title: Effectiveness of an antioxidant in preventing restenosis after percutaneous transluminal coronary angioplasty: the Probucol Angioplasty Restenosis Trial.
abstract: OBJECTIVE
  The Probucol Angioplasty Restenosis Trial was a prospective, randomized, controlled study that investigated the effectiveness of probucol therapy in reducing the rate of restenosis after percutaneous transluminal coronary angioplasty (PTCA).
  
  
  BACKGROUND
  Antioxidants have an inhibitory effect on smooth muscle cell growth in experiments in vitro and in vivo, which suggests a possible pharmacologic effect on restenosis after PTCA.
  
  
  METHODS
  One hundred one patients were randomly assigned to receive 1,000 mg/day of probucol or control (no lipid-lowering) therapy 4 weeks before PTCA. After 4 weeks of premedication, both groups underwent PTCA. Probucol was continued until follow-up angiography 24 weeks after PTCA. Angiographic results were analyzed at a core laboratory by quantitative coronary angiography.
  
  
  RESULTS
  Dilation was successful in 46 of 50 patients in the probucol group and 45 of 51 in the control group. At follow-up angiography 24 weeks after angioplasty, angiographic restenosis occurred in 9 (23%) of 40 patients in the probucol group and 22 (58%) of 38 in the control group (p = 0.001). Minimal lumen diameter was 1.49 +/- 0.75 mm (mean +/- SD) in the probucol group and 1.13 +/- 0.65 mm in the control group (p = 0.02). Percent diameter stenosis at follow-up angiography in the probucol group was significantly lower than that in the control group (43.9% vs. 56.4%, p = 0.009). The late loss was 0.37 +/- 0.69 mm in the probucol group and 0.60 +/- 0.62 mm in the control group (p = 0.13). The loss/gain ratio was 0.32 +/- 0.74 in the probucol group and 0.56 +/- 0.81 in the control group (p = 0.059). Net gain was greater in the probucol group than in the control group (0.77 +/- 0.70 vs. 0.48 +/- 0.59 mm, p = 0.053).
  
  
  CONCLUSIONS
  Probucol administered beginning 4 weeks before PTCA appears to reduce restenosis rates.
authors.affiliation: Department of Cardiology, Juntendo University, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yokoi
authors.forename: H
authors.initials: H
authors.lastname: Daida
authors.forename: Y
authors.initials: Y
authors.lastname: Kuwabara
authors.forename: H
authors.initials: H
authors.lastname: Nishikawa
authors.forename: F
authors.initials: F
authors.lastname: Takatsu
authors.forename: H
authors.initials: H
authors.lastname: Tomihara
authors.forename: Y
authors.initials: Y
authors.lastname: Nakata
authors.forename: Y
authors.initials: Y
authors.lastname: Kutsumi
authors.forename: S
authors.initials: S
authors.lastname: Ohshima
authors.forename: S
authors.initials: S
authors.lastname: Nishiyama
authors.forename: A
authors.initials: A
authors.lastname: Seki
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.forename: S
authors.initials: S
authors.lastname: Nishimura
authors.forename: T
authors.initials: T
authors.lastname: Kanoh
authors.forename: H
authors.initials: H
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011341:Probucol / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D000975:Antioxidants; D002784:Cholesterol; D011341:Probucol