永久性ポリマー・ゾタロリムス・エルーティング・ステントとポリマーフリー・アンフィリムス・エルーティング・ステントのランダム化全参加者評価
Rik Rozemeijer1, Mera Stein1,2, Michiel Voskuil1
1Departments of Cardiology (R.R., M.S., M.V., S.K., G.E.L., L.T., S.Z.R., A.O.K., P.A., P.A.D., P.S.), University Medical Center Utrecht, The Netherlands.
Circulation
|December 28, 2018
まとめ
ポリマーフリーアンフィリムス放出ステント (PF-AES) は,永久ポリマーゾタロリムス放出ステント (PP-ZES) に劣らず,標的病変の失敗を防ぐことができます. この大規模な試験は,冠動脈の介入における新しいPF-AES技術の安全性と有効性を示しています.
科学分野:
- 心血管医学
- 介入心臓科
- バイオマテリアル科学
背景:
- 新しいポリマーフリーアンフィリムス排出ステント (PF-AES) は,薬物排出ステントの代替エリューション技術を提供します.
- PF-AESを現在の永久ポリマーゾタロリムス放出ステント (PP-ZES) と比較する大規模なランダム化データは限られている.
研究 の 目的:
- 皮経冠動脈介入を受けた全入生集団において,PP-ZESと比較してPF-AESの非劣等性を評価する.
- 2種類のステントの臨床安全性と有効性を評価する.
主な方法:
- 1502人の患者を対象に実施された 多中心型ランダム化非劣等性試験です.
- 患者は,トロポニン状態と糖尿病の分層化後に,PP- ZESまたはPF- AESを1対1でランダムに配分された.
- 主なエンドポイントは12ヶ月後の標的病変不全であり,心臓死,標的血管筋梗塞,または標的病変再血管化と定義された.
主要な成果:
- PF- AESは,PP- ZESに劣らず,PF- AES受容者の6. 2%に対してPP- ZES受容者の5. 6%で標的の損傷が起こりました (リスク差は0. 5%,上限95%CIは2. 6%).
- 心臓死,標的血管筋梗塞,および標的損傷の再血管化の割合は,両グループ間で類似した.
- ステントの確固たるまたは確固たる血栓は,患者全体の1. 0%で発生した.
結論:
- ポリマーフリーなアンフィリムス放出ステントは,標的病変の失敗に関して,永久的なポリマーゾタロリムス放出ステントに劣らない.
- この研究は,冠動脈介入における有効な選択肢として,PF-AESの臨床的安全性と有効性を支持しています.
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