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J Neurointerv Surg:药物涂层球囊治疗冠状动脉新生病变的效果并不劣于BMS或DES

2020-11-12 MedSci原创 MedSci原创

药物涂层球囊(DCB)可避免支架相关的长期并发症,本试验比较了非ST-elevation心肌梗死(NSTEMI)患者接受DCB或支架治疗的临床结果,研究结果已在线发表于J Neurointerv Su

药物涂层球囊(DCB)可避免支架相关的长期并发症,本试验比较了非ST-elevation心肌梗死(NSTEMI)患者接受DCB或支架治疗的临床结果,研究结果已在线发表于J Neurointerv Surg。
此项随机、对照、非劣效性多中心试验纳入了210名NSTEMI患者,比较紫杉醇碘普罗米特涂层DCB与主要支架治疗。主要纳入标准为可识别的病变,无大血栓血管造影证据。主要终点为9个月后靶病变失败(TLF;由心脏或未知死亡、再梗死和靶病变血管重建组成的综合临床终点)。次要终点包括总的主要心血管不良事件(MACE)和单个临床终点。
 
结果,患者的平均年龄为67±12岁,67%为男性,62%患有多血管疾病,31%为糖尿病患者。随机分组后,104名患者接受DCB治疗,106人接受支架治疗。在支架组中,56%的患者采用BMS治疗,44%的患者采用新一代DES治疗。在DCB组中,85%的患者只接受DCB治疗,而15%的患者进行了额外的支架植入。在9.2±0.7个月的随访中,DCB的治疗效果并不劣于支架治疗,TLF率为3.8%vs6.6%(意向治疗,P=0.53)。BMS的治疗效果与当前一代DES的治疗效果之间无显著差异。DCB与支架治疗的总MACE率分别为6.7%vs14.2%(p=0.11),按方案分析的总MACE率为5.9%vs14.4%(p=0.056)。
 
综上所述,该研究结果表明,在NSTEMI患者中,DCB治疗冠状动脉新生病变的效果并不劣于BMS或DES进行支架治疗。这些数据表明,在这种情况下,需要在以DES为参照物的大型试验中进一步研究DCB(ClinicalTrials.gov Identifier: NCT01489449)。
 
原始出处:
 
Bruno Scheller, Marc-Alexander Ohlow, et al., Bare metal or drug-eluting stent versus drug-coated balloon in non-ST-elevation myocardial infarction: the randomised PEPCAD NSTEMI trial. EuroIntervention . 2020 Apr 17;15(17):1527-1533. doi: 10.4244/EIJ-D-19-00723.

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    2021-01-20 147e4706m08暂无昵称

