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Circulation. 1992;86:100-110

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Circulation, Vol 86, 100-110, Copyright © 1992 by American Heart Association


ARTICLES

Does the new angiotensin converting enzyme inhibitor cilazapril prevent restenosis after percutaneous transluminal coronary angioplasty? Results of the MERCATOR study: a multicenter, randomized, double-blind placebo-controlled trial. Multicenter European Research Trial with Cilazapril after Angioplasty to Prevent Transluminal Coronary Obstruction and Restenosis (MERCATOR) Study Group


BACKGROUND. Cilazapril is a novel angiotensin converting enzyme inhibitor with antiproliferative effects in the rat model after balloon injury. METHODS AND RESULTS. We conducted a randomized, double-blind placebo-controlled trial to assess the effect of cilazapril in angiographic restenosis prevention after percutaneous transluminal coronary angioplasty (PTCA). Patients received cilazapril 2.5 mg in the evening after successful PTCA and 5 mg b.i.d. for 6 months or matched placebo. In addition, all patients received aspirin for 6 months. Coronary angiograms before PTCA, after PTCA, and at 6-month follow-up were quantitatively analyzed. In 94% of 735 recruited patients, PTCA was successful and all inclusion and exclusion criteria were met. For the per-protocol analysis, quantitative angiography after PTCA and at follow-up was available in 595 patients who complied with the treatment regimen (309 control, 286 cilazapril). The mean difference in minimal coronary lumen diameter between post-PTCA and follow-up angiogram (primary end point) was -0.29 +/- 0.49 mm in the control group and - 0.27 +/- 0.51 mm in the cilazapril group. Clinical events during 6- month follow-up, analyzed on an intention-to-treat basis, were ranked according to the most serious clinical event ranging from death (control, two; cilazapril, three), nonfatal myocardial infarction (control, eight; cilazapril, 5), coronary revascularization (control, 51; cilazapril, 53), or recurrent angina requiring medical therapy (control, 67; cilazapril, 68) to none of the above (control, 224; cilazapril, 212). There were no significant differences in ranking. CONCLUSIONS. Long-term angiotensin converting enzyme inhibition with cilazapril in a dose of 5 mg b.i.d. does not prevent restenosis and does not favorably influence the overall clinical outcome after PTCA.


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HypertensionHome page
M. S. Fernandez-Alfonso, P. A. Martorana, I. Licka, P. van Even, D. Trobisch, B. A. Scholkens, and M. Paul
Early Induction of Angiotensin I–Converting Enzyme in Rat Carotid Artery After Balloon Injury
Hypertension, August 1, 1997; 30(2): 272 - 277.
[Abstract] [Full Text]


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Ann. Thorac. Surg.Home page
T. C. Koutlas, J. W. Gaynor, S. C. Nicolson, J. M. Steven, G. Wernovsky, and T. L. Spray
Modified Ultrafiltration Reduces Postoperative Morbidity After Cavopulmonary Connection
Ann. Thorac. Surg., July 1, 1997; 64(1): 37 - 42.
[Abstract] [Full Text]


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CirculationHome page
C. Amant, C. Bauters, J.-C. Bodart, J.-M. Lablanche, G. Grollier, N. Danchin, M. Hamon, F. Richard, N. Helbecque, E. P. McFadden, et al.
D Allele of the Angiotensin I–Converting Enzyme Is a Major Risk Factor for Restenosis After Coronary Stenting
Circulation, July 1, 1997; 96(1): 56 - 60.
[Abstract] [Full Text]


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CirculationHome page
G. W. Stone, J. M. Hodgson, F. G. St Goar, A. Frey, H. Mudra, H. Sheehan, and T. J. Linnemeier
Improved Procedural Results of Coronary Angioplasty With Intravascular Ultrasound–Guided Balloon Sizing : The CLOUT Pilot Trial
Circulation, April 15, 1997; 95(8): 2044 - 2052.
[Abstract] [Full Text]


