NEJM:高出血风险患者PCI方案选择——聚合物药物洗脱支架 vs 无聚合物药物涂层支架

2020-03-26 MedSci原创 MedSci原创

在PCI后1个月接受双重抗血小板治疗的高出血风险患者中,使用聚合物Zotarolimus洗脱支架在安全性和有效性方面与无聚合物药物涂层支架相当

对于接受经皮冠状动脉介入治疗(PCI)且需接受1个月双重抗血小板治疗的高出血风险患者,无聚合物药物涂层支架比裸金属支架具有更好的临床效果。近日研究人员考察了聚合物药物洗脱支架对高出血风险患者的效果。
 
高出血风险患者随机接受聚合物Xotarolimus洗脱支架或无聚合物佐他莫司涂层支架,在PCI后,患者接受1个月的双重抗血小板治疗,随后接受单一抗血小板治疗。研究的主要结果是由心脏原因、心肌梗死或支架血栓形成导致的一年内死亡。次要结果是靶病变衰竭,包括心脏原因死亡、靶血管心肌梗死或血运重建的复合终点。
 
共有1996名高出血风险患者参与研究,其中Xotarolimus洗脱支架组1003名患者,无聚合物药物涂层支架组993名患者。 1年后,Zotarolimus洗脱支架组988例患者中的169例(17.1%),无聚合物药物涂层支架组969例患者中的164例(16.9%)观察到主要结果(风险差异:0.2%)。Zotarolimus洗脱支架组174例(17.6%),无聚合物药物涂层支架组169例(17.4%)患者观察到次要结果(风险差异:0.2%)。
 
在PCI后1个月接受双重抗血小板治疗的高出血风险患者中,使用聚合物Zotarolimus洗脱支架在安全性和有效性方面与无聚合物药物涂层支架相当。
 
原始出处:
 
Stephan Windecker et al. Polymer-based or Polymer-free Stents in Patients at High Bleeding Risk. N Engl J Med, March 26, 2020.

 

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    2020-03-28 yese
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    2020-03-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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