Hillegass W B, Ohman E M, Leimberger J D, Califf R M
Interventional Cardiac Catheterization Laboratory, Duke University Medical Center, Durham, North Carolina 27710.
Am J Cardiol. 1994 May 1;73(12):835-9. doi: 10.1016/0002-9149(94)90805-2.
The usefulness of calcium antagonists to reduce restenosis after coronary angioplasty remains uncertain despite 5 randomized trials involving 919 patients. Review and meta-analysis of these trials are performed to provide insight into whether calcium antagonists reduce angiographic restenosis. In aggregate, these trials suggest that patients treated with calcium antagonists had approximately a 30% reduction in the odds of angiographic restenosis (odds ratio = 0.68; 95% confidence interval of 0.49 to 0.94, p = 0.03) compared with control patients. Given the relatively low toxicity and cost of these agents, this reduction in angiographic restenosis may translate into a meaningful clinical benefit. A large, randomized clinical trial should be performed to confirm these findings before widespread adoption of this treatment strategy.
尽管有5项涉及919名患者的随机试验，但钙拮抗剂在冠状动脉血管成形术后减少再狭窄方面的有效性仍不确定。对这些试验进行了综述和荟萃分析，以深入了解钙拮抗剂是否能减少血管造影再狭窄。总体而言，这些试验表明，与对照组患者相比，接受钙拮抗剂治疗的患者血管造影再狭窄几率降低了约30%（优势比=0.68；95%置信区间为0.49至0.94，p=0.03）。鉴于这些药物的毒性和成本相对较低，血管造影再狭窄的这种降低可能转化为有意义的临床益处。在广泛采用这种治疗策略之前，应进行一项大型随机临床试验来证实这些发现。