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CirculationHome page
V. Verin, P. Urban, Y. Popowski, M. Schwager, P. Nouet, P. A. Dorsaz, P. Chatelain, J. M. Kurtz, and W. Rutishauser
Feasibility of Intracoronary ß-Irradiation to Reduce Restenosis After Balloon Angioplasty: A Clinical Pilot Study
Circulation, March 4, 1997; 95(5): 1138 - 1144.
[Abstract] [Full Text]


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BMJHome page
D. Crossman
Science, medicine, and the future: The future of the management of ischaemic heart disease
BMJ, February 1, 1997; 314(7077): 356 - 356.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
R.D. Kenagy, S. Vergel, E. Mattsson, M. Bendeck, M.A. Reidy, and A.W. Clowes
The Role of Plasminogen, Plasminogen Activators, and Matrix Metalloproteinases in Primate Arterial Smooth Muscle Cell Migration
Arterioscler Thromb Vasc Biol, November 1, 1996; 16(11): 1373 - 1382.
[Abstract] [Full Text]


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CirculationHome page
C. Chen, S. G. Mattar, J. D. Hughes, G. F. Pierce, J. E. Cook, D. N. Ku, S. R. Hanson, and A. B. Lumsden
Recombinant Mitotoxin Basic Fibroblast Growth Factor–Saporin Reduces Venous Anastomotic Intimal Hyperplasia in the Arteriovenous Graft
Circulation, October 15, 1996; 94(8): 1989 - 1995.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
C. Gerdes, V. Faber-Steinfeld, O. Yalkinoglu, and S. Wohlfeil
Comparison of the Effects of the Thrombin Inhibitor r-Hirudin in Four Animal Models of Neointima Formation After Arterial Injury
Arterioscler Thromb Vasc Biol, October 1, 1996; 16(10): 1306 - 1311.
[Abstract] [Full Text]


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Arch Intern MedHome page
F. H. Messerli, M. A. Weber, and H. R. Brunner
Angiotensin II Receptor Inhibition: A New Therapeutic Principle
Arch Intern Med, September 23, 1996; 156(17): 1957 - 1965.
[Abstract] [PDF]


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CirculationHome page
L. A. Guzman, V. Labhasetwar, C. Song, Y. Jang, A. M. Lincoff, R. Levy, and E. J. Topol
Local Intraluminal Infusion of Biodegradable Polymeric Nanoparticles: A Novel Approach for Prolonged Drug Delivery After Balloon Angioplasty
Circulation, September 15, 1996; 94(6): 1441 - 1448.
[Abstract] [Full Text]


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VASC ENDOVASCULAR SURGHome page
M. A. Golden
Intimal Hyperplasia: Prospects for Its Control in the Human
Vascular and Endovascular Surgery, September 1, 1996; 30(5): 361 - 364.
[PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
E. M. van Kleef, J. Fingerle, and M. J.A.P. Daemen
Angiotensin II-Induced Progression of Neointimal Thickening in the Balloon-Injured Rat Carotid Artery Is AT1 Receptor Mediated
Arterioscler Thromb Vasc Biol, July 1, 1996; 16(7): 857 - 863.
[Abstract] [Full Text]


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CirculationHome page
N. A. Scott, G. D. Cipolla, C. E. Ross, B. Dunn, F. H. Martin, L. Simonet, and J. N. Wilcox
Identification of a Potential Role for the Adventitia in Vascular Lesion Formation After Balloon Overstretch Injury of Porcine Coronary Arteries
Circulation, June 15, 1996; 93(12): 2178 - 2187.
[Abstract] [Full Text]


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CirculationHome page
S. B. King III
Angioplasty From Bench to Bedside to Bench
Circulation, May 1, 1996; 93(9): 1621 - 1629.
[Full Text]


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CirculationHome page
A. D. Hamdan, W. C. Quist, J. B. Gagne, and E. P. Feener
Angiotensin-Converting Enzyme Inhibition Suppresses Plasminogen Activator Inhibitor-1 Expression in the Neointima of Balloon-Injured Rat Aorta
Circulation, March 15, 1996; 93(6): 1073 - 1078.
[Abstract] [Full Text]


