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ȣ - 520899 318 |
| Short-term Clopidogrel Maintenance after Endeavor™ Stent Deployment |
| 연세대학교 영동세브란스병원 심장내과¹,연세대학교 신촌세브란스병원 심장내과²,국민건강보험공단 일산병원 심장내과³,인제대학교 상계백병원 심장내과⁴,경희대학교병원 심장내과5,단국대학교병원 심장내과6,이화대학교 목동병원 심장내과7,연세대학교 원주의과대학 원주기독병원 심장내과8 |
| 문희선¹, 민필기¹,윤영원¹,홍범기¹,권혁문¹,장양수²,최동훈²,김중선²,양주영³,전동운³,오성진³,김병극³,김병옥⁴,이병권⁴,고충원⁴,김명곤5,박병은6,강태수6,권기환7,윤정한8,이승환8 |
Background; The Endeavor™ stent elutes zotarolimus via a biocompatible phosphorylcholine a polymer designed to simulate the outside surface of a red blood cell and mimic the structure of the natural cell membrane. This trial examined the clinical safety of short-term clopidogrel-based antiplatelet therapy after Endeavor™ stent deployment.
Methods; Eight referral centers in Korea participated in this prospective, single-arm, multicenter trial. 170 patients, in whom Endeavor™ stent(s) was(were) deployed for de novo coronary artery stenoses (diameter stenosis more than 75%) according to a standardized procedures, were enrolled from August 2006 to October 2007. Clopidogrel among antiplatelets was maintained for only 3 months after stenting. Patients with left ventricular ejection fraction < 30% and/or major bleeding tendency which limiting the use of antiplatelet therapy were excluded. The primary end points were major adverse cardiac events (MACE); defined as death, myocardial infarction(MI), emergent cardiac surgery, or repeat revascularization of the target lesion (TLR) in hospital and at 9 months. The secondary end points included angiographic late loss evaluated by quantitative coronary angiographic measurements at 9 months.
Results; The average reference vessel diameter was 3.11±0.48mm, and the mean lesion length was 15.36±0.99mm. Clinical follow-up at 9 months was accomplished for 153 patients. The in-hospital MACE was 1.76% (3 of 170; non Q wave MI). The incidence of MACE at 9 months was 7.19% (11 of 153). One patient was dead on arrival at emergency room 4 months after the procedure, suggested as possible stent thrombosis by Academic Research Consortium definition. At 9 months, overall rate of TLR was 4.57% (7 0f 153), and in-stent late luminal loss was 0.46±0.79mm.
Conclusion;
Treatment with Endeavor™ stent is associated with low rates of MACE, revascularization, and angiographic binary restenosis. More importantly, this study strongly supports the safety of short-term clopidogrel therapy in patients undergoing deployment with Endeavor™ stents. Further study in a larger patient cohort and for a longer duration is warranted.
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