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