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Effects of Statins on Restenosis After Coronary Stent Implantation

Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Kamishirado Heart Clinic, Ichikawa, Japan, kamishirado{at}icnet.ne.jp

Teruo Inoue, MD, FACC

Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Kamishirado Heart Clinic, Ichikawa, Japan

Masashi Sakuma, MD

Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA, Kamishirado Heart Clinic, Ichikawa, Japan

Tatsuhiro Tsuda, MD

Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Kamishirado Heart Clinic, Ichikawa, Japan

Terumi Hayashi, MD

Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Kamishirado Heart Clinic, Ichikawa, Japan

Kan Takayanagi, MD, FACC

Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Kamishirado Heart Clinic, Ichikawa, Japan

Koichi Node, MD

Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, Saga, Kamishirado Heart Clinic, Ichikawa, Japan

Experimental data and preliminary clinical studies suggest that lipid-lowering drugs might have a beneficial effect on restenosis after coronary angioplasty. Recently, statins have been focused on prevention of restenosis after coronary stent implantation. However, their benefit has not yet been established. The authors studied the effects of statins on stent restenosis. We compared retrospectively the quantitative coronary angiographic (QCA) variables between 62 dyslipidemic patients treated with statins (pravastatin or fluvastatin) and 62 normolipidemic patients, as a control, treated without statins after undergoing successful coronary stent implantation with 6-month follow-up angiography from May 1999 to December 2002. Major cardiac events were about the same in both groups. Each of the QCA variables before and immediately after coronary stenting was similar in the 2 groups. At follow-up angiography, however, minimal lumen diameter (MLD) (2.12 0.73 vs 1.78 0.7; p<0.01) was larger in the statin group than in the normolipidemia group. Both restenosis rate (15% vs 31%; p=0.05) and target lesion revascularization rate (10% vs 24%; p=0.05) were lower in the statin group than in the normolipidemia group. Statin reduced restenosis rate. The efficacy of statins appears to be dependent on their pleiotropic effects on vascular wall rather than on lipid-lowering effects.

Angiology, Vol. 58, No. 1, 55-60 (2007)
DOI: 10.1177/0003319706295223


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