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【JACC】真实世界中药物洗脱支架的发生率及其相
4-Year Results From a Large 2-Institutional Cohort Study
abstract:
Objectives: We sought to determine the risk of late stent thrombosis (ST) during long-term follow-up beyond 3 years, searched for predictors, and assessed the impact of ST on overall mortality.
Background: Late ST was reported to occur at an annual rate of 0.6% up to 3 years after drug-eluting stent (DES) implantation.
Methods: A total of 8,146 patients underwent percutaneous coronary intervention with a sirolimus-eluting stent (SES) (n = 3,823) or paclitaxel-eluting stent (PES) (n = 4,323) and were followed up to 4 years after stent implantation. Dual antiplatelet treatment was prescribed for 6 to 12 months.
Results: Definite ST occurred in 192 of 8,146 patients with an incidence density of 1.0/100 patient-years and a cumulative incidence of 3.3% at 4 years. The hazard of ST continued at a steady rate of 0.53% (95% confidence interval [CI]: 0.44 to 0.64) between 30 days and 4 years. Diabetes was an independent predictor of early ST (hazard ratio [HR]: 1.96; 95% CI: 1.18 to 3.28), and acute coronary syndrome (HR: 2.21; 95% CI: 1.39 to 3.51), younger age (HR: 0.97; 95% CI: 0.95 to 0.99), and use of PES (HR: 1.67; 95% CI: 1.08 to 2.56) were independent predictors of late ST. Rates of death and myocardial infarction at 4 years were 10.6% and 4.6%, respectively.
Conclusions: Late ST occurs steadily at an annual rate of 0.4% to 0.6% for up to 4 years. Diabetes is an independent predictor of early ST, whereas acute coronary syndrome, younger age, and PES implantation are associated with late ST. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title Incidence and Correlates of Drug-Eluting Stent Thrombosis in Routine Clinical Practice
4-Year Results From a Large 2-Institutional Cohort Study
题目：日常临床工作中药物洗脱支架植入后血栓的发生率及相关因素的探讨
abstract:
摘要：原文略
Objectives: We sought to determine the risk of late stent thrombosis (ST) during long-term follow-up beyond 3 years, searched for predictors, and assessed the impact of ST on overall mortality.
研究目的：我们通过3年以上的长期随访，试图发现晚期发生的支架内血栓的危险因素，寻找预测因子，并且评估支架内血栓对总死亡率的影响。
Background: Late ST was reported to occur at an annual rate of 0.6% up to 3 years after drug-eluting stent (DES) implantation.
研究背景：据报道，药物洗脱支架植入后3年的晚期支架内血栓年发生率为0.6％。
Methods: A total of 8,146 patients underwent percutaneous coronary intervention with a sirolimus-eluting stent (SES) (n = 3,823) or paclitaxel-eluting stent (PES) (n = 4,323) and were followed up to 4 years after stent implantation. Dual antiplatelet treatment was prescribed for 6 to 12 months.
研究方法：我们对8146例PCI术后的患者进行了为期4年的随访。这些患者进行了支架植入术，并接受了6～12个月的双重抗血小板治疗。其中，3823例植入西罗莫司洗脱支架(FBS)，4323例植入紫杉醇洗脱支架。
Results: Definite ST occurred in 192 of 8,146 patients with an incidence density of 1.0/100 patient-years and a cumulative incidence of 3.3% at 4 years. The hazard of ST continued at a steady rate of 0.53% (95% confidence interval [CI]: 0.44 to 0.64) between 30 days and 4 years. Diabetes was an independent predictor of early ST (hazard ratio [HR]: 1.96; 95% CI: 1.18 to 3.28), and acute coronary syndrome (HR: 2.21; 95% CI: 1.39 to 3.51), younger age (HR: 0.97; 95% CI: 0.95 to 0.99), and use of PES (HR: 1.67; 95% CI: 1.08 to 2.56) were independent predictors of late ST. Rates of death and myocardial infarction at 4 years were 10.6% and 4.6%, respectively.
结果：在8146例患者中，192例明确地发生了支架内血栓，发病密度为1.0/100患者年，4年的累计发病率为3.3％。在支架植入后30天到4年间，支架内血栓的形成危险持续稳定在0.53％（95％可信区间0.44～0.64）。糖尿病是早期发生支架内血栓的独立预测因子（相当危险比1.96，95％可信区间1.18～3.28）。晚期发生支架内血栓的独立预测因子分别是：急性冠脉综合症（相当危险比2.21，95％可信区间1.39～3.51）；低龄（相当危险比0.97，95％可信区间0.95～0.99）；使用紫杉醇洗脱支架（相当危险比1.67，95％可信区间1.08～2.56）。4年的死亡率为10.6％，心梗发生率为4.6％。
Conclusions: Late ST occurs steadily at an annual rate of 0.4% to 0.6% for up to 4 years. Diabetes is an independent predictor of early ST, whereas acute coronary syndrome, younger age, and PES implantation are associated with late ST.
结论：支架植入术后4年的晚期支架内血栓持续年发生率达0.4％。支架内血栓形成的早期预测因子是糖尿病，晚期预测因子有急性冠脉综合征、低龄和紫杉醇洗脱支架。
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作者:admin@医学,生命科学 2011-03-09 13:19
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