Objective To evaluate the efficacy o f three kinds of endovascular stents (Excel, Cypher and BMS) in emergency percutaneous coronary inlervenlion( PCI) in elder patients with ST -segment elevation myocardialinfarction ( STEMI) . Methods 252 acute myocardial infarction ( AMI) elderly palienls wilh ST - segmenl elevalion or new - found LBBB, who were 65 ～ 84 years old, were enrolled. The elder palienls were divided into ihree groups; Excel stent group, Cypher stent group, bare metat stent(BMS) group, The followed -up was 12 monlhs to compare the efficacy of differenl slenls. Results The clinical data of the palienls and coronary arleriography (CAG) results before operalion were of no slalislical differences. During 30 - days post operalion and follow up, the major adverse cardiac evenls ralios of ihree groups was of slalislical differences. According to CAG re - examinalion of ihree groups, in - stent minimal lumen diameler( MLD) , in - stent tate lumen loss(LLL) showed Cypher stent group and Excel stent group were o f no differences ( P > 0. 05 ) , while the bare metal stent (BMS) group was of statistical difference wilh other two groups(P <0. 05) . Conclusion new domestic biodegradable drug - eluling stents in emergency PCI in STEMI elder palienls are efficient, similar with Foreign sirolimus - eluting. Compared with bare metal slenl, Excel stent can evidently reduce vessel stenosis, and decrease in stent LLL,lime of anliplatelet therapy of receiving clopidogrel for stent eluting sirolimus from a biodegradable polymer can be adminislerd shorler than that of slenl eluling sirolimus from a durable polymer.%目的 观察新型国产生物涂层可降解药物洗脱(Excel)、进口药物洗脱(Cypher)和裸金属(BMS)三种不同支架在老年ST段抬高型急性心肌梗死(STEAMI)患者急诊经皮冠状动脉介入(PCI)治疗中的疗效.方法 选取2006-09~2008-04间65~84岁老年患者252例,均确诊为急性ST段抬高心肌梗死(STEMI),急诊行PCI治疗患者,其中Excel支架组90例,Cypher支架组96例,裸金属支架组66例,首先对三组患者基线临床资料、靶病变血管部位、靶病变血管分布、PCI手术基本参数进行分析,了解是否对分组有影响.观察各组术后30 d、12个月再发心绞痛及主要心脏不良事件(MACE)例数,复查冠状动脉造影(CAG),记录血管最小管腔直径(MLD)并计算晚期管腔丢失率(LLL),比较不同支架近期治疗的效果.结果 PCI前三组患者临床指标及冠状动脉病变情况比较差异均无统计学意义,对研究无影响;术后12个月Excel支架组及Cypher支架组再发心绞痛、MACE发生率与BMS支架组比较,差异有统计学意义(P<0.05);复查CAG,三组靶血管再狭窄率、靶血管血运重建率比较及复查时支架内MLD、LLL在Excel支架组及Cypher支架组与BMS组支架比较,差异均有统计学意义(P<0.05).结论 Excel支架与Cypher支架治疗老年STEMI有效,且临床疗效等同,与BMS支架组比较可减少支架内再狭窄的发生,降低支架内LLL,可缩短应用氯吡格雷抗血小板的疗程.
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