    学习了

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    2020-11-14 canlab
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    2020-11-14 花花1366
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    2020-11-14 fusion
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  6. [GetPortalCommentsPageByObjectIdResponse(id=918383, encodeId=f102918383a0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cb355252510, createdName=147e4706m08暂无昵称, createdTime=Wed Jan 20 13:58:35 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378685, encodeId=41b313e8685d8, content=<a href='/topic/show?id=f238358866' target=_blank style='color:#2F92EE;'>#BMS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3588, encryptionId=f238358866, topicName=BMS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384429, encodeId=53fd138442906, content=<a href='/topic/show?id=2e956863556' target=_blank style='color:#2F92EE;'>#球囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68635, encryptionId=2e956863556, topicName=球囊)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0361487, createdName=花花1366, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558546, encodeId=c65715585468e, content=<a href='/topic/show?id=b68a586365' target=_blank style='color:#2F92EE;'>#DES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5863, encryptionId=b68a586365, topicName=DES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=432c14994935, createdName=fusion, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559915, encodeId=b1e21559915b1, content=<a href='/topic/show?id=020e8e802a9' target=_blank style='color:#2F92EE;'>#药物涂层球囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87802, encryptionId=020e8e802a9, topicName=药物涂层球囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=597715042971, createdName=circumcision, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564555, encodeId=ff4a15645556f, content=<a href='/topic/show?id=b68a586365' target=_blank style='color:#2F92EE;'>#DES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5863, encryptionId=b68a586365, topicName=DES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=432c14994935, createdName=fusion, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565924, encodeId=1927156592493, content=<a href='/topic/show?id=020e8e802a9' target=_blank style='color:#2F92EE;'>#药物涂层球囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87802, encryptionId=020e8e802a9, topicName=药物涂层球囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=597715042971, createdName=circumcision, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047213, encodeId=54c4104e21334, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Nov 12 15:25:02 CST 2020, time=2020-11-12, status=1, ipAttribution=)]
    2020-11-14 fusion
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  8. [GetPortalCommentsPageByObjectIdResponse(id=918383, encodeId=f102918383a0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cb355252510, createdName=147e4706m08暂无昵称, createdTime=Wed Jan 20 13:58:35 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378685, encodeId=41b313e8685d8, content=<a href='/topic/show?id=f238358866' target=_blank style='color:#2F92EE;'>#BMS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3588, encryptionId=f238358866, topicName=BMS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512d422, createdName=canlab, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384429, encodeId=53fd138442906, content=<a href='/topic/show?id=2e956863556' target=_blank style='color:#2F92EE;'>#球囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68635, encryptionId=2e956863556, topicName=球囊)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0361487, createdName=花花1366, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558546, encodeId=c65715585468e, content=<a href='/topic/show?id=b68a586365' target=_blank style='color:#2F92EE;'>#DES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5863, encryptionId=b68a586365, topicName=DES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=432c14994935, createdName=fusion, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1559915, encodeId=b1e21559915b1, content=<a href='/topic/show?id=020e8e802a9' target=_blank style='color:#2F92EE;'>#药物涂层球囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87802, encryptionId=020e8e802a9, topicName=药物涂层球囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=597715042971, createdName=circumcision, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564555, encodeId=ff4a15645556f, content=<a href='/topic/show?id=b68a586365' target=_blank style='color:#2F92EE;'>#DES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5863, encryptionId=b68a586365, topicName=DES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=432c14994935, createdName=fusion, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1565924, encodeId=1927156592493, content=<a href='/topic/show?id=020e8e802a9' target=_blank style='color:#2F92EE;'>#药物涂层球囊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87802, encryptionId=020e8e802a9, topicName=药物涂层球囊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=597715042971, createdName=circumcision, createdTime=Sat Nov 14 03:25:02 CST 2020, time=2020-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047213, encodeId=54c4104e21334, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Nov 12 15:25:02 CST 2020, time=2020-11-12, status=1, ipAttribution=)]
    2020-11-12 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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心力衰竭(HF)是急性心肌梗死(MI)的最常见的远期并发症。了解与MI后HF相关的血浆蛋白及其基因表达可能会为发现生物标志物和药物靶标确定新的候选对象。

TCT 2020丨比伐芦定与肝素在患者水平的荟萃分析引发了一场争论

一项汇集了八项比较比伐芦定与肝素的随机临床试验中的个体患者数据的汇总分析得出结论:术前使用比伐芦定可被视为STEMI的首选药物,这一发现与过去十年来几项支持放弃使用比伐芦定的研究和指南背道而驰。

ESC 2020:2型糖尿病患者心肌梗死发病率和死亡率趋势

线上举行的欧洲心脏病学会年会(ESC 2020)LBS专场,重磅推出丹麦研究团队的一项颇具思考性的重要研究,该研究探索了丹麦全国范围内2型糖尿病患者的心梗和死亡风险趋势,研究结果非常引人注目。

JAHA:银屑病对心肌梗死患者死亡率和结局的影响

在所有MI病例中,只有0.3%的患者被诊断为银屑病,而患有银屑病的MI患者比没有银屑病的MI患者中位年龄要小5岁。银屑病似乎可以增加已知心血管危险因素的患病率。

探索|富含Omega-3脂肪酸食物可改善STEMI患者预后

“在一项新的前瞻性观察研究中,定期食用富含Omega-3脂肪酸的食物可改善ST段抬高型心肌梗死(STEMI)患者预后。”

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