当前位置:循环首页>正文

DECLARE-DIABETES:糖尿病患者置入DES后联合西洛他唑减少晚期再狭窄

Drug-eluting stenting followed by cilostazol treatment reduces late restenosis in patients with diabetes mellitus the DECLARE-DIABETES Trial (A Randomized Comparison of Triple Antiplatelet Therapy with Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Diabetic Patients)

作者:国际循环网   日期:2008/8/11 16:09:00

国际循环网版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。

DECLARE-DIABETES试验设计: 糖尿病患者行药物洗脱支架(DES)置入后被随机分为:西洛他唑、阿司匹林和氯吡格雷(三联药物治疗)或阿司匹林加氯吡格雷组(二联药物治疗)。研究其中期临床和血管造影结果。

   
DECLARE-DIABETES

试验设计: 糖尿病患者行药物洗脱支架(DES)置入后被随机分为:西洛他唑、阿司匹林和氯吡格雷(三联药物治疗)或阿司匹林加氯吡格雷组(二联药物治疗)。研究其中期临床和血管造影结果。

结果
    ● 6个月时支架内晚期丢失:0.25 ± 0.53 mm(三联治疗组) vs. 0.38 ± 0.54 mm (双联药物治疗组);P=0.025 

    ● 血管造影显示再狭窄:8.0% vs. 15.6%;P=0.03

    ● 靶病变重建率(TLR)在:三联药物治疗组(2.5%)低于二联药物治疗组 (7.0%),P=0.03

    结论
    ● 与二联药物治疗相比,三联药物治疗在减少再狭窄和TLR上较好,但在6~9个月时的心肌梗死、死亡率和支架血栓等方面无优势

    ● 三联药物治疗组中途停药发生率高 

    Lee SW, et al. J Am Coll Cardiol. 2008;51:1181-1187.

     原始摘要:

OBJECTIVES: We sought to evaluate the impact of cilostazol on neointimal hyperplasia after drug-eluting stent (DES) implantation in patients with diabetes mellitus (DM).

BACKGROUND: Although cilostazol has reduced the extent of neointimal hyperplasia and restenosis in patients after bare-metal stent implantation, it is not known whether this effect occurs after DES implantation in diabetic patients.

METHODS: This randomized, multicenter, prospective study compared triple antiplatelet therapy (aspirin, clopidogrel, and cilostazol, triple group, n = 200) and dual antiplatelet therapy (aspirin and clopidogrel, standard group, n = 200) for 6 months in patients with DM receiving DES. The primary end point was in-stent late loss at 6 months.

RESULTS: The 2 groups had similar baseline clinical and angiographic characteristics. The in-stent (0.25 +/- 0.53 mm vs. 0.38 +/- 0.54 mm, p = 0.025) and in-segment (0.42 +/- 0.50 mm vs. 0.53 +/- 0.49 mm, p = 0.031) late loss were significantly lower in the triple versus standard group, as were 6-month in-segment restenosis (8.0% vs. 15.6%, p = 0.033) and 9-month target lesion revascularization (TLR) (2.5% vs. 7.0%, p = 0.034). At 9 months, major adverse cardiac events, including death, myocardial infarction, and TLR, tended to be lower in the triple than in the standard group (3.0% vs. 7.0%, p = 0.066). Multivariate analysis showed that sirolimus-eluting stents and the use of cilostazol were strong predictors of reduced restenosis or TLR.

CONCLUSIONS: Triple antiplatelet therapy after DES implantation decreased angiographic restenosis and extent of late loss, resulting in a reduced risk of 9-month TLR compared with dual antiplatelet therapy in diabetic patients.

版面编辑:何迎



糖尿病DES西洛他唑

分享到: 更多


设为首页 | 加入收藏 | 关于我们 | 联系方式 | 招贤纳士
声明:国际循环网( www.icirculation.com)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。
京ICP备15014970号-5  互联网药品信息服务资格证书编号(京)-非经营性-2017-0063  京公网安备 11010502033353号  增值电信业务经营许可证:京ICP证150541号
国际循环 版权所有   © 2004-2024 www.icirculation.com All Rights Reserved
公司名称:北京美赞广告有限公司 公司地址:北京市朝阳区朝阳门北大街乙12号天辰大厦1座1409 电话:010-51295530