Nishio Kazuaki, Hosaka Michio, Shigemitsu Meiei, Kobayashi Youichi
The Third Department of Internal Medicine, School of Medicine Showa University, Tokyo, Japan.
Cardiovasc Revasc Med. 2011 Jul-Aug;12(4):197-202. doi: 10.1016/j.carrev.2009.10.003. Epub 2011 Apr 12.
The aim of this study was to examine outcome subsequent to implantation of bare-metal stents (BMS) with pioglitazone, which are novel insulin-sensitizing agents, and drug-eluting stents (DES) in patients with diabetes.
A total of 139 consecutive Type 2 diabetic patients treated with stent were followed up for 3 years. Data on death, myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis were ascertained from January 2003 to January 2006. Eighty-nine patients were treated with a BMS with pioglitazone, and 50 patients were treated with a DES. The incidence of MI was 1.1% in the BMS with pioglitazone group, 4.0% in the DES group [relative risk RR):0.52; 95% CI: 0.10-2.56]. The incidence of TLR was 22.5% in the BMS with pioglitazone group, 28.0% in the DES group (RR 0.89; 95% CI: 0.65-1.22). The incidence of stent thrombosis was 1.0% in the BMS with pioglitazone group, 4.0% in the DES group (RR 0.52; 95% CI: 0.10-2.56). Overall 3-year mortality was similar in the two groups (RR 0.77; 95% CI: 0.34-1.74).
During 3 years of follow-up, patients treated with BMS with pioglitazone had similar risks of death, TLR, MI, and stent thrombosis compared with patients treated with DES.
本研究旨在探讨使用新型胰岛素增敏剂吡格列酮的裸金属支架（BMS）和药物洗脱支架（DES）植入术后糖尿病患者的预后情况。
连续纳入139例接受支架治疗的2型糖尿病患者，随访3年。收集2003年1月至2006年1月期间有关死亡、心肌梗死（MI）、靶病变血运重建（TLR）和支架血栓形成的数据。89例患者接受了含吡格列酮的BMS治疗，50例患者接受了DES治疗。含吡格列酮的BMS组MI发生率为1.1%，DES组为4.0%[相对风险（RR）：0.52；95%置信区间（CI）：0.10 - 2.56]。含吡格列酮的BMS组TLR发生率为22.5%，DES组为28.0%（RR 0.89；95% CI：0.65 - 1.22）。含吡格列酮的BMS组支架血栓形成发生率为1.0%，DES组为4.0%（RR 0.52；95% CI：0.10 - 2.56）。两组总体3年死亡率相似（RR 0.77；95% CI：0.34 - 1.74）。
在3年随访期间，与接受DES治疗的患者相比，接受含吡格列酮的BMS治疗的患者在死亡、TLR、MI和支架血栓形成方面的风险相似。
