摘要
目的:对比评价药物洗脱支架和金属裸支架对75岁以上高龄患者的安全性和有效性。方法:2005-11至2006-12我院75岁以上接受冠状动脉支架置入术的患者269例,年龄在75～87岁;其中,药物洗脱支架组140例,金属裸支架组129例。30天、6～12个月进行临床随访,对比2组全因死亡和主要不良心脏事件(MACE,包括心脏性死亡,非致死性心肌梗死和靶病变血运重建的发生率)。结果:药物洗脱支架组支架直径显著小于金属裸支架组(P<0.05),支架长度显著大于金属裸支架组(P<0.05)。30天 MACE 药物洗脱支架组与金属裸支架组差异无统计学意义(P>0.05)。术后6～12月随访,两组只有靶病变血运重建率在药物洗脱支架组显著低于金属裸支架组(P<0.001),在总随访率、造影复查率、造影复查时间、MACE 和全因死亡率等之间均无显著差异(P 均>0.05)。药物洗脱支架组晚期血栓发生率为1.4%,金属裸支架组未见晚期血栓发生。结论:药物洗脱支架和金属裸支架对75岁以上的高龄患者具有同样的疗效和安全性,并且 MACE 有减少的趋势,但药物洗脱支架有发生晚期血栓的可能性。
Objective：To compare the outcomes of drug- eluting stent （DES） with bare metal stent （BMS） in patients over 75 years. Methods ： From November 2005 to December 2006, 269 consecutive patients were included in this study who underwent coronary stent implantation, including 140（76. 2 ± 2. 5 years old） DES and 129 （77.6 ± 3.0 years old）BMS. Incidence of major adverse cardiovascular events （ MACE）, including death, acute myocardial infarction （ AMI）, and target lesion revascularization （TLR） were evaluated at 30 days, 6 months to 1 year after percutaneous coronary intervention. Resuhs：There were longer stents length and smaller stents diameter （28. 13 ± 14. 31 mm vs 24.71 ± 11.96 mm, P 〈0. 05 ; 3.02 ± 0. 39 mm vs 3.33 ± 0. 56 mm, P 〈 0. 05 ） in the DES group. There was no statistical difference in the MACE rate between groups both at 30 days and 1 year follow-up（ DES vs BMS ： 1.4% vs 3. 1% , P 〉 0. 05 ; 5.0% vs 12. 4% , P 〉 0. 05 ） , and there was no statistical difference for death and AMI in the two groups（ DES vs BMS：2. 8% vs 3.9% ,P 〉0. 05 ;2. 1% vs 2. 3% ,P 〉 0. 05 ） for 6-12 months follow up. TLR was significantly lower in DES group （0. 7 % vs 6.9%, P 〈 0. 001 ） and the rate of late stent thrombosis was lower in BMS group（0% vs 1.4% ）. Conclusion： DES and BMS had the same effect and safety for the patients over 75 years, the treatment could reduce MACE. DES may have the possibility for the risk of late stent thrombosis.
出处
《中国循环杂志》
CSCD
北大核心
2008年第4期278-281,共4页
Chinese Circulation Journal
