Gaddi Antonio Vittorino, Capello Fabio, Gheorghe-Fronea Oana Florentina, Fadda Simone, Darabont Roxana Oana
EuroGenLab, Bologna, Italy.
Department of Paediatrics, AUSL della Romagna, Ospedale Morgagni-Pierantoni, Forlì, Italy.
JRSM Cardiovasc Dis. 2020 Feb 14;9:2048004020907002. doi: 10.1177/2048004020907002. eCollection 2020 Jan-Dec.
Peripheral arterial disease is associated with very high cardiovascular risk. The main symptom is intermittent claudication, which strongly affects the quality of life. Therefore, treatment goals in peripheral arterial disease consist of the reduction of cardiovascular events and the relief of symptoms. An increase in pain-free walking distance, evaluated based on the Initial Claudication Distance, was also a strong positive prognostic factor in patients with peripheral arterial disease. Our objective was to reassess whether sulodexide is effective in improving Initial Claudication Distance. For this, we searched the literature according to the PRISMA checklist for double blind clinical trials assessing the improvement in the Initial Claudication Distance after 90 days of standard therapeutic regimen with sulodexide in adult patients with peripheral arterial disease. We found and assessed for bias in 11 studies eligible for review and meta-analysis. Data extracted from those studies favoured the sulodexide group, showing an overall difference in Initial Claudication Distance of +68.9 (CI 95%; ± 11.9 m) at the end of treatment (p < 0.001). According to this review, sulodexide is effective in improving Initial Claudication Distance and consequently the quality of life in patients with peripheral arterial disease. Further studies are needed to assess the effects of this drug on disease progression in asymptomatic patients with peripheral arterial disease.
外周动脉疾病与极高的心血管风险相关。主要症状为间歇性跛行，这对生活质量有严重影响。因此，外周动脉疾病的治疗目标包括减少心血管事件和缓解症状。基于初始跛行距离评估的无痛步行距离增加，也是外周动脉疾病患者的一个强有力的阳性预后因素。我们的目的是重新评估舒洛地昔是否能有效改善初始跛行距离。为此，我们根据PRISMA清单检索了文献，以查找评估在成年外周动脉疾病患者中采用舒洛地昔标准治疗方案90天后初始跛行距离改善情况的双盲临床试验。我们找到了11项符合审查和荟萃分析条件的研究，并对其进行了偏倚评估。从这些研究中提取的数据支持舒洛地昔组，显示治疗结束时初始跛行距离的总体差异为+68.9（95%CI；±11.9米）（p<0.001）。根据这项综述，舒洛地昔可有效改善外周动脉疾病患者的初始跛行距离，从而改善其生活质量。需要进一步研究来评估这种药物对无症状外周动脉疾病患者疾病进展的影响。
