Objectives: 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) enhances the inhibitory effects of angiotensin-receptor blocker (ARB) on vascular neointimal formation in mice. The present case-control study investigated the efficacy of combined treatment with statin and ARB for preventing restenosis in patients with coronary artery disease.
Methods: We examined 210 patients with angina pectoris undergoing elective coronary stenting for de novo lesions of native coronary arteries. All enrolled patients received aspirin and ticlopidine. The subjects included patients who received no statin (control group, n = 137) or started statin treatment (statin group, n = 73) with or without ARB treatment after stenting.
Results: The rate of restenosis at 6 months after stent implantation in the statin group (19%) was significantly lower than that in the control group (32%). The restenosis rate in self-expanding Radius stents. (23%) was significantly lower than that in balloon-expandable Velocity stents (42%) independent of statin treatment. Patients treated with statins and ARBs were least likely [odds ratio (95% confidence interval): 0.30 (0.12-0.74)] to develop coronary restenosis, as assessed by multiple logistic regression analysis.
Conclusions: These findings indicate that combined treatment with statin and ARB after stenting is a useful strategy for the prevention of coronary restenosis.