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Updated: Aug 8, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Comparison between a sustained administration of carvedilol versus atenolol to reduce restenosis after coronary
Kwang Soo Cha1, Moo Hyun Kim, Jin Woo Kim
1Department of Cardiology, Dong-A University Hospital, Busan, South Korea. kwangsoo@damc.or.kr
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.
Insights
Oral carvedilol did not reduce restenosis after coronary stenting in patients. Further studies on stent-based delivery may be needed to achieve higher local concentrations for effective neointimal inhibition.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Carvedilol inhibits vascular smooth muscle cell migration and proliferation.
- Preclinical studies showed carvedilol suppressed neointimal hyperplasia in a rat model.
- No data existed on carvedilol's effect on in-stent restenosis in humans.
Purpose of the Study:
- To evaluate the efficacy of sustained oral carvedilol administration in reducing restenosis after coronary stenting.
- To compare carvedilol with atenolol for preventing in-stent restenosis.
Main Methods:
- 159 patients were randomized to receive carvedilol (50 mg/d) or atenolol (50 mg/d) before stenting for 3 months.
- The primary endpoint was angiographic restenosis, defined as >50% diameter stenosis at follow-up.
- Angiographic follow-up was performed in 86% of patients.
Main Results:
- Baseline characteristics were similar between groups.
- Carvedilol was generally well-tolerated, with dose reduction in 3 patients.
- The restenosis rate was not significantly different between the carvedilol (17.1%) and atenolol (19.4%) groups (P=.732).
Conclusions:
- Sustained oral carvedilol is ineffective in reducing restenosis after coronary stenting.
- Further research into stent-based delivery of carvedilol may be warranted to achieve higher local concentrations.
- Carvedilol's potential for neointimal inhibition warrants investigation with localized delivery methods.
