Liu Jichen, Li Menghao, Lu Hao, Qiao Weiguang, Xi Dan, Luo TianTian, Xiong Haowei, Guo Zhigang
Division of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, P.R. China.
Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, P.R. China.
PLoS One. 2015 Apr 21;10(4):e0124021. doi: 10.1371/journal.pone.0124021. eCollection 2015.
Restenosis after percutaneous coronary intervention (PCI) is a remained clinical problem which limits long-term success of PCI. Although there was recognition that probucol in treating restenosis after percutaneous transluminal coronary angioplasty, the efficacy of probucol on restenosis after stent-implantation is controversial. So this meta-analysis was conducted to investigate the association between probucol and late restenosis.
Articles were assessed by four trained investigators, with divergences resolved by consensus. PubMed, EMBASE, ScienceDirect and the Cochrane Central Register of clinical trials were searched for pertinent studies. Inclusion criteria were random allocated to treatment and a comparison of probucol-treated patients and control patients (not treated with lipid-lowering drug) undergoing PCI.
Fifteen studies with 859 subjects were analyzed. Major outcome, binary angiographic restenosis defined as >50% stenosis upon follow-up angiography, was significantly decreased with probucol treatment (RR = 0.59 [0.43, 0.80] among vessels, P = 0.0007; and RR = 0.52 [0.40, 0.68] among patients, P<0.00001). Probucol also increased the minimal luminal diameter (SMD = 0.45 [0.30, 0.61], P<0.00001) and decreased late loss upon follow-up after 6 months (SMD = -0.41 [-0.60, -0.22], P<0.0001). Moreover, there was a significantly lower incidence of major adverse cardiac events (MACE) in the probucol group than control group (RR = 0.69 [0.51, 0.93], P = 0.01).
Probucol is more than a lipid-lowering drug. It is also effective in reducing the risk of restenosis and incidence of MACE after PCI.
经皮冠状动脉介入治疗（PCI）后的再狭窄是一个依然存在的临床问题，限制了PCI的长期成功率。尽管人们认识到普罗布考可用于治疗经皮腔内冠状动脉成形术后的再狭窄，但普罗布考对支架植入术后再狭窄的疗效仍存在争议。因此，进行了这项荟萃分析以研究普罗布考与晚期再狭窄之间的关联。
由四名经过培训的研究人员对文章进行评估，分歧通过协商解决。在PubMed、EMBASE、ScienceDirect和Cochrane临床试验中央注册库中搜索相关研究。纳入标准为随机分配治疗方案，并对接受PCI的普罗布考治疗患者和对照患者（未接受降脂药物治疗）进行比较。
分析了15项研究，共859名受试者。主要结局为随访血管造影显示狭窄>50%定义的二元血管造影再狭窄，普罗布考治疗使其显著降低（血管层面RR = 0.59 [0.43, 0.80]，P = 0.0007；患者层面RR = 0.52 [0.40, 0.68]，P<0.00001）。普罗布考还增加了最小管腔直径（标准化均数差SMD = 0.45 [0.30, 0.61]，P<0.00001），并减少了6个月随访后的晚期管腔丢失（SMD = -0.41 [-0.60, -0.22]，P<0.0001）。此外，普罗布考组主要不良心脏事件（MACE）的发生率显著低于对照组（RR = 0.69 [0.51, 0.93]，P = 0.01）。
普罗布考不仅仅是一种降脂药物。它在降低PCI后再狭窄风险和MACE发生率方面也有效。
