emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2022.6.1.1510emcardio-109Research ArticleОригинальные научные публикацииOriginal Scientific ResearchОтдалённые результаты коррекции протяженных поражений коронарных артерий с применением биодеградируемых сосудистых скаффолдовLong-term outcomes after correction of long coronary lesions using biodegradable vascular scaffoldsСтригоН. П.StrygoN.

220036, Минск, ул. Розы Люксембург, 110б-203

R. Luxemburg str. 110b-203, Minsk, 220036

info@cardio.byСтельмашокВ. И.StelmashokV.

220036, Минск, ул. Розы Люксембург, 110б-203

R. Luxemburg str. 110b-203, Minsk, 220036

ПолонецкийО. Л.PolonetskyO.

220036, Минск, ул. Розы Люксембург, 110б-203

R. Luxemburg str. 110b-203, Minsk, 220036

Республиканский научно-практический центр «Кардиология»Republican Scientific and Practical Centre «Cardiology»2022270620256115101518Copyright © Стриго Н.П., Стельмашок В.И., Полонецкий О.Л., 20252025Стриго Н.П., Стельмашок В.И., Полонецкий О.Л.Strygo N., Stelmashok V., Polonetsky O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/109

Цель. Изучить клинические результаты коррекции протяженных (более 25 мм) поражений коронарных артерий с помощью биодеградируемых сосудистых скаффолдов в сравнении с металлическими стентами с лекарственным покрытием эверолимус в отдалённом периоде наблюдения.Материалы и методы. В исследование включены 80 пациентов, которым за период с 2013 по 2018 годы на базе РНПЦ «Кардиология» была выполнена эндоваскулярная коррекция протяженных (более 25 мм) поражений коронарных артерий. Пациенты рандомно были разделены на опытную и контрольную группы. Численность каждой из групп составила 40 пациентов. В опытной группе (ОГ) выполнена коррекция поражений с помощью биодеградируемых сосудистых скаффолдов BVS Absorb с медикаментозным покрытием эверолимус. В контрольной группе (КГ) проведена коррекция поражений с помощью металлических стентов Xience V/Xience Pro с аналогичным лекарственным покрытием. В дальнейшем периоде наблюдения оценивалось развитие смертельных исходов (от любых причин, а также по причине болезней сердца), случаи острого инфаркта миокарда, число случаев проведения повторной реваскуляризации по причине развития несостоятельности проходимости целевого поражения, а также комбинированная конечная точка (все случаи смерти + случаи развития острого инфаркта миокарда + случаи проведения повторной реваскуляризации по причине развития несостоятельности целевого поражения). Сведения о наличии или отсутствии негативных исходов собирались в период наблюдения с помощью телефонного контакта с пациентом или его родственниками.Результаты. Средняя продолжительность наблюдения пациентов после эндоваскулярной коррекции протяженных поражений коронарных артерий составила 86,5 месяцев (интерквартильный размах 77,0–93,0 месяца). Общая смертность была зарегистрирована у 7.5% пациентов в опытной группе и у 5% пациентов в контрольной группе (p = 1,00). Достижение комбинированной конечной точки (смерть от любых причин + развитие острого инфаркта миокарда + проведение повторной реваскуляризации по причине несостоятельности целевого поражения) регистрировалось у 17,5% лиц ОГ и 15% пациентов КГ (p = 1,00). Анализ Каплан-Мейера не выявил достоверных различий по данному показателю между пациентами обеих изучаемых групп (p = 0,78).Заключение. Коррекция протяженных поражений с помощью биодеградируемых сосудистых скаффолдов показала сопоставимые отдалённые клинические результаты в сравнении с металлическими стентами с медикаментозным покрытием эверолимус. Риск достижения комбинированной конечной точки (все случаи смерти + случаи развития острого инфаркта миокарда + случаи повторной реваскуляризации по причине развития несостоятельности целевого поражения) в долгосрочном периоде наблюдения не различался статистически между лицами обеих изучаемых групп.

Materials and methods. Over the period of 2013 to 2018, endovascular correction of long (more than 25 mm) coronary artery lesions was performed on 80 patients in RSPC “Cardiology”, Minsk. Randomly the patients were divided into 2 groups: experimental group (EG) (n = 40) – endovascular correction with bioresorbable everolimus-eluting vascular scaffold Absorb BVS, and control group (CG) (n = 40) – endovascular correction with everolimus-eluting metallic stent Xience V/ Xience Pro. During further observations we estimated the development of death outcomes (from any reasons and from heart diseases), cases of acute myocardial infarction, incidence of revascularization due to target lesion patency failure, as well as a combined endpoint (all death cases + cases of acute myocardial infarction+ revascularization due to target lesion patency failure). The information about the presence or absence of negative outcomes was collected during the observation via a telephone contact with the patient or their relatives.Results. In the mean long-term observational period of 86.5 months (interquartile range from 77.0 to 93.0 months) after percutaneous intervention (PCI) total death cases were registered in 7.5% cases for the experimental group and in 5% cases for the control group (CG) (p = 1.00). The combined endpoint (death + myocardial infarction + target lesion revascularization) was registered in 17.5% cases for EG and in 15% cases for CG (p = 1.00). Kaplan-Meier analysis did not reveal statistical significance between the study groups (p = 0.78).Conclusion. Long lesion correction with biodegradable vascular scaffolds shows similar long-term clinical results in comparison with everolimus-eluting stents. The combined endpoint risk (all death cases + myocardial infarction + revascularization due to target lesion failure) statistically did not differ in long-term period between both groups.

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The authors declare that there are no conflicts of interest present.