Effect of amlodipine on vascular responses after coronary stenting compared with an angiotensin-converting enzyme inhibitor.
BACKGROUND
Prevention of restenosis after coronary stenting is clinically important. We compared amlodipine and quinapril to determine which is more effective in preventing restenosis after stenting.


RESULTS
Immediately after successful coronary stenting of 101 lesions in 63 consecutive patients, the patients were randomly divided into 2 groups: 32 patients with 48 lesions were administered amlodipine 5 mg/day (group A), and 31 patients with 53 lesions were administered quinapril 10 mg/day (group Q). Lesions were assessed by quantitative coronary angiography (QCA) before and immediately after stenting and in the follow-up phase. Intravascular ultrasound (IVUS) could only be performed on 20 lesions in group A and 16 lesions in group Q throughout the follow-up period. We analyzed each lesion at 5 sites. In the follow-up phase, the minimal lumen diameter in group A was significantly larger than that in group Q (1.88 +/- 0.64 mm vs 1.52 +/- 0.53 mm, p<0.01). In the follow-up phase, the neointimal area (stent area-lumen area) in group A was significantly smaller than that in group Q (1.9 +/- 0.5 mm2 vs 2.7 +/- 0.8 mm2 at the middle portion of stent, p<0.01).


CONCLUSIONS
These QCA and IVUS findings suggest that amlodipine has beneficial effects in inhibiting neointimal hyperplasia in stented lesions compared with quinapril.
Yamazaki
Tatsuo
T
Division of Cardiology, Jikei University School of Medicine, Tokyo, Japan. t.yama@jikei.ac.jp
Taniguchi
Ikuo
I
Kurusu
Takashi
T
Shimazu
Yoshihisa
Y
Hashizume
Yoshiyuki
Y
Takikawa
Kazutoshi
K
Kuwata
Masao
M
Onodera
Tatsuyuki
T
Yoshikawa
Makoto
M
Mochizuki
Seibu
S
D000368:Aged; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000188:drug therapy / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077583:Quinapril; D015607:Stents; D044005:Tetrahydroisoquinolines / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D018084:Ultrasonography, Interventional; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D044005:Tetrahydroisoquinolines; D014665:Vasodilator Agents; D017311:Amlodipine; D000077583:Quinapril