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双盲平行安慰剂对照研究评价吗地尔对经皮冠状动脉介入治疗稳定型心绞痛患者内皮功能障碍的影响:MEDCOR 试验。

Double-blind parallel placebo-controlled study to evaluate the effect of molsidomine on the endothelial dysfunction in patients with stable angina pectoris undergoing percutaneous coronary intervention: the MEDCOR Trial.

机构信息

Cardiovascular Center Aalst, OLV Clinic, Moorselbaan n. 164, 9300, Aalst, Belgium,

出版信息

J Cardiovasc Transl Res. 2014 Mar;7(2):226-31. doi: 10.1007/s12265-013-9513-9. Epub 2013 Oct 19.

Abstract

The effects of molsidomine (a direct nitric oxide donor) on the endothelial dysfunction have never been evaluated using reactive hyperemia peripheral arterial tonometry (RH-PAT). The objective of the MEDCOR double-blind trial will be to demonstrate the superiority of molsidomine (Coruno® 16 mg, once daily) over placebo, on improving the endothelial function (Endoscore by RH-PAT) after 12 months of treatment in stable angina patients undergoing elective percutaneous coronary intervention (PCI). Study design will take care of the real-life situation, in which patients are being offered PCI and stent placement (drug-eluting or bare metal), but also gold standard medical therapy (beta-blockers, statins, angiotensin-converting enzyme inhibitors (ACEIs), and/or calcium antagonists). Demonstrating clinical and statistical superiority of the study drug over placebo will be a real challenge. Therefore, a sequential approach has been designed with a pilot phase aiming at recruiting 50 patients. Upon evaluation of the results by an independent data steering committee, a larger sample size phase will eventually be considered.

摘要

莫索尼定(一种直接的一氧化氮供体)对内皮功能障碍的影响从未通过反应性充血外周动脉张力测定(RH-PAT)进行过评估。MEDCOR 双盲试验的目的将是证明莫索尼定(Coruno® 16mg,每日一次)在改善稳定型心绞痛患者经皮冠状动脉介入治疗(PCI)后 12 个月内皮功能(通过 RH-PAT 的 Endoscore)方面优于安慰剂。研究设计将考虑到实际情况,即患者正在接受 PCI 和支架置入(药物洗脱或裸金属),但也接受标准的医学治疗(β受体阻滞剂、他汀类药物、血管紧张素转换酶抑制剂(ACEIs)和/或钙拮抗剂)。证明研究药物优于安慰剂在临床和统计学上的优越性将是一个真正的挑战。因此,采用了一种序贯方法,首先进行一项招募 50 名患者的试点阶段。在独立的数据指导委员会对结果进行评估后,最终将考虑更大的样本量阶段。

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