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European Heart Journal 1989 10(Supplement G):64-68; doi:10.1093/eurheartj/10.suppl_G.64
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Prevention of restenosis after coronary angioplasty: A pharmacological approach

B. Meier

Cardiology Centre, University Hospital Geneva, Switzerland

Address for correspondence: PD Dr B. Meier, Centre de Cardiologie, Hôpital Cantonal Universitaire, CH-1211 Genève 4, Switzerland

Evaluations of drugs for the prevention of resrenosis after human coronary angioplasty have been disappointing. Heparin failed to reduce resrenosis in a randomized study in Atlanta, Georgia, in patients maintained on heparin for 24 h. A randomized study in the same centre compared acetylsalicylic acid to anricoagulation with coumadin. Restenosis was slightly but nor significantly less frequent in patients on acelylsalicylic acid. An American multicentre randomized study comparing a combination of acetylsalicylic acid and dipyridamole to ticlopidine and to placebo revealed no difference in tertns of incidence of restenosis. Dipyridamole alone shows no effect against acute or late coronary artery resrenosis. Two calcium antagonists (diltiazem and nifedipine) did not significantly diminish restenosis in randomized trials. Neither did a thromboxane A inhibitor. Only eicosapentaenoic acid (EPA), an n-3fatty acid, significantly reduced reslenosis in a randomized study using a high dose. But the same compound proved ineffective in a similar study using a somewhat lower dose. Despite scientific evidence for the inefficacy of virtually all tested compounds, I do not know of a single institution that does not continue to discharge its patients after coronary angioplasty on one or several of them.

Key Words: Coronary artery disease • coronary vasomotion, percutaneous transluminal coronary angioplasty • supine bicycle exercise


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