Nyssen Astrid, Legrand Victor, Scheen André J
Service de cardiologie, Département de médecine CHU de Liège, Sart Tilman, 4000 Liège, Belgique.
Rev Med Suisse. 2008 Aug 27;4(168):1806-10.
In diabetic patients, the use of drug-eluting stents (paclitaxel-PES or sirolimus-SES) reduces the risk of restenosis as compared to bare-metal stents. However, the risk of (very) late thrombosis is higher with drug-eluting stents than with bare-metal stents. All together, the incidence of major cardiovascular events is reduced with drug-eluting stents, mainly resulting from a diminution of revascularisation procedures rather than from a reduction in myocardial infarcts or cardiovascular deaths. Attempts to compare SES and PES gave discordant results in both randomised trials and registries. Efficacious antiplatelet therapy in the long run is mandatory in all diabetic patients treated with drug-eluting stents.
在糖尿病患者中，与裸金属支架相比，使用药物洗脱支架（紫杉醇洗脱支架或西罗莫司洗脱支架）可降低再狭窄风险。然而，药物洗脱支架发生（极）晚期血栓形成的风险高于裸金属支架。总体而言，药物洗脱支架可降低主要心血管事件的发生率，这主要是由于血管重建手术减少，而非心肌梗死或心血管死亡减少。在随机试验和登记研究中，比较西罗莫司洗脱支架和紫杉醇洗脱支架的尝试得出了不一致的结果。对于所有接受药物洗脱支架治疗的糖尿病患者，长期有效的抗血小板治疗是必不可少的。
