Interventional Cardiology and Angiology

• The rationale of Mercator or Marcator was that ACE inhibitors are thought to preserve endothelial integrity and to prevent lipid accumulation as well as to inhibit cellular growth and proliferation of SMC (Powell et al.).
• Both studies showed that low dose or even high dose ACE inhibition with cilazapril did not prevent restenosis.
• Reasons for the lack of effect: Dose relation?, time relation?, alternative pathways of angiotensin II?, many other factors!
• QUIET: The trial will evaluate the ability of quinapril to reduce the rate of cardiac ischemic event and to slow or prevent the development of coronary artery disease assessed by QCA.
• Trapidil: The results of three human trials showed that trapidil is capable to reduce restenosis after PTCA by 40%-53%.
• Although there is a beneficial effect on restenosis, trapidil has not received more attention!
• Probucol: The antioxidant probucol is effective in reducing the rate of restenosis by 20% after balloon coronary angioplasty.