Restenosis probucol

Tardif, J., Probucol and multivitamins in the prevention of restenosis after coronary angioplasty, N. Engl. Med., 337,365-372,1997. 

Other drugs that have an impact on serum lipids have also been examined. Probucol pretreatment has been shown to lower the rate of restenosis after balloon angioplasty in clinical trials (88,89). Although its lipid-lowering effect is due to an increase in the fractional catabolic rate of LDL cholesterol (90), its antirestenotic effect is believed to be related to other properties, including inhibition of LDL oxidation, promotion of endothelial regeneration, and anti-inflammatory effects (91). However, probucol is not widely available due to its ability to lower HDL-cholesterol and concerns relating to proarrhythmia. 

Yokoi H, Daida H, Kuwabara Y et al. Effectiveness of an antioxidant in preventing restenosis after percutaneous transluminal coronary angioplasty the Probucol Angioplasty Restenosis Trial. J Am Coll Cardiol 1997 30 855-862. 

Probucol Antioxidant MVT and Probucol Study Group (52) PART (53) CART (54) Low restenosis Low TLR Less neointimal proliferation... 

Daida H, Kuwabara Y, Yokoi H, et al. Effect of probucol on repeat revascularization rate after percutaneous transluminal coronary angioplasty (from the Probucol Angioplasty Restenosis Trial [PART]). Am J Cardiol 2000 86 550-552. 

Inflammatory response after stent implantation plays an important role in the cascade of neointimal formation. A positive correlation between inflammatory reaction and restenosis has been observed (16). Perivasculitis caused by stent deployment also participates in the neointimal formation (17). Corticosteroids, as an anti-inflammatory agent, have been evaluated. Methylprednisolone (MP)-loaded stents with different doses showed a positive dose-related effect on neointimal hyperplasia (18). Furthermore, MP-coated stents showed decreased macrophages at the stented sites (19). In clinic, dexamethasone-coated stents showed an inhibitive effect on neointimal hyperplasia in selected patients (20), although no beneficial effect was observed in a randomized trial compared to bare stents (21). For other type of drugs with anti-inflammatory characteristics, such as ibuprofen, colchicine, aton/astatin, and probucol, no favorable effects on neointimal hyperplasia were observed (18,22,23). 

Kim W, Jeong MH, Cha KS, et al. Effect of anti-oxidant (carvedilol and probucol) loaded stents in a porcine coronary restenosis model. CircJ 2005 69(1) 101-106. 

Schneider, J.E., Berk, B.C., Gravanis, M.B., Santoian, E.C., Cipolla, G.D., Tarazona, N., Lassegue, B., and King, S.B. (1993) Probucol Decreases Neointimal Formation in a Swine Model of Coronary Artery Balloon Injury. A Possible Role for Antioxidants in Restenosis, Circulation 88,628-637. 

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