PDF(Pubmed)
Abstract：
UNASSIGNED: Small reference vessel diameters (RVDs) are a predictor of ischemic events after coronary stenting. Among patients at high bleeding risk (HBR) precluding long-term dual antiplatelet therapy (DAPT), those with small vessel disease (SVD) constitute an especially high-risk subgroup. Here, we evaluated the results of a durable-polymer, coronary zotarolimus-eluting stent (ZES) for the treatment of patients with SVD at HBR with 1-month DAPT.
UNASSIGNED: In the prospective, multicenter Onyx ONE (One-Month DAPT) Clear study, 1506 patients at HBR treated with a ZES that discontinued DAPT at 30 days were included. The clinical outcomes of patients undergoing treatment of lesions with an RVD of ≤2.5 mm (SVD group, as determined by the angiographic core laboratory) were compared with patients without SVD. The primary end point was the composite of cardiac death or myocardial infarction between 1 and 12 months.
UNASSIGNED: Small vessel diameter treatment was performed in 489 (32.5%) patients. Patients with SVD were more likely to be women, have undergone a previous percutaneous intervention, and have multivessel coronary artery disease than patients without SVD. There were no significant differences in lesion, device, or procedural success between the groups. The Kaplan-Meier rate estimate of the primary end point was 8.5% and 6.8% in patients with SVD and those without SVD, respectively (P = .425). No significant differences were found in any secondary end point. The Kaplan-Meier rate of stent thrombosis was 0.6% and 0.8% in patients with SVD and those without SVD, respectively (P = .50).
UNASSIGNED: Among patients at HBR treated with a ZES and 1-month DAPT, those with SVD had favorable 12-month ischemic and bleeding outcomes, which were comparable with those of patients with larger caliber vessels.
UNASSIGNED: In the prospective, multicenter Onyx ONE (One-Month DAPT) Clear study, 1506 patients at HBR treated with a ZES that discontinued DAPT at 30 days were included. The clinical outcomes of patients undergoing treatment of lesions with an RVD of ≤2.5 mm (SVD group, as determined by the angiographic core laboratory) were compared with patients without SVD. The primary end point was the composite of cardiac death or myocardial infarction between 1 and 12 months.
UNASSIGNED: Small vessel diameter treatment was performed in 489 (32.5%) patients. Patients with SVD were more likely to be women, have undergone a previous percutaneous intervention, and have multivessel coronary artery disease than patients without SVD. There were no significant differences in lesion, device, or procedural success between the groups. The Kaplan-Meier rate estimate of the primary end point was 8.5% and 6.8% in patients with SVD and those without SVD, respectively (P = .425). No significant differences were found in any secondary end point. The Kaplan-Meier rate of stent thrombosis was 0.6% and 0.8% in patients with SVD and those without SVD, respectively (P = .50).
UNASSIGNED: Among patients at HBR treated with a ZES and 1-month DAPT, those with SVD had favorable 12-month ischemic and bleeding outcomes, which were comparable with those of patients with larger caliber vessels.
摘要：
■小参考血管直径(RVD)是冠状动脉支架置入术后缺血事件的预测因子。在高出血风险（HBR）排除长期双重抗血小板治疗（DAPT）的患者中，小血管疾病(SVD)患者构成了一个特别高危的亚组.这里,我们评估了耐用聚合物的结果，冠状动脉唑他莫司洗脱支架（ZES）用于治疗1个月DAPT的HBRSVD患者。
■在未来，多中心OnyxONE（一个月DAPT）清除研究，纳入了在30天停止DAPT的ZES治疗的HBR患者1506例。RVD≤2.5mm（SVD组，由血管造影核心实验室确定）与无SVD的患者进行比较。主要终点是1至12个月之间的心脏死亡或心肌梗死的复合终点。
■对489例（32.5%）患者进行了小血管直径治疗。SVD患者更可能是女性，之前经历过经皮介入，与没有SVD的患者相比，患有多支冠状动脉疾病。病变无显著差异，装置,或组间程序上的成功。SVD患者和无SVD患者的主要终点Kaplan-Meier率估计分别为8.5%和6.8%。分别（P=.425）。在任何次要终点均未发现显着差异。SVD患者和无SVD患者的Kaplan-Meier支架内血栓形成率分别为0.6%和0.8%,分别（P=.50）。
■在接受ZES和1个月DAPT治疗的HBR患者中，SVD患者12个月缺血和出血结局良好,与较大口径血管的患者相当。
■在未来，多中心OnyxONE（一个月DAPT）清除研究，纳入了在30天停止DAPT的ZES治疗的HBR患者1506例。RVD≤2.5mm（SVD组，由血管造影核心实验室确定）与无SVD的患者进行比较。主要终点是1至12个月之间的心脏死亡或心肌梗死的复合终点。
■对489例（32.5%）患者进行了小血管直径治疗。SVD患者更可能是女性，之前经历过经皮介入，与没有SVD的患者相比，患有多支冠状动脉疾病。病变无显著差异，装置,或组间程序上的成功。SVD患者和无SVD患者的主要终点Kaplan-Meier率估计分别为8.5%和6.8%。分别（P=.425）。在任何次要终点均未发现显着差异。SVD患者和无SVD患者的Kaplan-Meier支架内血栓形成率分别为0.6%和0.8%,分别（P=.50）。
■在接受ZES和1个月DAPT治疗的HBR患者中，SVD患者12个月缺血和出血结局良好,与较大口径血管的患者相当。
