International Circulation: The ZEST study showed that the rate of ischemia-driven TLR and TVR and stent thrombosis in the Cypher stent group was lower than the Endeavor and Taxus group. Could these results influence stent selection when performing PCI?
Prof. Chevalier: I think so. Some of the data in the ZEST trial is not very new as the comparison between Taxus and Cyper is usually in favor of Cypher in terms of restenosis and thrombosis. What is relatively different is the result of Endeavor in this trial and we have to consider what the mechanism is of this result. What is sure is that Cypher， which has a very low late loss， had the best TLR result.

国际循环: ZEST研究显示Cypher支架组缺血导致的TLR 、TVR 和支架血栓形成率低于Endeavor和 Taxus组。这些结果是否对施行PCI时支架选择有影响？
 Prof. Chevalier: 我觉得是有影响的。ZEST试验的一些数据不是很新，考虑到再狭窄和血栓形成，Taxus 和 Cyper 的比较通常支持Cypher 。相对不同的是这次试验中Endeavor的结果，我们不得不考虑造成这一结果的机制是什么。可以确定的是非常低迟发损失的Cypher有最佳的TLR结果。

International Circulation: There has been continuous improvement in stent design. Are there any improvements in stent design such as bioabsorbable polymers that have been presented here at EuroPCR?
Prof. Chevalier: At this EuroPCR meeting we have confirmation that bioabsorbable polymer coating as for delivering drugs is an interesting approach. We now have a lot of data coming from Biosensor with the Biomatrix， Terumo with the Nobori stent， and from Cordis with the Nevo stent. All these stents are using DES technology but with a bioabsorbable coating and all of them produce extremely good results in terms of restenosis and biocompatibility.

 

国际循环: 支架的设计不断在改进。在此次EuroPCR会议上有没有提到支架设计改进，如生物可降解聚合物？
Prof. Chevalier: 此次EuroPCR会议我们达成共识，认为生物可降解聚合物包被释放药物是一个有趣的方法。我们现在有来自去氧肾上腺素生物传感器、美达西半支架和来自Nevo支架导管的大量数据。所有这些支架都使用药物洗脱支架技术，但有生物可降解聚合物包被，它们在再狭窄和生物相容性方面均有极好的结果。.

International Circulation: Compared to conventional primary PCI for STEMI patients， Thomas Engstrom found in his study that post conditioning could significantly reduce the infarction area and the incidence of heart failure. What is your opinion on that?
Prof. Chevalier: It is an extremely interesting approach because we know that approximately 30~40% of the damage that is created by myocardial infarction is due to reperfusion injury. We do not have any efficient treatment for this reperfusion injury. I am interested in different approaches to treat this reperfusion injury and I think this is a very important treatment for M.I.

国际循环: Thomas Engstrom在他的研究中发现与常规初期PCI相比，后条件反射可以显著减少自发性血栓栓塞心肌梗死患者的梗死区域和降低其心力衰竭发生率。您对此怎么看？
Prof. Chevalier: 这是一个极其有趣的方法，因为我们知道大约30~40% 心肌梗死造成的损伤源于再灌注损伤。我们没有有效的方法治疗再灌注损伤。我对治疗再灌注损伤的不同方法感兴趣，我认为心肌梗死的一个重要治疗手段。

International Circulation: Previous studies have found that omega-3 fatty acids benefited heart disease patients， but the OMEGA study found that in moderate/high risk AMI patients omega-3 fatty acid therapy with strict guideline treatment did not bring additional benefit. What is your opinion of this study?
Prof. Chevalier: It is a very important approach in terms of secondary prevention in M.I patients. It is data that is emphasizing the role of a global approach and not only an interventional approach.

国际循环: 以前的研究发现omega-3脂肪酸对心脏病患者有益，但OMEGA研究发现中高风险患者的严格遵守指南omega-3脂肪酸治疗没有得到额外益处。您如何看待这一研究？
Prof. Chevalier: 对心肌梗死患者二级预防来说，这是一个非常重要的方法。数据强调整体治疗的作用而不是只有介入治疗。

International Circulation: What other work is being done by yourself and others in the area of prevention?
Prof. Chevalier: We are working in several different directions. We are working in the direction of pushing the role of PCI in some frontier areas like left main disease. We are also doing some important research for quality of life and cost effectiveness. This is a challenge because all of these interventional treatments are very expensive.

国际循环: 在预防方面您和其他人在进行其它哪些工作？
 Prof. Chevalier: 我们朝几个不同方向开展工作。我们针对推动PCI在边界区域如左主干疾病方面的使用。我们同时也针对生活质量和费用效应做一些重要研究。这是一个挑战，因为所有这些介入治疗都非常昂贵。

International Circulation: The one year follow-up results of the SYNTAX study showed that CABG resulted in lower rates of MACE than PCI for patients with left main and/or 3-vessel disease. If you treat a patient with left main and/or 3-vessel disease， would you choose CABG or PCI， and why?
Prof. Chevalier: There is no simple answer to this question. The important role of SYNTAX was to show the complexity of disease is the most important factor to decide between PCI and CABG. The SYNTAX score is a very good tool to differentiate multivessel disease patients with relatively simple lesions that are very well treated with PCI and more complex multivessel disease patients who are best treated by surgery.

国际循环: SYNTAX研究一年随访结果显示左主干和/或3血管疾病的患者冠状动脉旁路移植术比PCI有较低的MACE发生率。假如您治疗一名左主干和/或3血管疾病患者，您会选择冠状动脉旁路移植术还是PCI，为什么？
Prof. Chevalier: 对于这一问题没有简单的答案。SYNTAX 的重要作用是提示疾病的复杂性是决定PCI 还是CABG的最重要因素。SYNTAX评分是一个区分工具，相对单纯损伤的多血管疾病患者选择PCI可以得到很好治疗，比较复杂多血管疾病患者最好手术治疗。

International Circulation: Is the SYNTAX score more of a research tool or is it clinically useful?
Prof. Chevalier: I think it is something that is applicable in the clinic. There are now some tools like a cd-rom and website to help use the SYNTAX score and quickly assess the SYNTAX score of the patient. In our clinical practice we use the SYNTAX score to define the risks of PCI the same as the EUROSCORE has been used to define the risk of surgery.

 国际循环: SYNTAX 评分更多的是一个研究工具还是其有临床实用性？
 Prof. Chevalier: 我认为其适用于临床。现在有一些新的工具如cd-rom 和网页帮助我们使用SYNTAX 评分，快速评定患者的SYNTAX 评分。在我们的临床实践中，我们使用SYNTAX 评分决定PCI的风险，和EURO评分用于决定手术风险一样。

International Circulation: There is obviously a lot of information being presented here at EuroPCR. Are there any particular topics that you think are very important or you are excited about?
Prof. Chevalier: What is important at EuroPCR is the value of the education. You can learn a lot in different fields when you attend EuroPCR. You can also find educational tools on our website.

国际循环:显然此次EuroPCR会议报道了大量信息。有没有您认为非常重要或感兴趣的特别议题？
Prof. Chevalier: EuroPCR 重要的是教育的价值。参加EuroPCR你可以在不同领域学到东西。你也可以在我们的网页找到学习工具。

International Circulation: Can you tell us if there are any plans for collaboration between EuroPCR and China?
Prof. Chevalier