Combined treatment with statin and angiotensin-receptor blocker after stenting as a useful strategy for prevention of coronary restenosis.
OBJECTIVE
3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) enhances the inhibitory effects of angiotensin-receptor blocker (ARB) on vascular neointimal formation in mice. The present case-control study investigated the efficacy of combined treatment with statin and ARB for preventing restenosis in patients with coronary artery disease.


METHODS
We examined 210 patients with angina pectoris undergoing elective coronary stenting for de novo lesions of native coronary arteries. All enrolled patients received aspirin and ticlopidine. The subjects included patients who received no statin (control group, n = 137) or started statin treatment (statin group, n = 73) with or without ARB treatment after stenting.


RESULTS
The rate of restenosis at 6 months after stent implantation in the statin group (19%) was significantly lower than that in the control group (32%). The restenosis rate in self-expanding Radius stents. (23%) was significantly lower than that in balloon-expandable Velocity stents (42%) independent of statin treatment. Patients treated with statins and ARBs were least likely [odds ratio (95% confidence interval): 0.30 (0.12-0.74)] to develop coronary restenosis, as assessed by multiple logistic regression analysis.


CONCLUSIONS
These findings indicate that combined treatment with statin and ARB after stenting is a useful strategy for the prevention of coronary restenosis.
Nishikawa
Hiroaki
H
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka.
Miura
Shin-ichiro
S
Shimomura
Hideki
H
Tsujita
Kenichi
K
Okamura
Keisuke
K
Zhang
Bo
B
Iwata
Atsushi
A
Shirai
Kazuyuki
K
Matsuo
Kunihiro
K
Arai
Hidekazu
H
Saku
Keijiro
K
D000368:Aged; D000787:Angina Pectoris / Q000628:therapy; D057911:Angiotensin Receptor Antagonists; D000818:Animals; D016022:Case-Control Studies; D003327:Coronary Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D051379:Mice; D008875:Middle Aged; D016017:Odds Ratio; D015607:Stents
D057911:Angiotensin Receptor Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors