Sekiya M, Funada J, Watanabe K, Miyagawa M, Akutsu H
The Department of Cardiology, Ehime National Hospital, Japan.
Am J Cardiol. 1998 Jul 15;82(2):144-7. doi: 10.1016/s0002-9149(98)00323-3.
The present study was conducted to assess the preventive effect of combined treatment with probucol, an antioxidant, and cilostazol, a phosphodiesterase inhibitor, against poststenting restenosis. Study patients were randomized to 4 modality groups 1 week before stenting: control, probucol (500 mg/day), cilostazol (200 mg/day), and probucol plus cilostazol. Treatment on these modalities was conducted from 5 prestent days until the poststenting follow-up evaluation (6 poststenting months). All patients received aspirin (81 mg/day). The efficacy of each modality against restenosis was evaluated in a total 126 patients with 165 coronary arterial lesions, using a quantitative method. The decrease in luminal diameter at the poststenting follow-up was 1.04 +/- 0.57 mm for controls, 0.88 +/- 0.82 mm for those taking probucol, 0.61 +/- 0.59 mm for those taking cilostazol (p <0.05 vs control), and 0.40 +/- 0.52 mm (p <0.01 vs control) for the combined treatment group. Restenosis rate per segment was 31.7% for controls, 16.7% for the probucol group, 12.5% for the cilostazol group (p <0.05 vs control), and 9.5% for the combined treatment group (p <0.05 vs the control). Neither mortality, myocardial infarction, stent thrombosis, or coronary bypass surgery, nor any serious complications were observed in the combined treatment group. Combined treatment with probucol and cilostazol has thus proved safe and effective in preventing acute poststenting complications and suppressing chronic restenosis.
本研究旨在评估抗氧化剂普罗布考与磷酸二酯酶抑制剂西洛他唑联合治疗对支架置入术后再狭窄的预防作用。研究患者在支架置入术前1周被随机分为4个治疗组：对照组、普罗布考组（500毫克/天）、西洛他唑组（200毫克/天）以及普罗布考加西洛他唑组。这些治疗从支架置入术前5天开始，持续至支架置入术后随访评估（术后6个月）。所有患者均服用阿司匹林（81毫克/天）。采用定量方法对总共126例患有165处冠状动脉病变的患者评估了每种治疗方式对再狭窄的疗效。支架置入术后随访时，对照组管腔直径减小1.04±0.57毫米，服用普罗布考的患者减小0.88±0.82毫米，服用西洛他唑的患者减小0.61±0.59毫米（与对照组相比，p<0.05），联合治疗组减小0.40±0.52毫米（与对照组相比，p<0.01）。每段血管的再狭窄率，对照组为31.7%，普罗布考组为16.7%，西洛他唑组为12.5%（与对照组相比，p<0.05），联合治疗组为9.5%（与对照组相比，p<0.05）。联合治疗组未观察到死亡、心肌梗死、支架血栓形成或冠状动脉搭桥手术，也未出现任何严重并发症。因此，普罗布考与西洛他唑联合治疗在预防支架置入术后急性并发症和抑制慢性再狭窄方面已被证明是安全有效的。