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CirculationHome page
K. G. Lehmann, R. Melkert, and P. W. Serruys
Contributions of Frequency Distribution Analysis to the Understanding of Coronary Restenosis : A Reappraisal of the Gaussian Curve
Circulation, March 15, 1996; 93(6): 1123 - 1132.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
L. A. Guzman, M. J. Mick, A. M. Arnold, F. Forudi, and P. L. Whitlow
Role of Intimal Hyperplasia and Arterial Remodeling After Balloon Angioplasty : An Experimental Study in the Atherosclerotic Rabbit Model
Arterioscler Thromb Vasc Biol, March 1, 1996; 16(3): 479 - 487.
[Abstract] [Full Text]


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CirculationHome page
R. E. Pratt and V. J. Dzau
Pharmacological Strategies to Prevent Restenosis : Lessons Learned From Blockade of the Renin-Angiotensin System
Circulation, March 1, 1996; 93(5): 848 - 852.
[Full Text]


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CirculationHome page
A. G. Violaris, R. Melkert, J.-P. R. Herrman, and P. W. Serruys
Role of Angiographically Identifiable Thrombus on Long-term Luminal Renarrowing After Coronary Angioplasty : A Quantitative Angiographic Analysis
Circulation, March 1, 1996; 93(5): 889 - 897.
[Abstract] [Full Text]


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CirculationHome page
W. R. Huckle, M. D. Drag, W. R. Acker, M. Powers, R. C. McFall, D. J. Holder, T. Fujita, I. I. Stabilito, D. Kim, D. L. Ondeyka, et al.
Effects of Subtype-Selective and Balanced Angiotensin II Receptor Antagonists in a Porcine Coronary Artery Model of Vascular Restenosis
Circulation, March 1, 1996; 93(5): 1009 - 1019.
[Abstract] [Full Text]


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CirculationHome page
Y. Furukawa, A. Matsumori, T. Hirozane, and S. Sasayama
Angiotensin II Receptor Antagonist TCV-116 Reduces Graft Coronary Artery Disease and Preserves Graft Status in a Murine Model : A Comparative Study With Captopril
Circulation, January 15, 1996; 93(2): 333 - 339.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. L. Geary, J. K. Williams, D. Golden, D. G. Brown, M. E. Benjamin, and M. R. Adams
Time Course of Cellular Proliferation, Intimal Hyperplasia, and Remodeling Following Angioplasty in Monkeys With Established Atherosclerosis : A Nonhuman Primate Model of Restenosis
Arterioscler Thromb Vasc Biol, January 1, 1996; 16(1): 34 - 43.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
J. Fingerle, R. M.K. Muller, H. Kuhn, M. Pech, and H. R. Baumgartner
Mechanism of Inhibition of Neointimal Formation by the Angiotensin-Converting Enzyme Inhibitor Cilazapril : A Study in Balloon Catheter–Injured Rat Carotid Arteries
Arterioscler Thromb Vasc Biol, November 1, 1995; 15(11): 1945 - 1950.
[Abstract] [Full Text]


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CirculationHome page
F. M. van Bockxmeer, C. D. S. Mamotte, F. A. Gibbons, V. Burke, and R. R. Taylor
Angiotensin-Converting Enzyme and Apolipoprotein E Genotypes and Restenosis After Coronary Angioplasty
Circulation, October 15, 1995; 92(8): 2066 - 2071.
[Abstract] [Full Text]


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Circ. Res.Home page
S. M. Schwartz, D. deBlois, and E. R. M. O'Brien
The Intima : Soil for Atherosclerosis and Restenosis
Circ. Res., September 1, 1995; 77(3): 445 - 465.
[Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. Schmitt, J.-P. Clozel, N. Iberg, and F. R. Buhler
Mibefradil Prevents Neointima Formation After Vascular Injury in Rats : Possible Role of the Blockade of the T-Type Voltage-Operated Calcium Channel
Arterioscler Thromb Vasc Biol, August 1, 1995; 15(8): 1161 - 1165.
[Abstract] [Full Text]


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CirculationHome page
M. Hamon, C. Bauters, C. Amant, E. P. McFadden, N. Helbecque, J.-M. Lablanche, M. E. Bertrand, and P. Amouyel
Relation Between the Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene and Late Luminal Narrowing After Coronary Angioplasty
Circulation, August 1, 1995; 92(3): 296 - 299.
[Abstract] [Full Text]


