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首页> 外文期刊>The American Journal of Cardiology >Impact of routine angiographic follow-up after percutaneous coronary intervention with drug-eluting stents in the SPIRIT III randomized trial at three years
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Impact of routine angiographic follow-up after percutaneous coronary intervention with drug-eluting stents in the SPIRIT III randomized trial at three years

机译：SPIRIT III随机试验在3年时使用药物洗脱支架经皮冠状动脉介入治疗后常规血管造影随访的影响

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Routine angiographic follow-up after bare-metal stent implantation has been associated with an increase in coronary revascularization. The impact of angiographic follow-up after drug-eluting stent placement remains poorly characterized. The prospective, randomized, single-blinded SPIRIT III trial assigned patients to the everolimus-eluting stent or the paclitaxel-eluting stent (PES). Major adverse cardiovascular events (cardiac death, myocardial infarction, and ischemia-driven target lesion revascularization [ID-TLR]) at 3 years were assessed by angiographic versus clinical-only follow-up at 8 months ± 28 days and a landmark survival analysis from 9 months to 3 years. Of 1,002 patients, 564 patients were assigned to angiographic follow-up at 8 months ± 28 days and 438 patients underwent clinical follow-up alone. Three-year major adverse cardiovascular event rates were 10.6% in the angiographic group and 12.0% in the clinical follow-up group (p = 0.64). Ischemia-driven revascularization increased twofold at 9 months, but no difference was noted in ID-TLR for either device. Non-ID-TLR was significantly higher in patients in the angiographic group (4.5% vs 1.0%, p = 0.002), a difference resulting from PES (9.1% vs 0.7%, p = 0.0007) rather than everolimus-eluting stent (2.2% vs 1.1%, p = 0.36) treatment. The landmark analysis showed no significant differences between the angiographic and clinical follow-up groups from 9 months to 3 years of major clinical outcomes. In conclusion, routine angiographic follow-up in SPIRIT III did not increase rates of ID-TLR compared to clinical follow-up alone. Despite higher nonischemia-driven revascularization rates with angiographic follow-up of patients with PESs, none of the safety end points were adversely affected.
机译：裸金属支架植入后的常规血管造影随访与冠状动脉血运重建的增加有关。药物洗脱支架置入后血管造影随访的影响仍然不明确。前瞻性，随机，单盲SPIRIT III试验将患者分配至依维莫司洗脱支架或紫杉醇洗脱支架（PES）。在8个月±28天时通过血管造影与仅临床随访，评估了3年时的主要不良心血管事件（心脏死亡，心肌梗塞和局部缺血性靶病变血运重建[ID-TLR]），并从中得出了里程碑式的生存分析9个月至3年。在1,002例患者中，有564例在8个月±28天时接受了血管造影随访，仅438例接受了临床随访。血管造影组的三年主要不良心血管事件发生率分别为10.6％和临床随访组的12.0％（p = 0.64）。缺血驱动的血运重建在9个月时增加了两倍，但两种设备的ID-TLR均未发现差异。血管造影组患者的非ID-TLR显着更高（4.5％vs 1.0％，p = 0.002），这是PES引起的差异（9.1％vs 0.7％，p = 0.0007），而不是依维莫司洗脱支架（2.2 ％对1.1％，p = 0.36）治疗。标志性分析显示，从9个月至3年的主要临床结果，血管造影和临床随访组之间无显着差异。总之，与单独的临床随访相比，SPIRIT III的常规血管造影随访并未增加ID-TLR的发生率。尽管对PES患者进行了血管造影随访，但非缺血驱动的血运重建率更高，但安全终点均未受到不利影响。

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