シロリムス放出ステントとパクリタキセル放出ステントは,慢性冠動脈疾患を患っている患者のためのものです
Young-Hak Kim1, Seong-Wook Park, Seung-Whan Lee
1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Circulation
|October 25, 2006
まとめ
シロリムス放出ステント (SES) は,パクリタキセル放出ステント (PES) と比較して,長い冠動脈損傷におけるレステノスと再血管化の必要性を有意に減少させました. この発見は,複雑な病変のために冠動脈の介入を受けている患者にとって改善された結果を提供します.
科学分野:
- 心血管医学 心血管医学
- 介入性心臓病学 介入性心臓病学
- バイオマテリアル科学 バイオマテリアル科学
背景:
- 長い病変に対する冠動脈の介入は,最適な結果を下回っている.
- 薬物排出ステントは,これらの結果を改善することを目的としています.
- シロリムス放出ステント (SES) とパクリタキセル放出ステント (PES) が一般的に使用されています.
研究 の 目的:
- SESとPESの有効性を比較して,長期にわたる本来の冠動脈病変の治療を図る.
- 回復率と再血管化の必要性を評価する.
主な方法:
- 500人の患者を対象としたランダム化,多センター,前向きな研究です.
- 患者は,長い冠動脈病変 (>=25mm) に対して,SESまたはPESのいずれかを投与された.
- プライマリエンドポイントは,6ヶ月のフォローアップアニオグラフィーのセグメント内静止症でした.
主要な成果:
- SESは,PESと比較して,セグメント内バイナリレステノシス率 (3.3%対14.6%,P<0.001) が著しく低いことを示した.
- ステント内での遅いルメンの損失は,SES (0.09mm vs. 0.45mm,P<0.001) で有意に低かった.
- SESグループは,9ヶ月で標的の損傷の再血管化の割合が低下した (2.4%対7.2%,P=0.012) ことを示しました.
結論:
- SESのインプラントは,長い本来の冠動脈の損傷に対してPESよりも優れています.
- SESは,血管学的静止症を軽減し,標的病変の再血管化の必要性を軽減します.
- 死亡率や心筋梗塞率では,グループ間で有意な差はみられなかった.
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