Abstract
Restenosis has been recognized as the main limitation of coronary balloon angioplasty since its introduction in 1978. The main causes were the constrictive vessel remodeling (acute and chronic) and the neointimal hyperplasia. The coronary stents were introduced in 1986 and reduced restenosis from 30–40% to 15–20% in certain type of lesions by eliminating the vessel remodeling. The advent of drug-eluting stents in 2000 reduced restenosis even further to single digit numbers (5–8%), by eliminating the formation of neointimal hyperplasia. Despite these significant improvements restenosis has not been eradicated, whereas the long-term outcome after drug-eluting stent implantation with potential delayed restenosis, remains unknown. Furthermore, the reported randomized drug-eluting stent trials investigated mainly patients with selected simple lesions and the outcome in more complex patients with bifurcations, long lesions, in small vessels or in diabetics still remains largely unknown. In this chapter, the use of systemic drug therapy to prevent restenosis after coronary balloon angioplasty, or after coronary stent implantation will be reviewed.
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References
Chan AW, Moliterno DJ. Restenosis: the clinical issues. In: Topol, ed. Textbook of Interventional Cardiology. WB Saunders, Philadelphia, PA, 2003, pp. 415–454.
Carew TE, Schwenke DC, Steinberg D. Antiatherogenic effect of probucol unrelated to its hypocholesterolemic effect: evidence that antioxidants in vivo can selectively inhibit low density lipoprotein degradation in macrophage-rich fatty streaks and slow the progression of atherosclerosis in the Watanabe heritable hyperlipidemic rabbit. Proc Natl Acad Sci USA 1987;84:7725–7729.
Tardif JC, Cote G, Lesperance J, et al. Probucol and multivitamins in the prevention of restenosis after coronary angioplasty. Multivitamins and Probucol Study Group. N Engl J Med 1997;337:365–372.
Tardif JC, Gregoire J, Schwartz L, et al. Effects of AGI-1067 and probucol after percutaneous coronary interventions. Circulation 2003;107:552–558.
Schnyder G, Roffi M, Pin R, et al. Decreased rate of coronary restenosis after lowering of plasma homocysteine levels. N Engl J Med 2001;345:1593–1600.
Brara PS, Moussavian M, Grise MA, et al. Pilot trial of oral rapamycin for recalcitrant restenosis. Circulation 2003;107:1722–1724.
Serruys PW, Foley DP, Pieper M, Kleijne JA, de Feyter PJ. The TRAPIST Study. A multicentre randomized placebo controlled clinical trial of trapidil for prevention of restenosis after coronary stenting, measured by 3-D intravascular ultrasound. Eur Heart J 2001;22:1938–1947.
The ERASER Investigators. Acute platelet inhibition with abciximab does not reduce in-stent restenosis (ERASER study). Circulation 1999;100:799–806.
Neumann F, Kastrati A, Miethke T, et al. Treatment of Chlamydia pneumoniae infection with roxithromycin and effect on neointima proliferation after coronary stent placement (ISAR-3): a randomised, double-blind, placebo-controlled trial. Lancet 2001;357:2085–2089.
Kiesz RS, Buszman P, Martin JL, et al. Local delivery of enoxaparin to decrease restenosis after stenting: results of initial multicenter trial: Polish-American Local Lovenox NIR Assessment study (The POLONIA study). Circulation 2001;103:26–31.
Wilensky RL, Tanguay JF, Ito S, et al. Heparin infusion prior to stenting (HIPS) trial: final results of a prospective, randomized, controlled trial evaluating the effects of local vascular delivery on intimal hyperplasia. Am Heart J 2000;139:1061–1070.
Kutryk MJ, Foley DP, van den Brand M, et al. Local intracoronary administration of antisense oligonucleotide against c-myc for the prevention of in-stent restenosis: results of the randomized investigation by the Thoraxcenter of antisense DNA using local delivery and IVUS after coronary stenting (ITALICS) trial. J Am Coll Cardiol 2002;39:281–287.
Versaci F, Gaspardone A, Tomai F, et al. Immunosuppressive Therapy for the Prevention of Restenosis after Coronary Artery Stent Implantation (IMPRESS Study). J Am Coll Cardiol 2002;40:1935–1942.
