PubMed日本語 - 安全な場所の上の高齢の影響とST部分の上昇心筋梗塞患者におけるパクリタクセル溶出ステント埋め込みの効果は、一次血管形成術を受ける:HORIZONS-AMI試験。―QLifePro医療翻訳医療翻訳 QLifePro


Impact of advanced age on the safety and effectiveness of paclitaxel-eluting stent implantation in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: The HORIZONS-AMI trial.


Published date



Dariusz Dudek, Roxana Mehran, Artur Dziewierz, Bernhard Witzenbichler, Bruce R Brodie, Ran Kornowski, Martin Fahy, Alexandra J Lansky, Tomasz Rakowski, Jacek Legutko, Leszek Bryniarski, Gregg W Stone


Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland.


OBJECTIVES: To assess the impact of age on safety and efficacy of paclitaxel-eluting stent (PES) implantation during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).


BACKGROUND: The benefits of paclitaxel-eluting stent (PES) implantation during primary PCI were confirmed by the long-term results of the HORIZONS-AMI trial. Whether the effects of PES are independent of age has not been reported.


METHODS: Data on 3,006 patients from the HORIZONS-AMI study randomized in a 3:1 ratio to PES or bare-metal stent (BMS) in whom at least one stent was implanted were assessed. There were 2,302 (76.6%) patients <70, and 704 patients ≥70 years of age.


RESULTS: At 3 years, among older patients a trend toward lower risk of major adverse cardiac events (MACE; death from any cause, stroke, reinfarction and unplanned revascularization for ischemia) related to PES use was observed (PES vs. BMS: 18.0% vs. 21.3%; P = 0.07). There was also a trend for reduction of MACE related to PES in older patients (26.4% vs. 33.1%; P = 0.09). Both, patients <70 and ≥70 years of age treated with PES were at lower risk for ischemic target vessel revascularization. However, a higher risk of major bleeding in elderly patients treated with PES was observed (P = 0.02 for interaction between age group and PES effects). No interaction between age and stent type in terms of the risk of other clinical end points, including all-cause death, was confirmed.


CONCLUSIONS: For STEMI patients undergoing primary PCI, the implantation of PES as compared with BMS reduced ischemic TVR, and this effect was independent of age.





結果3年に、高齢患者の間で、PES使用に関連した主要心事故(MACE;全死因死亡、脳卒中、再梗塞と虚血のための計画されてない血行再建術)の低いリスクに向かう傾向は、観察された(PES対BMS:18.0%対21.3%; P = 0.07)。
傾向が、高齢患者(26.4%対33.1%; P = 0.09)で、PESに関連したMACEの減少のためにもあった。
しかしながら、PESで治療を受ける高齢患者における大出血のより高いリスクは、観察された(年齢層とPES効果の間の相互作用のためのP = 0.02)。


460万語の専門辞書を備えた医療者専用翻訳サービス QLifePro医療翻訳