[Reduction in the rates of restenosis after coronary angioplasty with simvastatin and probucol].
OBJECTIVE
The restenosis rates after coronary angioplasty persist as an important problem even though multiple drug therapies and different devices have been tried. The reduction of the cholesterol and low density lipoproteins levels (and their oxidation) have proved to have a beneficial effect on atherosclerosis evolution. Both the lipid lowering and antioxidant agents have caused a reduction in the neointimal formation generated with the angioplasty balloon in animals, and their combination to improve endothelial dysfunction in humans. The aim of the present study is to prove whether the whole administration of two potent agents such as simvastatin and probucol, which reduce the lipid levels and their oxidation, are able to lessen the restenosis related process.


METHODS
Thirty five consecutive patients with coronary angioplasty with no stent to whom 20 mg simvastatin and 500 mg probucol bid were given (group-A) were studied in a prospective non-randomized study. They were compared to a historic group of 40 patients under the standard treatment (group-B). Both groups were angiographically evaluated to determine the restenosis percentage. A lipid profile was performed on group-A patients.


RESULTS
The restenosis occurred in 4 (11.4%) in group-A and in 17 (42.5%) in group-B patients and in 4 (10.0%) and 18 (39.1%) lesions respectively (p < 0.01). A new PTCA was performed on 2 (5.7%) group-A patients vs 13 (32.5%) in group-B (p < 0.01). There was a reduction in residual stenosis (34.2 +/- 19.7% vs 48.8 +/- 23.5%, p < 0.01) and a greater minimum luminal diameter (1.76 +/- 0.59 vs 1.46 +/- 0.70 mm, p < 0.05) in group-A than in group-B patients.


CONCLUSIONS
Although studies with more patients are required, a combined lipid lowering and antioxidant therapy could achieve a reduction in angioplasty coronary restenosis.
Merchán Herrera
A
A
Servicio de Cardiología, Hospital Regional Universitario Infanta Cristina, Badajoz. merchanh@jet.es
López Mínguez
J R
JR
Alonso Ruiz
F
F
Escola
J M
JM
Címbora Ortega
A
A
Poblador Curto
M A
MA
Redondo Méndez
A
A
Romero Santisteban
R
R
Geniz Gallardo
I
I
González Fernández
R
R
Millán Núñez
V
V
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011341:Probucol / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D019821:Simvastatin / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D002784:Cholesterol; D019821:Simvastatin; D011341:Probucol