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目的探讨国产雷帕霉素药物洗脱支架Firebird在急性ST段抬高心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)中应用的安全性和近、远期疗效。方法选择我院心内科2005年3月￣2006年6月收治的STEMI且在发病12h内接受急诊置入雷帕霉素药物洗脱支架的患者105例,分为Cypher组(33例)和Firebird组(72例)。比较2组住院期间和随访10个月时心脏事件(MACE)的发生率。结果Cypher组33例梗死相关血管的33处病变置入42枚Cypher支架,Firebird组72处梗死相关病变置入113枚Firebird支架。支架置入成功率为100%。无再流现象:Cypher1例,Firebird组2例(P=1.000)。Cypher组心脏破裂死亡1例,Firebird组亚急性支架内血栓形成死亡1例。住院期间MACE发生率Firebird组为1.4%(1/72),Cypher组3.0%(1/33)(P>0.1),临床PCI成功率91.4%(96/105)。对86例患者进行了平均[10.2±4.2(6￣20)]个月随访,Cypher组28例和Firebird组58例;再发心绞痛3例,Cypher组1例和Firebird组2例;Firebird组术后3个月心衰死亡1例;随访时MACE发生率:Firebird组3.4%(2/59),Cypher组3.4%(1/29)(P=1.000)。结论国产雷帕霉素药物洗脱支架Firebird在STEMI急诊PCI中应用安全有效,近、远期疗效与Cypher支架相近。
Objective To investigate the safety, short-term and long-term efficacy of the domestic Rapamycin-eluting stent Firebird in emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 105 patients with STEMI admitted to our hospital from March 2005 to June 2006 and underwent emergency razor stent implantation within 12 hours of onset were divided into Cypher group (33 cases) and Firebird Group (72 cases). The incidence of cardiac events (MACE) was compared between 2 inpatients and at 10 months of follow-up. Results Forty-three Cypher stents were placed in 33 lesions of infarct-related vessels in 33 Cypher patients and 113 Firebird stents in 72 Infarct-related lesions in the Firebird group. Stent implantation success rate was 100%. No reflow phenomenon: Cypher 1 cases, Firebird group 2 cases (P = 1.000). 1 patient died of heart rupture in Cypher group, 1 died of subthreshold stent thrombosis in Firebird group. The incidence of MACE during hospitalization was 1.4% (1/72) in the Firebird group and 3.0% (1/33) in the Cypher group (P> 0.1). The clinical success rate of PCI was 91.4% (96/105). A mean of [10.2 ± 4.2 (6-20)] months were followed up in 86 patients, 28 in the Cypher group and 58 in the Firebird group; 3 in the recurrent angina pectoris, 1 in the Cypher group and 2 in the Firebird group; and Firebird One case died of HF after 3 months. The incidence of MACE at follow-up was 3.4% (2/59) in Firebird group and 3.4% (1/29) in Cypher group (P = 1.000). Conclusion The domestic application of Firebird, a rapamycin eluting stent, is safe and effective in STEMI emergency PCI. The near-term and long-term effects are similar to those of Cypher stent.