抗组胺药吡嘧司特钾对支架置入术后再狭窄的预防作用：定量冠状动脉造影和血管内超声研究

Preventive effect of an antiallergic drug, pemirolast potassium, on restenosis after stent placement: quantitative coronary angiography and intravascular ultrasound studies.

作者信息

Ohsawa Hidefumi, Noike Hirofumi, Kanai Masahito, Hitsumoto Takashi, Aoyagi Kaneyuki, Sakurai Takeshi, Sugiyama Yuhkoh, Yoshinaga Kunio, Kaku Michihisa, Matsumoto Jun, Iizuka Takuo, Shimizu Kazuhiro, Takahashi Mao, Tomaru Takanobu, Sakuragawa Hiroshi, Tokuhiro Keiichi

机构信息

Cardiovascular Center, Sakura Hospital, Toho University School of Medicine, Shimoshizu 564-1, Sakura, Chiba 285-0841.

出版信息

J Cardiol. 2003 Jul;42(1):13-22.

PMID:12892037

Abstract

OBJECTIVES

The preventive effect of pemirolast against restenosis after coronary stent placement was evaluated.

METHODS

Eighty-four patients with 89 de novo lesions who underwent successful coronary stenting were assigned to the pemirolast group(40 patients, 45 lesions) and the control group(44 patients, 44 lesions). Administration of pemirolast(20 mg/day) was initiated from the next morning after stenting and continued for 6 months of follow-up. Quantitative coronary angiography was performed immediately after stenting and at follow-up. Angiographic restenosis was defined as diameter stenosis > or = 50% at follow-up. Intravascular ultrasound study conducted at follow-up angiography was used to measure vessel cross-sectional area(CSA), stent CSA, lumen CSA, neointima CSA(stent CSA--lumen CSA), and percentage neointima CSA(neointima CSA/stent CSA x 100%) at the minimal lumen site.

RESULTS

There were no significant differences in baseline characteristics between the two groups. Restenosis rate was significantly lower in the pemirolast group than in the control group(15.0% vs 34.1% of patients, 13.3% vs 34.1% of lesions, p < 0.05, respectively). The intravascular ultrasound study at follow-up(36 lesions in the pemirolast group, 33 in the control group) found no significant differences in vessel CSA and stent CSA between the two groups(17.3 +/- 2.2 vs 16.8 +/- 2.4 mm2, 8.6 +/- 1.9 vs 8.4 +/- 1.7 mm2, respectively). However, lumen CSA was significantly larger in the pemirolast group than in the control group(5.5 +/- 1.3 vs 4.4 +/- 1.1 mm2, p < 0.05). Moreover, neointima CSA and percentage neointima CSA were significantly smaller in the pemirolast group(3.1 +/- 1.1 vs 4.0 +/- 1.2 mm2, p < 0.05 and 36.2 +/- 15.9% vs 47.4 +/- 15.6%, p < 0.01).

CONCLUSIONS

Pemirolast has a preventive effect against restenosis after stent placement, possibly by inhibiting neointimal hyperplasia.

摘要

目的

评估吡嘧司特对冠状动脉支架置入术后再狭窄的预防作用。

方法

84例成功进行冠状动脉支架置入术且有89处新发病变的患者被分为吡嘧司特组（40例患者，45处病变）和对照组（44例患者，44处病变）。吡嘧司特（20毫克/天）于支架置入术后次日早晨开始给药，并持续6个月的随访期。在支架置入后即刻及随访时进行定量冠状动脉造影。血管造影再狭窄定义为随访时直径狭窄≥50%。随访血管造影时进行的血管内超声检查用于测量最小管腔部位的血管横截面积（CSA）、支架CSA、管腔CSA、新生内膜CSA（支架CSA - 管腔CSA）以及新生内膜CSA百分比（新生内膜CSA/支架CSA×100%）。

结果

两组患者的基线特征无显著差异。吡嘧司特组的再狭窄率显著低于对照组（患者分别为15.0%对34.1%，病变分别为13.3%对34.1%，p均<0.05）。随访时的血管内超声检查（吡嘧司特组36处病变，对照组33处病变）发现两组间血管CSA和支架CSA无显著差异（分别为17.3±2.2对16.8±2.4平方毫米，8.6±1.9对8.4±1.7平方毫米）。然而，吡嘧司特组的管腔CSA显著大于对照组（5.5±1.3对4.4±1.1平方毫米，p<0.05）。此外，吡嘧司特组的新生内膜CSA和新生内膜CSA百分比显著更小（分别为3.1±1.1对4.0±1.2平方毫米，p<0.05；36.2±15.9%对47.4±15.6%，p<0.01）。