Beneficial Effects of Valsartan on Target Lesion Revascularization After Percutaneous Coronary Interventions With Bare-Metal Stents

Abstract

he growing use of coronary stents has improved the results of percutaneous coronary intervention (PCI) over the last decade. 1 However, in-stent restenosis continues to limit the long-term success of this procedure. 2 Drug-eluting stents (DES) coated with strong antiproliferative agents such as sirolimus or paclitaxel have dramatically reduced the need for repeat revascularization procedures due to reduction in restenosis rates after PCI. [3][4][5][6] Notwithstanding this tremendous progression in antirestenotic therapies, with the use of DES, target lesion revascularization (TLR) remains necessary in approximately 12% of patients at 2 years after PCI. 7 Moreover, there is increasing concern about the safety of DES, in light of reports that they are associated with a slightly increased rate of late stent thrombosis and possibly increased rates of myocardial infarction (MI) and death after PCI. 8 Although the efficacy of DES lies in reducing restenosis-related TLR, lesions at low risk of restenosis might still be considered suitable for bare-metal stents (BMS) in the contemporary DES era. 9 Previous studies have shown the benefits of angiotensin converting enzyme (ACE) inhibitors in patients with coronary artery disease. 10,11 In contrast, the effects of angiotensin II receptor blockers (ARBs) with coronary artery disease remain to be determined. While 2 open-label studies suggested beneficial effects of ARBs on neointimal proliferation at 6 months, 12,13 a smaller randomized open-label study did not show a reduction in neointimal proliferation for ARB-related patients after coronary stent implantation at 6 months. Background: Angiotensin II receptor blockers (ARB) have been shown to reduce cardiovascular events in patients at risk. The effect of valsartan on outcomes after percutaneous coronary interventions (PCI) with bare-metal stents (BMS) was investigated.

Balloon expandable coronary stent materials: a systematic review focused on clinical success

“…In the application of stents for clinical use, the in-stent restenosis (ISR) still exists as a major limitation for wide usage and the development of anti-restenosis for stents is highly demanding in the cardiovascular research area. In recent years, it was found that after implantation of a BMS, the utilization of the probucol and valsartan oral drugs may show the effective in minimization of ISR rate [148,149].…”