Circulation:新一代超薄药物洗脱支架可明显提高经皮冠状动脉介入治疗患者一年内的临床预后

2018-11-17 MedSci MedSci原创

与一代支架相比,二代药物洗脱支架(DES)用于经皮冠状动脉介入治疗的效果和安全性均更好,部分原因在于其支架更薄。而新一代超薄支架是否能够在二代DES的基础上进一步改善临床预后呢?研究人员在PubMed、Embase和临床试验的Cochrane中心注册处中检索对比新一代超薄DES(支架厚度<70μm)和二代DES的随机临床试验和临床报告。主要结点是随访1年内靶病灶衰竭(包括心血管死亡、靶血管心

与一代支架相比,二代药物洗脱支架(DES)用于经皮冠状动脉介入治疗的效果和安全性均更好,部分原因在于其支架更薄。而新一代超薄支架是否能够在二代DES的基础上进一步改善临床预后呢?

研究人员在PubMed、Embase和临床试验的Cochrane中心注册处中检索对比新一代超薄DES(支架厚度<70μm)和二代DES的随机临床试验和临床报告。主要结点是随访1年内靶病灶衰竭(包括血管死亡、靶血管心肌梗死或缺血驱动的靶病灶血管重建)。

研究人员筛选到10个临床试验,包含11658位患者,评估了3种新一代超薄DES:Orsiro支架(60μm)、MiStent(64μm)和BioMime(65μm)。与二代DES相比,新一代超薄DES可降低16%的由心肌梗死(相对风险0.80,95% CI 0.65-0.99)导致的靶病灶衰竭(相对风险0.84;95% CI 0.72-0.99)。超薄DES的支架血栓形成率也相对降低(相对风险0.72,95% CI 0.51-1.01)。超薄支架亚组之间没有显著差异。

对于进行经皮冠状动脉介入治疗的患者,新一代超薄DES相比二代DES可明显提高1年内的临床预后。


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