老年急性ST段抬高心肌梗死患者应用国产雷帕霉素药物洗脱支架5年临床随访

摘要

目的 评估老年急性ST段抬高心肌梗死(STEMI)患者应用国产支架的长期安全性.方法 入选年龄≥60岁的急性STEMI患者113例,随机分为国产雷帕霉素药物洗脱支架(DES)组56例和金属裸支架(BMS)组57例.随访5年,观察支架内血栓形成和主要心脏不良事件(MACE)发生率情况.结果 5年随访期间,DES组与BMS组病死率分别为7.1％和7.0％ (P＞0.05)；DES组靶病变重建、MACE分别为10.7％、23.2％,BMS组分别为28.1％、42.1％ (P＜0.05).DES组支架内血栓、极晚期支架内血栓发生率分别为8.9％、3.6％;BMS组分别为7.0％、1.8％,2组比较差异无统计学意义.结论 老年急性STEMI患者应用国产雷帕霉素DES较BMS明显降低MACE,且极晚期血栓发生率无明显升高.%Objective To assess the long-term safety of China-made firebird rapamycin drug-eluting stent(DES)in elderly patients with acute STEMI. Methods One hundred and thirteen elderly patients with acute STEM] aged S&60 years were randomly divided into DES group(n = 56)and bare metal stent(BMS)group(rt = 57). The patients were followed up for 5 years,during which stent thrombosis and MACE were observed. Results During the 5-year follow-up period,the mortality was 7. 1% and 7. 0% respectively in DES group and BMS group(P>0. 05) ,the incidence of target vessel revascularization and MACE was 10. 7% and 23. 2% respectively in DES group,and 28. 1% and 42. 1% respectively in BMS group(P<0. 05),the incidence of stent thrombosis and extreme late stent thrombosis was 8. 9% and 3. 6% respectively in DES group, and 7. 0% and 1. 8% respectively in BMS group. Conclusion China-made firebird rapamycin DES is more effective than BMS in reducing MACE in elderly patients with acute STEMI and does not significantly increase the incidence of late and extreme late stent thrombosis.