Polymer free biolimus coated stents to treat acute ST-elevation myocardial infarction in Asian patients.

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Paul J L Ong, Shing Fung Chui, Frankie Chor-Cheung Tam, Quang Tuan Nguyen, Cheng-Ting Tsai, Woong Chol Kang, Amin Arif Nuruddin, Ramesh Singh, Chunhakasem Chotinaiwattarakul, Michael Lee
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Abstract

Background: Patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction (STEMI) have a high thrombotic burden and often have a high bleeding risk (HBR). Asian patients have different patterns of thrombotic and bleeding risk from other populations which may be particularly relevant in the setting of PPCI for STEMI.

Objectives: To assess the safety and efficacy of the polymer free biolimus coated coronary stent (PF-BCS, BioFreedomTM, Biosensors International) in Asian STEMI patients.

Methods: Patients with acute STEMI who received at least one PF-BCS were invited to participate after their index procedure. Follow-up was performed at 1, 4, and 12 months. The primary endpoint was the rate of target lesion failure (TLF) at 1 year. A performance goal was derived from the biolimus eluting stent arm of the COMFORTABLE AMI study which was the only prior dedicated study of biolimus eluting stents in patients with STEMI.

Results: A total of 914 patients with STEMI were enrolled. Mean patient age was 60 ± 13 years, diabetes was present in 23.2% and 43% were active smokers. According to the ARC definition, 12.4% of the patients were HBR. TLF rate was 2.54% [95% CI: 1.52-3.56], p-value for non-inferiority <0.0001, p-value for superiority = 0.0004). The rate of definite/probable stent thrombosis was 0.44% [95% CI: 0.16-1.16]. There was a trend toward more BARC 3 to 5 bleeding in ARC-HBR patients (3.69% vs 1.46%, HR = 2.74, [95% CI: 0.87-8.62], p = 0.07).

Conclusions: In Asian patients undergoing PPCI for STEMI and treated with variable durations of DAPT, the use of a PF-BCS was associated with low rates of TLF and stent thrombosis (NCT03609346).

治疗亚洲患者急性ST段抬高型心肌梗死的无聚合物生物利莫司涂层支架。
背景:因 ST 段抬高型心肌梗死(STEMI)而接受原发性经皮冠状动脉介入治疗(PPCI)的患者血栓形成负担很重,而且通常具有高出血风险(HBR)。亚洲患者的血栓形成和出血风险模式与其他人群不同,这可能与 STEMI 冠状动脉造影术尤其相关:评估亚洲 STEMI 患者使用无聚合物生物利莫司涂层冠状动脉支架(PF-BCS,BioFreedomTM,Biosensors International)的安全性和有效性:方法:邀请至少接受过一次 PF-BCS 手术的急性 STEMI 患者在手术后参加随访。随访时间为 1、4 和 12 个月。主要终点是1年后靶病变失败率(TLF)。该研究是之前唯一一项专门针对 STEMI 患者的 Biolimus 洗脱支架研究:共有 914 名 STEMI 患者入组。患者平均年龄(60 ± 13)岁,23.2%患有糖尿病,43%为主动吸烟者。根据 ARC 定义,12.4% 的患者为 HBR。TLF率为2.54%[95% CI:1.52-3.56],P值为非劣效性结论:在因 STEMI 而接受 PPCI 并接受不同持续时间的 DAPT 治疗的亚洲患者中,使用 PF-BCS 与较低的 TLF 和支架血栓形成率相关(NCT03609346)。
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来源期刊
CiteScore
5.40
自引率
8.70%
发文量
419
审稿时长
2 months
期刊介绍: Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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