ティクロピジンとクロピドグレルのランダム化比較は,広範囲の患者集団で冠内ステントを埋め込んだ後に実施された
M Taniuchi1, H I Kurz, J M Lasala
1Department of Medicine, Washington University School of Medicine, Barnes-Jewish Hospital, St Louis, MO 63110, USA. mtaniuch@imgate.wustl.edu
Circulation
|August 2, 2001
まとめ
クロピドグレルとティクロピディンは,冠動脈ステント移植後のステント血栓症の予防に類似した有効性を示した. クロピドグレルは,ティクロピジンよりも2週間にわたってよく耐えました.
科学分野:
- 心血管医学 心血管医学
- 薬理学 薬理学とは
- 介入性心臓病学 介入性心臓病学
背景:
- 亜急性ステント血栓症は,冠内ステントインプランテーション後のリスクです.
- クロピドグレルは予防のために使用されていますが,米国でのティクロピジンとの直接的なランダム化比較は欠けていました.
研究 の 目的:
- 亜急性ステント血栓症の予防におけるクロピドグレルとティクロピディンの安全性と有効性を比較する.
- 冠動脈内ステントを投与している患者の主要な不良心疾患を評価する.
主な方法:
- ランダム化試験で,冠動脈内ステントの成功移植を受けた患者1016人が参加した.
- 患者は,処置後2週間,チクロピジンまたはクロピドグレルを投与された.
- 収集されたデータには,治療完了率,ステント血栓症,および30日以内の主要な心疾患の有害事象が含まれています.
主要な成果:
- クロピドグレル (98.38%) の治療完了率は,ティクロピジン (96.36%) (P=0.043) と比較して高かった.
- ステント栓塞は,クロピドグレル群の2.02%,ティクロピジン群の1.92%で発生した (P=0.901).
- 主要な心疾患の有害事象は類似しており,クロピドグレルの3.85%,ティクロピディンの4.60% (P=0.551) であった.
結論:
- クロピドグレルは,ステント移植後の2週間のレジメンでチクロピジンよりもよく耐えます.
- 両剤とも,グリコプロテインIIb/IIIa阻害剤と併用すると安全性が実証されました.
- クロピドグレルは,亜急性ステント血栓症およびチクロピジンと同じような重大な不良心事に対して,比較可能な保護を提供します.
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