Iglesias JF et al.Cardiovasc Revasc Med. 2022 Jan;34:3-10.

肺动脉高压(PAH)是一种罕见的进行性疾病，虽然预后仍然不佳，但靶向治疗可以显著改善患者预后。Selexipag是一种口服前列环素受体(IP受体)激动剂用于治疗PAH，延缓疾病进展并降低住院风险。

该项GRIPHON研究纳入574例患者，随机选择selexipag的生存期。第1、3、5和7年生存率(95%CI)分别为92.0%(89.4，94.0)、79.3%(75.4，82.6)、71.2%(66.5，75.3)和63.0%(57.4，68.1)。

本项研究包括selexipag治疗PAH患者的长期生存、耐受性和安全性数据。是迄今为止发表的使用任何PAH药物治疗的PAH患者最长的随访期。这些数据在罕见疾病中具有重要的临床意义。

Abstract

Background: Thin-strut biodegradable polymer sirolimus-eluting stents (BP-SES) have been shown to reduce target lesion failure (TLF) at one-year follow-up compared with durable polymer everolimus-eluting stents (DP-EES) among patients with acute coronary syndrome (ACS). The long-term clinical benefits of thin-strut BP-SES over DP-EES in ACS patients after complete degradation of the polymer coating remain uncertain.

Methods: We performed a post-hoc subgroup analysis of ACS patients included into the BIOSCIENCE randomized trial (NCT01443104). The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target-vessel myocardial infarction or clinically indicated target lesion revascularization, at 5 years.

Results: Among 2119 patients enrolled between March 2012 and May 2013, 1131 (53%) presented with ACS. The 5-year cumulative incidence of TLF was significantly lower in patients with ACS compared to chronic coronary syndrome [16.5% vs. 22.9%; rate ratio (RR), 0.69; 95% confidence interval (CI), 0.57-0.85; p < 0.001]. At 5 years, TLF occurred similarly in ACS patients treated with BP-SES and DP-EES (16.9% vs. 16.0%; RR, 1.04; 95% CI, 0.78-1.41; p = 0.78). The individual components of the primary endpoint did not differ between ACS patients treated with BP-SES or DP-EES at 5 years. Overall, there was no interaction between clinical presentation and treatment effect.

Conclusions: In a subgroup analysis of the BIOSCIENCE trial, we found no difference in long-term outcomes between ACS patients treated with BP-SES or DP-EES at 5 years.

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