Low molecular weight heparin in prevention of restenosis after PTCA.
Late restenosis occurring after successful PTCA continues to represent a major problem limiting the clinical efficacy of the procedure. It has been shown that smooth muscle cell proliferation plays a major role in this accelerated atherosclerotic process. In vitro and in vivo experiments with the low molecular weight heparin reviparin showed a pronounced inhibitory effect by this compound on smooth muscle cell proliferation. To evaluate the safety of reviparin and the incidence of angiographic restenosis in humans, a study of increasing dosages was conducted in 41 patients. Repeat coronary angiography was performed 3 months after angioplasty. Restenosis occurred in 5 of 37 evaluable patients with initially successful PTCA. No major bleeding complication was documented for any patient in this first pilot trial. A randomized, double-blind, multicentre trial is being carried out to define the real impact of this compound in reducing restenosis in patients who undergo successful balloon angioplasty.
Preisack
M B
MB
Department of Cardiology, Tübingen University, Germany.
Karsch
K R
KR
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D004247:DNA / Q000096:biosynthesis; D004261:DNA Replication / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004333:Drug Administration Routes; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000166:cytology / Q000187:drug effects; D011817:Rabbits; D012008:Recurrence; D012307:Risk Factors
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; C094240:reviparin; D004247:DNA