[TCT2008]ABSORB研究2年随访结果

发布于:2008-10-17 10:43

ABSORB研究最新资料显示：应用生物可降解依维莫司药物洗脱支架，患者2年随访时MACE率非常低。来自荷兰鹿特丹Patrick W. Serruys博士汇报了应用该支架治疗冠脉单支病变的临床结果。

Serruys及其同事采用IVUS测量28例患者PCI后6个月和2年的血管、管腔、斑块和最小管腔面积。经对比发现，2年后，患者血管面积减少(–3.31%)、斑块面积增加(4.73%)，虽未达到统计学意义，但是在与PCI术后相比，2年时管腔面积丢失有明显增加的趋势，达9.66%，并且最小管腔面积丢失（–12.78%）已达到统计学意义（见图）。与PCI术后相比，6个月随访时发现，钙化和高回音明显降低，但是在6个月到2年之间的时间内，两者却无差别。

“该试验最初入选患者30例，6个月随访时一例患者掉队，另一例属非心源性死亡。在两年随访期间，没有因缺血导致的MACE事件，无心源性死亡和支架内血栓发生，没有因缺血驱使的TLR。”Serruys说。

生物可吸收的依维莫司药物洗脱支架与其他DES相比可能会更具有优势，他们很少在IVUS检查中成像，因此，不会像其他支架那样对影像的清晰程度造成任何影响。用OCT成像检查时发现，6个月到2年时，有超过1/3的支架结构降解，基线时支架小梁的数目为59个，6个月随访时是48个，2年随访时为38个。

（医心评论：马秀芹译朱婧校）

By TCT Daily Staff

Patients treated with a bioabsorbable everolimus-eluting stent had a low risk of major adverse cardiac events during two-years of follow-up, according to the latest results from the first-in-man ABSORB trial.

Patrick W. Serruys, MD, PhD, from the Erasmus Medical Center in Rotterdam, The Netherlands, presented results of the trial that examined treatment with the Absorb everolimus-eluting stent (Abbott) in patients with single de novo coronary artery lesions.

Using IVUS, Serruys and colleagues measured the vessel, lumen, plaque, and minimal lumen area of 28 patients post-PCI at six months and again at two years. Decreases in vessel area (–3.31%) and increases in plaque area (4.73%) at two years were not statistically significant, while the two-year decrease in lumen area (–9.66%) showed a strong trend compared with post-PCI measurements, and the decrease in minimal lumen area (–12.78%) was statistically significant (see Figure).

Six-month follow-up revealed significant decreases in dense calcium and hyperechogenicity compared with post-PCI measurements, but there were no significant changes between six months and two years.

Thirty patients were initially enrolled in the trial. One patient dropped out of the study after six months and another died from a noncardiac event. During the two-year follow-up period, there was one ischemia-driven MACE, no cardiac deaths, no stent thrombosis, and no ischemia-driven TLR, Serruys said.

The bioabsorbable everolimus-eluting stent may have additional benefits when compared with other types of DES. They are less visible in IVUS images, he explained, and therefore do not impair image clarity like other stents.

Between six months and two years, more than one-third of strut sites had no remaining discernible features when viewed by optical coherence tomography (OCT). The number of features visible by OCT at strut sites was 59 at baseline, 48 at six-month follow-up, and 38 at two-year follow-up.

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