7% vs 1.8%,P0.05） at 12 months between Firebird group and Coroflex group. Conclusion Firebird and Coroflex stents may have similar mid-term efficacy and safety in patients with STEMI treated with primary PCI.Further investigation is warranted to validate the long-term efficacy and safety.