佐他莫司药物洗脱支架和依维莫司药物洗脱支架二年临床疗效比较

目的:比较佐他莫司药物洗脱支架(ZES)和依维莫司药物洗脱支架(EES)的2年临床疗效。方法:纳入2013年在中国医学科学院阜外医院初次行经皮冠状动脉介入治疗(PCI)的患者2655例,根据支架类型分为两组:ZES组(n=1637)和EES组(n=1018)。2年随访的主要终点为主要不良心血管事件(MACE),包括死亡、非致死性心肌梗死和靶血管血运重建。结果:两组患者的人口学特征、危险因素和既往史、实验室检查结果以及药物应用方面均相似(P均>0.05)。在冠状动脉病变和介入治疗方面,与EES组相比,ZES组SYNTAX积分更高,左主干病变、B2/C型病变的比例更高,置入的支架直径更大、长度更长(P均<0.05)。2年随访结果显示,ZES组与EES组中MACE(5.4%vs 4.9%)以及各独立终点事件的发生率差异均无统计学意义(P均>0.05)。结论:以ZES和EES为代表的新一代药物洗脱支架临床应用安全、有效;2年随访结果显示,两种支架MACE发生率差异无统计学意义。

Clinical Efficacy Comparison Between Zotarolimus-eluting Stent and Everolimus-eluting Stent:Two Years Follow-up Results

Objectives:To compare the clinical efficacy of two classes of drug-eluting stents of zotarolimus and everolimus.Methods:A total of 2655 patients who underwent primary percutaneous coronary intervention(PCI)in Fuwai Hospital in 2013 were enrolled in the study.The patients were divided into two groups:the zotarolimus-eluting stent group(ZES group,1637 patients)and everolimus-eluting stent group(EES group,1018 patients).The primary endpoint of 2-year follow-up was major adverse cardiovascular events(MACE),including death,nonfatal myocardial infarction,and revascularization.Results:Demographics,risk factors and past history,laboratory test results,and drug use were similar between the two groups(all P>0.05).Among the angiographic characteristics,the SYNTAX score was significantly higher in the ZES group,the proportion of left main lesions and type B2/C lesions was also significantly higher,the stent diameter was significantly larger,and the stent length was significantly longer in ZES group than in EES group(all P<0.05).Two years follow-up results showed that there were no significant differences in MACE(5.4%vs 4.9%)and independent endpoint events between the two groups(all P>0.05).Conclusions:Both ZES and EES are safe and effective for treating patients with ischemic heart disease and there is no significant difference in clinical outcome between ZES and EES.