课件：冠心病不同治疗方法的选择.ppt

RAVEL Update to 24m SIRIUS Update to 12m E-SIRIUS Result C-SIRIUS Result TAXUS I up to 12m Control PTx Ref Diameter(mm) 2.94 2.97 Late Loss(mm) 0.70 0.35 Binary Restenosis 10% 0% MI (Q non-Q-wave) 0% 0% TVR (non-target lesion) 0% 3.2% TLR 10% 0% CABG 3.3% 0% Death 0% 0% Stent Thrombosis 0% 0% 6-mo. Restenosis Rates 2.3% (3/128) 1.6% (2/127) 3.1% (8/262) Distal Edge 2.3% (3/128) 1.6% (2/127) 3.4 % (9/261) Proximal Edge 22.0% (58/264) 18.6% (49/263) 19.0% (50/263) Combined Control (n=270) 8.6% (11/128) 0.8% ( 1/128) 4.7% (6/128) TAXUSNIRx MR (n=135 ) 5.5% (7/128) Total Analysis Segment 1.5% (2/128) If confounders excluded 2.3% ( 3/128) Stented Segment TAXUSNIRx SR (n=131) TAXUS II QCA Analysis Stented Segment 0.80 + 0.55 0.51 + 0.32 0.78 + 0.47 1.57 + 0.37 Combined Control (n=270) 1.29 + 0.53 0.21 + 0.41 0.30 + 0.39 1.58 + 0.41 TAXUSNIRx MR (n=135 ) 1.21 + 0.53 Net Gain (mm) 0.22 + 0.30 Loss Index 0.31 + 0.38 Late Loss (mm) 1.52 + 0.37 Acute Gain (mm) TAXUSNIRx SR (n=131) TAXUS II 0.3716 0.7279 0.0003 0.0262 0.3552 1.0000 1.0000 0.0023 P-value overall 1.5 (2) 1.5 (2) 3.8 (5) 6.9 (9) 2.3 (3) 1.5 (2) 0.0 9.9 (13) TAXUSNIRx MR (n=135) Rate %/ (n) 0.2244 1.0000 0.0035 0.0704 0.2354 1.0000 1.0000 0.0082 P-value SR vs. Control 0.5069 3.1 (4) 3.0 (8) TVR Remote 1.0000 3.1 (4) 1.1 (3) CABG 0.0010 4.7 (6) 14.4 (38) TLR 0.0048 10.9 (14) 21.7 (57) 6-Month MACE 0.0034 0.4026 P-value MR vs. Control 10.1 (13) 1.6 (2) 0.8 (1) 0.0 TAXUSNIRx SR (n=131) Rate % / (n) 17.5 (46) TVR - Overall 4.2 (11) Non Q-Wave MI 1.1 (3) Q-Wave MI 0.8 (2) Death Combined Control (n=270) Rate % / (n) 1.0000 1.0000 12-Mo. Major Adverse Cardiac Events TAXUS II From ACC 2003, by Dr.Colombo 药物涂层支架不仅给介入心脏病学带来突 破性进展，而且可能影响整个心脏病学的发展。 对药物涂层支架的思考 更复杂病变的结果不一定有现在的报告好 晚期血栓,支架错位(mal apposition) 晚期再狭窄(“Catch-up”现象) 其它尚不明的病理—生物学反应 价格 目前应用在再狭窄高危患者 小结（1） 优先药物治疗者： 无症状或轻度（CCS I、II级）患者，无大面积心肌缺血证据者 二级分支病变 非前降支开口部或近端病变而不能进行血管重建者 病变70%者