Comparison between a sustained administration of carvedilol versus atenolol to reduce restenosis after coronary stenting.
Am Heart J
; 147(2): E7, 2004 Feb.
Article
em En
| MEDLINE
| ID: mdl-14760341
ABSTRACT
BACKGROUND:
Carvedilol is a direct inhibitor of vascular smooth muscle cell migration and proliferation through inhibition of mitogen-activated protein kinase activity and regulation of cell cycle progression. It produced an 84% suppression of neointimal hyperplasia in rat carotid angioplasty model, but no data are available regarding its effect on stent restenosis in patients. We tested whether a sustained oral administration of carvedilol reduces restenosis after coronary stenting in patients.METHODS:
One hundred fifty-nine patients were randomly assigned to receive either carvedilol (50 mg/d, n = 80) or atenolol (50 mg/d, n = 79) at least 1 day before stenting and continued on the same medication over a period of 3 months. The primary end point was angiographic restenosis (>50% diameter stenosis) at follow-up angiography.RESULTS:
Baseline clinical and angiographic variables were similar between the carvedilol and atenolol group. The carvedilol dose was tolerable in most patients but reduced in 3 patients because of hypotension or dizziness. Angiographic follow-up was done in 137 patients (86%), and restenosis rate was not different significantly between both groups (17.1% versus 19.4%, P =.732).CONCLUSIONS:
A sustained oral administration of carvedilol is not effective to reduce restenosis after stenting in patients. With carvedilol targeting regulators of cell cycle progression and having a profound neointimal inhibition with a high blood concentration in an animal study, further investigations with a stent-based delivery to achieve a high local concentration may be warranted.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Propanolaminas
/
Atenolol
/
Carbazóis
/
Stents
/
Antagonistas Adrenérgicos beta
/
Doença das Coronárias
/
Reestenose Coronária
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article