－S 209 －
― F-173 ―
The Clinical Effects of Cilostazol on Two-Year Clinical Outcomes in Diabetic Patients Who Underwent Drug Eluting Stent Implantation
전남대학교병원 심장센터, 전남대학교 심혈관질환 치료재생 특성화사업단, 과학기술부 제대혈 및 중간엽줄기세포 기능연구사업단
*정해창, 안영근, 오미숙, 강원유, 고점석, 김수현, 이민구, 이신은, 박근호, 심두선, 윤현주, 윤남식, 홍영준, 박형욱, 김주한, 정명호, 조정관, 박종춘, 강정채,
Background: The effect of cilostazol on long-term clinical outcomes in diabetic patients who underwent drug-eluting stent (DES) implantation was not evaluated. Method: A total of 109 patients were randomized. The patients who underwent successful stenting were randomized to aspirin (100~200 mg qd) and cilostazol (100 mg bid) (group I, n= 53, mean 64.1±9.7 years old, 27 males) vs. aspirin and clopidogrel (75 mg qd) (group II, n=56, mean 62.6±10.3 years old, 27 males) after one month of aspirin, cilostazol, and clopidogrel combination treatment and treated for one-year. The primary endpoints were the incidence of in stent restenosis (ISR) at follow up coronary angiogram and major adverse cardiac event (MACE) at two year clinical follow-up. Result: Baseline patient characteristics were not different between the two groups. The types of DES implanted were not different between the groups (8 Cypher and 45 Taxus in group I vs. 11 Cypher and 45 Taxus in group II, p=0.532). There were no differences in angiographic and procedural characteristics between the groups. MACE including acute and subacute stent thrombosis within one month were not developed in both groups. According to the follow-up coronary angiogram, in-stent restenosis (stent plus 5-mm borders) was (n=6, 11.3%) in group I and (n=19, 33.9%) in group II, (p=0.005). The incidence of target lesion revascularization in group I was 6 (11.3%) and that in group II was 17 (30.4%) (p=0.015). Incidence of target vessel revascularization in group I was 5 (9.4%) and that in group II was 4 (7.1%) (p=0.664). The incidence of de novo lesion at any vessel was in group I was 5 (9.4%) and that in group II was 3 (5.4%) (p=0.415). At two-year clinical follow-up, the incidence of cardiac death and Q-wave myocardial infarction were not observed both group. The serious side effects were not observed in both groups, too. Conclusion: Our results demonstrated that the effects of combination therapy with aspirin and cilostazol for the prevention of acute and subacute stent thrombosis, in-stent restenosis and two year cardiac death and Q-wave myocardial infarction were comparable to those of aspirin and clopidogrel.
― F-174 ―
약물 용출성 스텐트 삽입 후 미세단백뇨 유무에 따른 추적 관상동맥조영술의 결과 비교
인제대학교 부산백병원 내과학교실 심장내과
*김기훈, 양태현, 노은지, 박영진, 한양천, 설상훈, 김성만, 김대경, 김두일, 김동수
Background/Aims: Microalbuminuria is one of the cardiovascular risk factors and surrogate marker of endothelial dysfunction. The aim of this study is to clarify whether microalbuminuria is risk factor of adverse cardiac events after drug-eluting stent (DES) implantation or not.
Methods: 63 patients with 85 coronary artery lesions, who underwent DES implantation and follow up coronary angiography, between April 2007 and July 2008, were targeted. They were divided into microalbuminuria (MG) (n=27, 37 lesions) and no-microalbuminuria group (NG) (n=36, 48 lesions). Microalbuminuria was defined by albumin/creatinine ratio (ACR) within 30-300mg/g, no-microalbuminuria was under ACR 30mg/g, but overt albuminuria (ACR >300mg/g) was excluded. Results: The clinical and angiographic characteristics were similar between the two groups and procedural characteristics were similar, too. Mean angiographic follow up period was 299±71 (MG) and 302±83 days (NG).
The late loss was 0.17±0.52 (MG) and 0.05±0.55 mm (NG) (p=0.320). The rate of in stent restenosis (ISR) was 5/37 (13.51%) (MG) and 1/48 (2.08%) (NG) (p=0.081) and target vessel revascularization (TVR) was 5/37 (13.51%) (MG) and 1/48 (2.08%) (NG) (p=0.081), respectively. Conclusion: Late loss was not statistically different between the two groups. ISR and TVR were tended to be higher in MG.
If we have more objectives, then we may conclude microalbuminuria is possible risk factor of ISR or TLR. So further investigation is needed.
