Jhajj Loveleen, Razick Shakira, Batea Khaleefah Balsam, Razick Abdulla, Moutasim Suliman Mohammed, Thapar Nandita, Thakali Hira
Xavier University School of Medicine, Oranjestad, Aruba.
Wycoff Heights Medical Center, Brooklyn, NY.
Ann Med Surg (Lond). 2024 Aug 22;86(10):6071-6078. doi: 10.1097/MS9.0000000000002373. eCollection 2024 Oct.
Sarpogrelate is a selective serotonin/5-hydroxytryptamine 2A receptor antagonist used in the management of peripheral artery disease (PAD). The drug has emerged as a promising choice for medical management post-endovascular therapy (EVT) due to its anti-platelet aggregation, vasoconstriction, and anti-vascular smooth muscle proliferation properties. The aim of the meta-analysis is to evaluate the efficacy and safety of sarpogrelate-based APT following arterial EVTs in PAD.
PubMed, Google Scholar, Scopus, and the Cochrane were systematically searched from inception to December 2023. Any randomized controlled trial studies in English that evaluated the efficacy and safety of sarpogrelate-based APT after EVT in patients with PAD was included. Data on the restenosis rate, target lesion revascularization (TLR), and safety parameters were extracted and studied. The pooled differences in efficacy and safety parameters between sarpogrelate-based APT and non-sarpogrelate-based APT was calculated using the relative risk (RR) with a 95% CI.
A total of three randomized controlled trials were included out of 354 articles obtained through a literature search. No significant differences were observed in the risk of restenosis (RR=0.74, 95% CI= 0.55-1.00, =0.954) and TLR (RR=0.76, 95% CI= 0.47-1.23, =0.476) among patients being treated with sarpogrelate and non-sarpogrelate-based APT. Likewise, sarpogrelate-based APT had a similar safety profile as non-sarpogrelate-based APT.
Sarpogrelate-based APT can be considered an effective alternative to clopidogrel-based conventional APT after EVTs. However, there is a huge need for a larger multicenter, multinational, and multiethnic global trial with sufficient participants in order to produce generalizable findings.
沙格雷酯是一种选择性5-羟色胺/5-羟色胺2A受体拮抗剂，用于治疗外周动脉疾病（PAD）。由于其抗血小板聚集、血管收缩和抗血管平滑肌增殖特性，该药物已成为血管内治疗（EVT）后药物治疗的一个有前景的选择。本荟萃分析的目的是评估基于沙格雷酯的抗血小板治疗（APT）在PAD患者动脉EVT后的疗效和安全性。
从创刊至2023年12月，对PubMed、谷歌学术、Scopus和考克兰图书馆进行了系统检索。纳入任何以英文发表的评估基于沙格雷酯的APT在PAD患者EVT后疗效和安全性的随机对照试验研究。提取并研究再狭窄率、靶病变血管重建（TLR）和安全参数的数据。使用相对风险（RR）及95%置信区间计算基于沙格雷酯的APT与非基于沙格雷酯的APT在疗效和安全参数方面的合并差异。
通过文献检索获得的354篇文章中，共纳入三项随机对照试验。接受基于沙格雷酯的APT和非基于沙格雷酯的APT治疗的患者在再狭窄风险（RR = 0.74，95% CI = 0.55 - 1.00，P = 0.954）和TLR（RR = 0.76，95% CI = 0.47 - 1.23，P = 0.476）方面未观察到显著差异。同样，基于沙格雷酯的APT与非基于沙格雷酯的APT具有相似的安全性。
基于沙格雷酯的APT可被视为EVT后基于氯吡格雷的传统APT的有效替代方案。然而，迫切需要进行一项更大规模的多中心、跨国和多民族全球试验，纳入足够的参与者，以便得出可推广的结果。
