The effects of lovastatin on neointimal hyperplasia following injury in a porcine coronary artery model.
OBJECTIVE
To assess the effectiveness of lovastatin, an HMGCoA reductase inhibitor, in the inhibition of coronary arterial restenosis post-balloon angioplasty.


METHODS
Randomized single-blind study comparing the degree of restenosis in a control and lovastatin group of animals with similar degree of arterial injury.


METHODS
Seventeen domestic cross-bred pigs received either oral lovastatin (11 animals) or no lovastatin (six animals).


METHODS
The pigs received 20 mg of oral lovastatin twice daily or no drug. All pigs received acetylsalicylic acid and verapamil preprocedure. One or more coronary arteries were injured by deployment of tantalum wire stents delivered on oversized percutaneous transluminal coronary angioplasty balloons. The balloons were intentionally overexpanded to create arterial injury. The animals were sacrificed at 28 days. The arteries were cross-sectioned and evaluated blindly by quantitative histomorphometry. The amounts of arterial injury and neointimal thickening were quantitated. A series of linear regression models was used to control for the degree of injury.


RESULTS
The reduction of neointimal thickness for the lovastatin group compared with the control animals was 0.08 mm, a statistically significant result (P < 0.05).


CONCLUSIONS
Although lovastatin produced a statistically significant decrease in neointimal thickness post-balloon angioplasty, when extrapolated to angiographical end-points, the differences would not be clinically significant. These data suggest that lovastatin may be of marginal use in humans for limiting restenosis.
Veinot
J P
JP
Section of Medical Pathology, Mayo Graduate School of Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA jpveinot@ottowa.on.ca
Edwards
W D
WD
Camrud
A R
AR
Jorgenson
M A
MA
Holmes
D R
DR
Schwartz
R S
RS
D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D003327:Coronary Disease / Q000188:drug therapy* / Q000473:pathology; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006965:Hyperplasia; D016014:Linear Models; D008148:Lovastatin / Q000627:therapeutic use*; D011897:Random Allocation; D012008:Recurrence; D016037:Single-Blind Method; D013552:Swine; D017539:Tunica Intima / Q000293:injuries / Q000473:pathology
D004791:Enzyme Inhibitors; D008148:Lovastatin