Heart:对生物可吸收血管支架和药物洗脱支架治疗冠状动脉疾病的二年预后比较

2017-01-26 xing.T MedSci原创

相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。

关于依维莫司洗脱生物可吸收血管支架(BVS)与第二代药物洗脱支架(DES)的长期临床结果数据较为缺乏。近日,在心脏病领域权威杂志Heart上发表了一篇荟萃分析文章,研究人员通过检索在线数据库截止日期至2016年10月,找出了比较的BVS与DES效果并报告了随访2年临床结局的研究 。

研究人员将针对所有冠状动脉疾病患者比较了BVS与DES的研究进行了一项荟萃分析,并通过随机效应模型计算了感兴趣的临床结局,这些包括器械水平的复合事件(DOCE;定义为心源性死亡、靶血管心肌梗死(TV-MI)和缺血驱动的靶病变的血运重建(TLR)的复合事件)、全因死亡率、明确的支架内血栓形成、TV-MI和TLR。

该荟萃分析共纳入了5项满足纳入分析标准的研究,共有2360例患者。在2 年后,相比于DES患者, BVS患者DOCE发生率较高(6.9% vs. 4.5%,比值比为1.53;95%可信区间为1.06-2.23;P=0.02),绝对风险增加(ARI)了2.4%,相对风险增加(RRI)了53%;TV-MI发生率也较高(4% vs. 1.8%,比值比为1.94;95%可信区间为1.02-3.67;P=0.04),ARI 增加了2.2%,RRI增加了122%,以及明确的支架内血栓形成发生率同样较高(2.1% vs. 0.6%,比值比为3.39;95%可信区间为1.46-7.88;P=0.005),ARI增加了1.5%,RRI增加了250%。全因死亡率(比值比为0.86;95%可信区间为0.26-2.81;P=0.80)和TLR(比值比为1.44;95%可信区间为0.81-2.54;P=0.21)两组间无显著差异。

由此可见,相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。

原始出处:

Ramez Nairooz,et al. Two-year outcomes of bioresorbable vascular scaffold versus drug-eluting stents in coronary artery disease: a meta-analysis. Heart. 2017. http://heart.bmj.com/content/early/2017/01/23/heartjnl-2016-310886.abstract

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  4. 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  5. 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topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Mar 06 23:35:00 CST 2017, time=2017-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173383, encodeId=23fd1e338301, content=长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOWcPEsEP4FrvDcicue5V6rMkmXmY73KjYP59vQrEdjU89iaN4ZkOhsItlHkmGTjhV3b5S3zOQA4E0/0, createdBy=cc261682151, createdName=卡圣, createdTime=Tue Jan 31 06:28:03 CST 2017, time=2017-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173093, encodeId=d6551e309353, content=相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。, 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GetPortalCommentsPageByObjectIdResponse(id=1252886, encodeId=e3de125288646, content=<a href='/topic/show?id=463230886b8' target=_blank style='color:#2F92EE;'>#冠状动脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30886, encryptionId=463230886b8, topicName=冠状动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310474, encodeId=992a13104e498, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356165, encodeId=f2b2135616597, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=)]
    2017-01-31 卡圣

    长见识了

    0

  6. 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createdName=智慧医人, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356165, encodeId=f2b2135616597, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=)]
    2017-01-29 ylzr123

    相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。

    0

  7. 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createdName=jeanqiuqiu, createdTime=Fri Jul 21 20:35:00 CST 2017, time=2017-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2076856, encodeId=eb4220e685696, content=<a href='/topic/show?id=0b93692e416' target=_blank style='color:#2F92EE;'>#生物可吸收#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69274, encryptionId=0b93692e416, topicName=生物可吸收)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Tue May 02 11:35:00 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1998741, encodeId=fbcd1998e41a1, content=<a href='/topic/show?id=80936510423' target=_blank style='color:#2F92EE;'>#洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Mar 06 23:35:00 CST 2017, time=2017-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173383, encodeId=23fd1e338301, content=长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOWcPEsEP4FrvDcicue5V6rMkmXmY73KjYP59vQrEdjU89iaN4ZkOhsItlHkmGTjhV3b5S3zOQA4E0/0, createdBy=cc261682151, createdName=卡圣, createdTime=Tue Jan 31 06:28:03 CST 2017, time=2017-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173093, encodeId=d6551e309353, content=相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Jan 29 08:04:39 CST 2017, time=2017-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173008, encodeId=7c601e300880, content=理论指导临床治疗,期待更多的科研数据验证, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160916/IMG57DBEDBBA66BD2947.jpg, createdBy=3b181951777, createdName=ren1mw, createdTime=Sat Jan 28 11:29:16 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1252886, encodeId=e3de125288646, content=<a href='/topic/show?id=463230886b8' target=_blank style='color:#2F92EE;'>#冠状动脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30886, encryptionId=463230886b8, topicName=冠状动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310474, encodeId=992a13104e498, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356165, encodeId=f2b2135616597, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=)]
    2017-01-28 ren1mw

    理论指导临床治疗,期待更多的科研数据验证

    0

  8. 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topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Mar 06 23:35:00 CST 2017, time=2017-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173383, encodeId=23fd1e338301, content=长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOWcPEsEP4FrvDcicue5V6rMkmXmY73KjYP59vQrEdjU89iaN4ZkOhsItlHkmGTjhV3b5S3zOQA4E0/0, createdBy=cc261682151, createdName=卡圣, createdTime=Tue Jan 31 06:28:03 CST 2017, time=2017-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173093, encodeId=d6551e309353, content=相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。, 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  9. 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  10. 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topicName=null, topicId=null, topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Mar 06 23:35:00 CST 2017, time=2017-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173383, encodeId=23fd1e338301, content=长见识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOWcPEsEP4FrvDcicue5V6rMkmXmY73KjYP59vQrEdjU89iaN4ZkOhsItlHkmGTjhV3b5S3zOQA4E0/0, createdBy=cc261682151, createdName=卡圣, createdTime=Tue Jan 31 06:28:03 CST 2017, time=2017-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=173093, encodeId=d6551e309353, content=相比于DES,BVS可能与较差长期临床预后相关。鼓励进行随机临床试验尽快报告的长期安全性和有效性的结果,并且确定BVS与DES相比不良事件的预测因素。, 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GetPortalCommentsPageByObjectIdResponse(id=1252886, encodeId=e3de125288646, content=<a href='/topic/show?id=463230886b8' target=_blank style='color:#2F92EE;'>#冠状动脉疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30886, encryptionId=463230886b8, topicName=冠状动脉疾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310474, encodeId=992a13104e498, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356165, encodeId=f2b2135616597, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jan 28 08:35:00 CST 2017, time=2017-01-28, status=1, ipAttribution=)]
    2017-01-28 zhaojie88