Clinical trials of primary and secondary prevention of thrombosis and restenosis.
In the primary prevention of arterial disease, there may be a role for anti-oxidant vitamins and for oestrogen replacement therapy in postmenopausal women. For the secondary prevention of thrombotic complications of atherosclerosis, aspirin has proven efficacious in reducing both mortality and morbidity. Patients with ischaemic heart disease and moderately elevated serum cholesterol benefit from simvastatin administration. Heparin and oral anticoagulants are the mainstay in the primary and secondary prevention of venous thrombosis. More potent antithrombotic compounds, the direct thrombin inhibitors and the glycoprotein IIb-IIIa antagonists, are mainly being evaluated in emergency coronary medicine. Preliminary results are encouraging but haemorrhagic problems need to be solved. The trend toward a decrease in late restenosis following coronary angioplasty using a IIb-IIIa antagonizing Fab fragment may prove to be a major therapeutic breakthrough.
Vermylen
J
J
Center for Molecular and Vascular Biology, University of Leuven, Belgium.
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D000991:Antithrombins / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000150:complications; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D004730:Endothelium, Vascular / Q000187:drug effects; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008077:Lipoproteins, LDL / Q000378:metabolism; D008297:Male; D010084:Oxidation-Reduction; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D014815:Vitamins / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D000975:Antioxidants; D000991:Antithrombins; D004967:Estrogens; D000960:Hypolipidemic Agents; D007140:Immunoglobulin Fab Fragments; D008077:Lipoproteins, LDL; D010975:Platelet Aggregation Inhibitors; D014815:Vitamins; D000077284:Abciximab