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CirculationHome page
B. H. Strauss, M. K. Natarajan, W. B. Batchelor, D. E. Yardley, J. A. Bittl, T. A. Sanborn, J. A. Power, L. E. Watson, R. Moothart, J. E. Tcheng, et al.
Early and Late Quantitative Angiographic Results of Vein Graft Lesions Treated by Excimer Laser With Adjunctive Balloon Angioplasty
Circulation, August 1, 1995; 92(3): 348 - 356.
[Abstract] [Full Text]


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CirculationHome page
S. Kim, M. Kawamura, H. Wanibuchi, K. Ohta, A. Hamaguchi, T. Omura, T. Yukimura, K. Miura, and H. Iwao
Angiotensin II Type 1 Receptor Blockade Inhibits the Expression of Immediate-Early Genes and Fibronectin in Rat Injured Artery
Circulation, July 1, 1995; 92(1): 88 - 95.
[Abstract] [Full Text]


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CirculationHome page
R. L. Geary, N. Koyama, T. W. Wang, S. Vergel, and A. W. Clowes
Failure of Heparin to Inhibit Intimal Hyperplasia in Injured Baboon Arteries : The Role of Heparin-Sensitive and -Insensitive Pathways in the Stimulation of Smooth Muscle Cell Migration and Proliferation
Circulation, June 15, 1995; 91(12): 2972 - 2981.
[Abstract] [Full Text]


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CirculationHome page
C. Rogers and E. R. Edelman
Endovascular Stent Design Dictates Experimental Restenosis and Thrombosis
Circulation, June 15, 1995; 91(12): 2995 - 3001.
[Abstract] [Full Text]


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HypertensionHome page
A. Kamitani, H. Rakugi, J. Higaki, M. Ohishi, S.-J. Shi, S. Takami, Y. Nakata, Y. Higashino, K. Fujii, H. Mikami, et al.
Enhanced Predictability of Myocardial Infarction in Japanese by Combined Genotype Analysis
Hypertension, May 1, 1995; 25(5): 950 - 953.
[Abstract] [Full Text]


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CirculationHome page
A. G. Violaris, R. Melkert, and P. W. Serruys
Long-term Luminal Renarrowing After Successful Elective Coronary Angioplasty of Total Occlusions : A Quantitative Angiographic Analysis
Circulation, April 15, 1995; 91(8): 2140 - 2150.
[Abstract] [Full Text]


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CirculationHome page
D. Keane, J. Haase, C. J. Slager, E. M. van Swijndregt, K. G. Lehmann, Y. Ozaki, C. di Mario, R. Kirkeeide, and P. W. Serruys
Comparative Validation of Quantitative Coronary Angiography Systems : Results and Implications From a Multicenter Study Using a Standardized Approach
Circulation, April 15, 1995; 91(8): 2174 - 2183.
[Abstract] [Full Text]


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HypertensionHome page
M. J.A.P. Daemen and J. G.R. De Mey
Regional Heterogeneity of Arterial Structural Changes
Hypertension, April 1, 1995; 25(4): 464 - 473.
[Abstract] [Full Text]


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CirculationHome page
C. Bauters, P. Khanoyan, E. P. Mc Fadden, P. Quandalle, J.-M. Lablanche, and M. E. Bertrand
Restenosis After Delayed Coronary Angioplasty of the Culprit Vessel in Patients With a Recent Myocardial Infarction Treated by Thrombolysis
Circulation, March 1, 1995; 91(5): 1410 - 1418.
[Abstract] [Full Text]


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CirculationHome page
P. de Groote, C. Bauters, E. P. McFadden, J.-M. Lablanche, F. Leroy, and M. E. Bertrand
Local Lesion-Related Factors and Restenosis After Coronary Angioplasty : Evidence From a Quantitative Angiographic Study in Patients With Unstable Angina Undergoing Double-Vessel Angioplasty
Circulation, February 15, 1995; 91(4): 968 - 972.
[Abstract] [Full Text]