Cheol Whan Lee MD, Jei-Kun Chae MD, Hee-Young Lim, et al. Prospective randomized trial of corticosteroids for the prevention of restenosis after intracoronary stent implantation. Am Heart J 1999;138:60–63.
Kamishirado H, Inoue T, Mizoguchi K, et al. Randomized comparison of cilostazol versus ticlopidine hydrochloride for antiplatelet therapy after coronary stent implantation for prevention of late restenosis. Am Heart J 2002;144:303–308.
Suzuki T, Hayase M, Hibi K, et al. Effect of local delivery of L-arginine on in-stent restenosis in humans. Am J Cardiol 2002;89:363–367.
Holmes DR, Jr, Savage M, LaBlanche JM, et al. Results of Prevention of Restenosis with Tranilast and its Outcomes (PRESTO) trial. Circulation 2002;106:1243–1250.
Meurice T, Bauters C, Hermant X, et al. Effect of ACE inhibitors on angiographic restenosis after coronary stenting (PARIS): a randomised, double-blind, placebo-controlled trial. Lancet 2001;357(9265):1321–1324.
Neumann FJ, Kastrati A, Schmitt C, et al. Effect of glycoprotein IIb/IIIa receptor blockade with abciximab on clinical and angiographic restenosis rate after the placement of coronary stents following acute myocardial infarction. J Am Coll Cardiol 2000;35:915–921.
Park SW, Lee CW, Kim HS, et al. Effects of cilostazol on angiographic restenosis after coronary stent placement. Am J Cardiol 2000;86:499–503.
Lefkovits J, Plow EF, Topol EJ. Platelet glycoprotein IIb/IIIa receptors in cardiovascular medicine. N Engl J Med 1995;332:1553–1559.
O’Neill WW, Serruys P, Knudtson M, et al. Long-term treatment with a platelet glycoprotein-receptor antagonist after percutaneous coronary revascularization. EXCITE Trial Investigators. Evaluation of Oral Xemilofiban in Controlling Thrombotic Events. N Engl J Med 2000;342:1316–1324.
Tamai H, Katoh O, Suzuki S, et al. Impact of tranilast on restenosis after coronary angioplasty: tranilast restenosis following angioplasty trial (TREAT). Am Heart J 1999;138:968–975.
O’Keefe JH, Jr, Stone GW, McCallister BD, Jr, et al. Lovastatin plus probucol for prevention of restenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol 1996;77:649–652.
Weintraub WS, Boccuzzi SJ, Klein JL, et al. Lack of effect of lovastatin on restenosis after coronary angioplasty. Lovastatin Restenosis Trial Study Group. N Engl J Med 1994;331:1331–1337.
Sahni R, Maniet AR, Voci G, Banka VS. Prevention of restenosis by lovastatin after successful coronary angioplasty. Am Heart J 1991;121:1600–1608.
Bertrand ME, McFadden EP, Fruchart JC, et al. Effect of pravastatin on angiographic restenosis after coronary balloon angioplasty. The PREDICT Trial Investigators. Prevention of Restenosis by Elisor after Transluminal Coronary Angioplasty. J Am Coll Cardiol 1997;30:863–869.
Serruys PW, Foley DP, Jackson G, et al. A randomized placebo-controlled trial of fluvastatin for prevention of restenosis after successful coronary balloon angioplasty; final results of the fluvastatin angiographic restenosis (FLARE) trial. Eur Heart J 1999;20:58–69.
Serruys PW, de Feyter P, Macaya C, et al. Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention: a randomized controlled trial. JAMA 2002;287:3215–3222.
Corpus RA, George PB, House JA, et al. Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II diabetic patients undergoing elective percutaneous coronary intervention. J Am Coll Cardiol 2004;43(1):8–14.
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de Feyter, P.J., Sianos, G. (2007). Pharmacotherapy of Restenosis. In: Duckers, H.J., Nabel, E.G., Serruys, P.W. (eds) Essentials of Restenosis. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-001-0_19
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DOI: https://doi.org/10.1007/978-1-59745-001-0_19
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