Krämer Jochen, Ruf Rainer G, Schmidt Sibylle, Axthelm Christoph, Strasser Ruth, Janssen Gerhard, Thieme Torsten, Kusch Angelika, Waigand Jürgen, Dietz Rainer, Gross C Michael
Franz-Volhard-Klinik, Dept. for Molecular and Clinical Cardiology, HELIOS Klinikum Berlin, Charité, CBB, Wiltbergstrasse 50, 13125 Berlin, Germany.
J Invasive Cardiol. 2008 May;20(5):205-10.
Angiotensin II (Ang II) is implicated in the development of in-stent restenosis (ISR). Ang II- and AT1-receptor blockade could possibly reduce ISR. We enrolled 206 patients into a prospective double-blind, placebo-controlled, multicenter randomized trial of candesartan cilexitil 16 mg to test this notion. Mean lumen diameter (MLD) was the primary objective measured by quantitative coronary angiography and intravascular ultrasound. The Candesartan Group showed a trend towards a larger MLD at follow up without significant differences in the binary ISR rate. In vessels < 2.75 mm, we found a larger MLD in the treatment group after 6 months. This might indicate the potential benefit of AT1-receptor blocker therapy for certain subgroups when percutaneous coronary intervention is performed with bare-metal stent implantation.
血管紧张素II（Ang II）与支架内再狭窄（ISR）的发生有关。阻断Ang II和AT1受体可能会降低ISR。我们纳入了206例患者，进行一项前瞻性双盲、安慰剂对照、多中心随机试验，使用坎地沙坦西酯16 mg来验证这一观点。平均管腔直径（MLD）是通过定量冠状动脉造影和血管内超声测量的主要指标。坎地沙坦组在随访时MLD有增大趋势，但在二元ISR率方面无显著差异。在直径<2.75 mm的血管中，我们发现治疗组在6个月后MLD更大。这可能表明，在进行裸金属支架植入的经皮冠状动脉介入治疗时，AT1受体阻滞剂治疗对某些亚组可能有益。
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