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The effect of lovastatin on early restenosis
Y Beigel1, N Zafrir, Y Teplitzky
1Department of Medicine, Beilinson Medical Center, Petah Tiqva, Israel.
Insights
Lovastatin before percutaneous coronary angioplasty (PTCA) did not reduce early restenosis in hypercholesterolemic men. This study found no benefit of pre-procedural cholesterol-lowering therapy on restenosis rates.
Area of Science:
- Cardiology
- Pharmacology
- Medical Research
Background:
- Hypercholesterolemia is a risk factor for cardiovascular disease.
- Percutaneous coronary angioplasty (PTCA) is a common procedure to treat coronary artery disease.
- Restenosis, the re-narrowing of an artery after PTCA, remains a clinical challenge.
Purpose of the Study:
- To investigate the effect of lovastatin administered before PTCA on early restenosis.
- To evaluate if pre-procedural hypocholesterolemic therapy impacts restenosis rates in hypercholesterolemic patients.
Main Methods:
- A prospective, double-blind, placebo-controlled trial involving 34 men with mild to moderate hypercholesterolemia.
- Patients received either lovastatin (20 mg/day) or placebo starting 10-21 days before their first PTCA.
- Restenosis was assessed by coronary angiography and thallium-201 scans at 6 months post-PTCA.
Main Results:
- The lovastatin group achieved significant hypocholesterolemic changes.
- No significant reduction in early restenosis rates was observed in the lovastatin group compared to placebo.
- The primary endpoints for restenosis were not met more frequently in the placebo group.
Conclusions:
- Pre-procedural effective hypocholesterolemic therapy with lovastatin does not reduce the early restenosis rate in men with mild to moderate hypercholesterolemia.
- The findings suggest that cholesterol-lowering therapy initiated shortly before PTCA may not be beneficial for preventing early restenosis in this patient population.
- Further research may be needed to explore the role of statins or other interventions at different time points or in different patient subgroups.
Abstract:
The effect of lovastatin given before percutaneous coronary angioplasty (PTCA) on early restenosis was investigated in men with mild to moderate hypercholesterolemia. Thirty-four hypercholesterolemic patients (serum LDL cholesterol 130-200 mg/dL) undergoing their first PTCA completed a 6-month prospective, double-blind, placebo-controlled trial. Eighteen received lovastatin 20 mg/day (Lo group) and 16 placebo (P1 group), beginning 10 to 21 days before PTCA. All underwent a thallium-201 quantitative exercise test 5 to 7 days after PTCA. Endpoints for restenosis were either 50% narrowing of the dilated artery on coronary angiography, performed in symptomatic patients or, in asymptomatic patients, the appearance of newly developed reversible filling defects in the vascular territory of the dilated artery on a second thallium scan done 6 months after PTCA. The hypocholesterolemic change observed in the Lo group was not accompanied by a reduction in early restenosis risk. The authors conclude that effective hypocholesterolemic therapy before PTCA does not affect early restenosis rate in men with mild to moderate hypercholesterolemia.