Endothelial progenitor cell capturing stent and short dual antiplatelet therapy in patients on chronic anti-vitamin k regimen undergoing percutaneous coronary interventions: long-term outcomes of a single centre registry
Endothelial progenitor cell capturing stent and short dual antiplatelet therapy in patients on chronic anti-vitamin k regimen undergoing percutaneous coronary interventions: long-term outcomes of a single centre registry
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DOI：
10.4244/eijv6i7a143
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发表时间：
2011-02-01
期刊：
影响因子：
6.2
通讯作者：
Sabate, Manel
中科院分区：
文献类型：
--
作者：
Martin-Yuste, Victoria;Brugaletta, Salvatore;Sabate, Manel
目的：评估内皮祖细胞（EPC）捕获支架对接受长期抗维生素K（AVK）治疗、需要经皮冠状动脉介入治疗（PCI）的患者的疗效。方法和结果：2007年2月至2008年2月期间，连续78名接受慢性AVK治疗并接受PCI的患者登记入册并接受EPC捕获支架。通过查尔森指数分析合并症的发生率。 PCI 后仅给予双重抗血小板治疗（DAT、阿司匹林和氯吡格雷）与 AVK 治疗一起为期 1 个月。收集主要不良临床事件（MACE）发生率，包括死亡、急性心肌梗死（MI）或靶病灶血运重建（TLR）、支架血栓发生率和出血事件发生率。 89% 的患者查尔森指数 >3。 14-8 个月时，MACE 累积率为 22%：10 例死亡（6 例心源性死亡），6 例 TLR。随访期间未发生心肌梗塞或明确/可能的支架血栓。随访期间发生了四次主要出血事件，全部发生在第一个月后。结论：接受 AVK 治疗的患者是一个高度共病的人群，PCI 后事件发生率很高。对于需要短期 DAT 的患者，可以采用采用 EPC 捕获支架和短期 DAT 的 PCI 策略。
Aims: To evaluate outcomes of the endothelial progenitor cell (EPC) capture stent in patients on chronic anti-vitamin K (AVK) regimen, requiring percutaneous coronary intervention (PCI).Methods and results: Between February 2007 and February 2008, 78 consecutive patients under chronic AVK treatment undergoing PCI were enrolled in the registry and received an EPC capture stent. The incidence of comorbid conditions was analysed by the Charlson index. Dual antiplatelet therapy (DAT, aspirin and clopidogrel) was prescribed for one month only together with the AVK treatment, after PCI. Major adverse clinical events (MACE) rate, included death, acute myocardial infarction (MI) or target lesion revascularisation (TLR), incidence of stent thrombosis and rate of haemorrhagic events were collected. A Charlson index >3 was present in 89% of patients. At 14 8 months the cumulative rate of MACE was 22%: 10 deaths (six cardiac deaths), and six TLR. No MI or definitive/probable stent thromboses occurred during follow-up. Four major haemorrhagic episodes occurred during follow-up, all of them after the first month.Conclusions: Patients on AVK treatment represent a highly comorbid population with a high event rate after PCI. The strategy of PCI with an EPC capture stent and short duration of DAT may be used in patients who need a short-term DAT.