Lancet:表面覆盖低剂量雷帕霉素的洗脱支架可有效用于缺血性冠状动脉疾病

2018-09-04 MedSci MedSci原创

FIREHAWK是一种药物洗脱支架,支架表面凹陷的腔外沟槽内覆盖完全可生物降解的含雷帕霉素的聚合物涂层。现有研究人员对这种靶向、低剂量、可生物降解的聚合物、雷帕霉素洗脱支架与XIENCE耐用聚合物、依维莫司洗脱支架在所有人群中的临床预后进行研究比较。研究人员在10个欧洲国家的21个中心开展一前瞻性、多中心、开放标签的随机非劣性性试验,招募有/无症状的冠状动脉疾病和明确心肌缺血的患者,并可行经皮冠状

FIREHAWK是一种药物洗脱支架,支架表面凹陷的腔外沟槽内覆盖完全可生物降解的含雷帕霉素的聚合物涂层。现有研究人员对这种靶向、低剂量、可生物降解的聚合物、雷帕霉素洗脱支架与XIENCE耐用聚合物、依维莫司洗脱支架在所有人群中的临床预后进行研究比较。

研究人员在10个欧洲国家的21个中心开展一前瞻性、多中心、开放标签的随机非劣性性试验,招募有/无症状的冠状动脉疾病和明确心肌缺血的患者,并可行经皮冠状动脉介入治疗。将患者按1:1随机分组,分别植入FIREHAWK或XIENCE。主要评估指标是12个月内靶病灶失败,包括心源性死亡、靶血管心肌梗死或缺血驱动靶病灶血管重建。

2015年12月17日-2016年10月14日,共有1653位患者被随机分至两个治疗组(FIREHAWK 823位;XIENCE 830位)。FIREHAWK组和XIENCE组分别有65位和66位患者随访数据不足,被排除分析。12个月里,FIREHAWK组和XIENCE组分别有46/758(6.1%)位和45/764(5.9%)位患者发生靶病灶失败(差值 0.2%,90% CI -1.9~2.2,p=0.004;95% CI -2.2~2.6,p=0.88)。12个月内,两组之间缺血驱动的血管重建和支架内血栓形成率无明显差别。此外,176位患者被纳入血管造影亚研究,其结果显示FIREHAWK组和XIENCE组晚期支架腔各缩小0.17mm(SD 0.48)和0.11mm(0.52)(p=0.48),绝对差0.05mm(95% CI -0.09~0.18,p=0.024)。

对于需要进行支架植入缓解心肌缺血的广泛人群,根据12个月内靶病灶失败率和13个月内支架腔缩小情况,FIREHAWK支架的效果并不次于XIENCE支架。在临床应用中,FIREHAWK支架可安全有效用于缺血性冠状动脉疾病患者。

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    2018-09-26 howi
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