Bioresorbable vascular scaffolds in acute ST-segment elevation myocardial infarction: a prospective multicentre study 'Prague 19'.
Bioresorbable vascular scaffolds in acute ST-segment elevation myocardial infarction: a prospective multicentre study 'Prague 19'.
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DOI：
10.1093/eurheartj/eht545
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发表时间：
2014-03
影响因子：
39.3
通讯作者：
Widimský P
中科院分区：
文献类型：
--
作者：
Kočka V;Malý M;Toušek P;Buděšínský T;Lisa L;Prodanov P;Jarkovský J;Widimský P
生物可吸收血管支架（BVS）已在慢性冠状动脉疾病中进行了研究，但尚未在急性ST段抬高型心肌梗死（STEMI）中进行研究。这项前瞻性多中心研究分析了STEMI患者在初次经皮冠状动脉介入治疗（p-PCI）期间植入BVS的可行性和安全性。生物可吸收血管支架植入成为2012年12月15日至2013年8月30日期间所有连续STEMI患者的默认策略。共142例患者接受了p-PCI;其中41例（28.9%）符合BVS植入的入选/排除标准。BVS器械成功率为98%，95%的患者在心肌梗死溶栓3血流恢复，急性支架回缩率为9.7%。一项光学相干断层扫描（OCT）子研究（21例患者）证明了极好的手术结果，支架支柱贴壁不良率仅为1.1%。38%的患者存在边缘夹层，但较小且无临床症状。定量冠状动脉造影测量的参考血管直径显著低于OCT测量的参考血管直径0.29（±0.56）mm，P = 0.028。比较BVS组和对照组的临床结局;后者由植入金属支架的患者组成，Killip I级或II级。联合临床终点定义为死亡、心肌梗死或靶血管血运重建。两组的无事件生存率相同; BVS组为95%，对照组为93%，P = 0.674。生物可吸收血管支架植入治疗急性STEMI是可行和安全的。通过血管造影和OCT评价的手术结果是极好的。早期临床结果令人鼓舞。
Bioresorbable vascular scaffolds (BVSs) have been studied in chronic coronary artery disease, but not in acute ST-segment elevation myocardial infarction (STEMI). This prospective multicentre study analysed the feasibility and safety of BVS implantation during primary percutaneous coronary intervention (p-PCI) in STEMI. Bioresorbable vascular scaffold implantation became the default strategy for all consecutive STEMI patients between 15 December 2012 and 30 August 2013. A total of 142 patients underwent p-PCI; 41 of them (28.9%) fulfilled the inclusion/exclusion criteria for BVS implantation. The BVS device success was 98%, thrombolysis in myocardial infarction 3 flow was restored in 95% of patients, and acute scaffold recoil was 9.7%. An optical coherence tomography (OCT) substudy (21 patients) demonstrated excellent procedural results with only a 1.1% rate of scaffold strut malapposition. Edge dissections were present in a 38% of patients, but were small and clinically silent. Reference vessel diameter measured by quantitative coronary angiography was significantly lower than that measured by OCT by 0.29 (±0.56) mm, P = 0.028. Clinical outcomes were compared between BVS group and Control group; the latter was formed by patients who had implanted metallic stent and were in Killip Class I or II. Combined clinical endpoint was defined as death, myocardial infarction, or target vessel revascularization. Event-free survival was the same in both groups; 95% for BVS and 93% for Control group, P = 0.674. Bioresorbable vascular scaffold implantation in acute STEMI is feasible and safe. The procedural results evaluated by angiography and OCT are excellent. The early clinical results are encouraging.
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影响因子：
168.9
作者：
Palmerini, Tullio;Biondi-Zoccai, Giuseppe;Stone, Gregg W.
通讯作者：
Stone, Gregg W.
影响因子：
2.3
作者：
Onuma, Yoshinobu;Serruys, Patrick W.;Ormiston, John A.
通讯作者：
Ormiston, John A.
影响因子：
4.8
作者：
Diletti, Roberto;Serruys, Patrick W.;Chevalier, Bernard
通讯作者：
Chevalier, Bernard
影响因子：
3.3
作者：
Kume, Teruyoshi;Okura, Hiroyuki;Yoshida, Kiyoshi
通讯作者：
Yoshida, Kiyoshi
影响因子：
24
作者：
Serruys, Patrick W.;Onuma, Yoshinobu;Ormiston, John A.
通讯作者：
Ormiston, John A.