title: Renin-angiotensin system intervention to prevent in-stent restenosis: an unclosed chapter.
abstract: The occurrence of in-stent restenosis is a major drawback of percutaneous transluminal coronary angioplasty with stent placement. Target vessel revascularization is necessary in 15% of patients who receive a stent. Recent advances in the development of drug-eluting stents have reduced these numbers tremendously. However refinement of antirestenotic therapies remains obligatory. The emerging interest in more physiological antirestenotic therapies might unchain an interest in the well-known inhibitors of the rennin-angiotensin system (RAS), the angiotensin-converting enzyme inhibitors, and the angiotensin II type I receptor blockers. Contradictory results overshadow the discussion of whether intervention in the RAS could prevent in-stent restenosis. This review discusses the pathophysiology of in-stent restenosis, the role of the RAS in in-stent restenosis, and the possible role of RAS intervention in the prevention of in-stent restenosis.
authors.affiliation: Department of Clinical Pharmacology, University Hospital Groningen, Groningen, the Netherlands. be.langeveld@med.rug.nl
authors.forename: Bas
authors.initials: B
authors.lastname: Langeveld
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: Roks
authors.forename: Rene A
authors.initials: RA
authors.lastname: Tio
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: Voors
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D002986:Clinical Trials as Topic; D023903:Coronary Restenosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology; D015607:Stents / Q000009:adverse effects*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors