Tan Jin-Yun, Shi Wei-Hao, He Jing, Zhu Lei, Wang Tie-Ping, Yu Bo
Department of Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Yi Xue Za Zhi. 2008 Mar 25;88(12):812-5.
To evaluate the clinical effect and restenosis rate of antiplatelet therapy following peripheral artery angioplasty and stenting.
After successful placement of peripheral artery stents to 103 patients with peripheral arterial occlusive disease (PAOD) in were randomized assigned to 2 groups: antiplatelet therapy group receiving clopidogrel 75 mg plus aspirin 100 mg (n = 56) and control group (n = 47) receiving anticoagulation therapy low molecular weight heparin (LWMH) for 7 d plus long-term warfarin. The patients were followed up 1 day, and 1, 6, 12, and 18 months after the operation to undergo color Doppler ultrasonography, and examinations of blood routine, bleeding time, coagulation time, and ankle-brachial Index. The primary endpoint events included major bleeding rate, and composite rate of restenosis and reocclusion. The secondary endpoint events included cardiovascular events, death, and adverse drug reaction.
There were no significant differences in the baseline data between these two groups. The thrombotic occlusion rate was 1.8% in the antiplatelet group and 0% in control group, and the restenosis rate was 14.3% in the antiplatelet group and 25.5% in control group (both P > 0.05). The bleeding complication rate of the antiplatelet group was 1.8%, significantly lower than that of the anticoagulation group (19.1%, P < 0.01). There were not significant differences in cardiovascular event rate and mortality 18 months after operation between these two groups.
Antiplatelet therapy combined with clopidogrel plus aspirin is effective and safe in preventing restenosis following peripheral artery angioplasty and stenting.
评估外周动脉血管成形术及支架置入术后抗血小板治疗的临床效果及再狭窄率。
对103例外周动脉闭塞性疾病(PAOD)患者成功置入外周动脉支架后,随机分为2组:抗血小板治疗组,接受氯吡格雷75mg加阿司匹林100mg(n = 56);对照组(n = 47),接受抗凝治疗,即低分子肝素(LWMH)治疗7天加长期华法林治疗。术后1天、1、6、12和18个月对患者进行随访,进行彩色多普勒超声检查、血常规、出血时间、凝血时间及踝肱指数检查。主要终点事件包括大出血率、再狭窄和再闭塞复合率。次要终点事件包括心血管事件、死亡及药物不良反应。
两组基线数据无显著差异。抗血小板组血栓闭塞率为1.8%,对照组为0%;抗血小板组再狭窄率为14.3%,对照组为25.5%(均P>0.05)。抗血小板组出血并发症发生率为1.8%,显著低于抗凝组(19.1%,P<0.01)。两组术后18个月心血管事件发生率及死亡率无显著差异。
氯吡格雷联合阿司匹林的抗血小板治疗对外周动脉血管成形术及支架置入术后预防再狭窄有效且安全。