Calcium-antagonists in preventing restenosis following coronary angioplasty.
In experimental studies the growth factor dependent proliferation and migration of medical smooth muscle cells was found to be inhibited by calcium-antagonists. Since this process seems to play an important role in the pathogenesis of recurrent stenosis, clinical trials were performed to evaluate the influence of calcium-channel blockers on restenosis rate after initially successful coronary angioplasty. However, according to the first 3 completed studies the restenosis rate was not decreased significantly either by the treatment with nifedipine or by the treatment with different dosages of diltiazem. The influence of high-dose verapamil treatment (Isoptin RR, 240 mg verapamil, twice daily) on the recurrence of coronary obstruction has been investigated by a recently completed prospective double-blind, placebo-controlled trial (VAS) which included 196 consecutive patients with at least one risk factor for restenosis. Patients with stable angina pectoris (n 75) and patients with unstable angina/non Q-wave infarction (n 97) were randomized separately. Follow-up angiography within 6 months after the procedure was performed in 88% of the recruited patients. Another 22 patients (11%) stopped the study medication before control angiography. At present, detailed data of the intention-to-treat analysis and the as-treated analysis of the results of VAS were submitted for publication.
Hoberg
E
E
Abteilung Kardiologie, Angiologie und Pulmologie, Universität Heidelberg, Germany.
Kübler
W
W
D015906:Angioplasty, Balloon, Coronary; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000517:prevention & control* / Q000628:therapy; D004110:Diltiazem / Q000627:therapeutic use; D006801:Humans; D009543:Nifedipine / Q000627:therapeutic use; D012008:Recurrence; D014700:Verapamil / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D014700:Verapamil; D004110:Diltiazem; D009543:Nifedipine