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目的:评价冠心病合并糖尿病患者成功置入Firebird雷帕霉素洗脱支架和Taxus紫杉醇洗脱支架后的长期有效性和安全性。方法:本研究入选了2004-04至2006-10在我院行择期支架置入术的冠心病合并糖尿病患者740例。入选患者分为Firebird组(518例)和Taxus组(222例)。临床随访资料包括术后30天、1年和2年的死亡、心肌梗死、血栓、靶病变血运重建和靶血管血运重建。本研究比较了两组间各种临床事件的累积发生率差异。同时通过倾向性评分调整后的Cox比例风险模型比较两组间的2年临床随访结果。结果:术后2年时,与Taxus组相比,Firebird组患者全因死亡率[1.54%比4.98%;风险比0.354(95%可信区间:0.129～0.971),P<0.05]和靶血管血运重建率[6.18%比10.41%;风险比0.555(95%可信区间:0.315～0.979),P<0.05]风险均显著降低。结论:对于冠心病合并糖尿病患者而言,置入Firebird雷帕霉素洗脱支架与置入Taxus紫杉醇洗脱支架相比,全因死亡率和靶血管血运重建率较低。
OBJECTIVE: To evaluate the long-term efficacy and safety of coronary heart disease patients with diabetes mellitus after successful implantation of Firebird rapamycin-eluting stents and Taxus paclitaxel-eluting stents. Methods: We selected 740 patients with coronary heart disease and diabetes mellitus undergoing elective stent implantation in our hospital from 2004-04 to 2006-10. The patients were divided into Firebird group (518 cases) and Taxus group (222 cases). Clinical follow-up data included deaths at 30 days, 1 year and 2 years after surgery, myocardial infarction, thrombosis, target lesion revascularization, and target vessel revascularization. This study compared the cumulative incidence of various clinical events between the two groups. At the same time, the 2-year clinical follow-up results between the two groups were compared by adjusting the Cox proportional hazards model with propensity score. Results: All-cause mortality (1.54% vs 4.98%; risk ratio 0.354 (95% CI: 0.129-0.971), P <0.05] and target vessel The rates of revascularization [6.18% vs 10.41%; risk ratio 0.555 (95% confidence interval: 0.315-0.979), P <0.05] significantly decreased the risk. Conclusion: All-cause mortality and target revascularization rates were lower in patients with coronary heart disease with diabetes than those treated with Taxus paclitaxel-eluting stents.