塞对预防心血管事件的影响在血管恰当牵拉:前瞻性随机、开放、blinded-endpoints审判。

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Ong KT,隐藏的J,德支持者J, Bozec E, Collignon P,艾默里奇J, Fauret, Fiessinger约,日尔曼DP, Georgesco G,洛JS, De Paepe, Plauchu H, Jeunemaitre X, Laurent年代,Boutouyrie P

塞对预防心血管事件的影响在血管恰当牵拉:前瞻性随机、开放、blinded-endpoints审判。

柳叶刀》。2010年10月30日,376 (9751):1476 - 84。doi: 10.1016 / s0140 - 6736 (10) 60960 - 9。Epub 2010年9月7日。

PubMed ID

20825986 (在PubMed

]

文摘

背景:血管恰当牵拉是一种罕见的严重的疾病,它导致动脉解剖和破裂会导致过早死亡。预防治疗尚未验证。我们的目的是评估的能力塞,β(1)与β肾上腺素能受体拮抗剂(2)肾上腺素能受体激动剂作用,防止动脉解剖和血管恰当牵拉的破裂。方法:我们的研究是一个多中心、随机、开放试验盲法评估的临床事件在法国和比利时八中心。临床血管恰当牵拉患者被随机分配到5年的塞治疗或不治疗。随机从集中完成,先前建立的密封信封与分层患者的年龄(32岁)。33例患者正突变的胶原蛋白3 a1 (COL3A1)。塞是uptitrated每6个月的步骤最多100毫克到400毫克每日两次。主要终点是动脉事件(破裂或解剖,致命的)。这项研究是在ClinicalTrials.gov注册,NCT00190411数量。 FINDINGS: 53 patients were randomly assigned to celiprolol (25 patients) or control groups (28). Mean duration of follow-up was 47 (SD 5) months, with the trial stopped early for treatment benefit. The primary endpoints were reached by five (20%) in the celiprolol group and by 14 (50%) controls (hazard ratio [HR] 0.36; 95% CI 0.15-0.88; p=0.040). Adverse events were severe fatigue in one patient after starting 100 mg celiprolol and mild fatigue in two patients related to dose uptitration. INTERPRETATION: We suggest that celiprolol might be the treatment of choice for physicians aiming to prevent major complications in patients with vascular Ehlers-Danlos syndrome. Whether patients with similar clinical presentations and no mutation are also protected remains to be established. FUNDING: French Ministry of Health, Programme Hospitalier de Recherche Clinique 2001.

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塞