Carvedilol for prevention of restenosis after directional coronary atherectomy : Final results of the european carvedilol atherectomy restenosis (EUROCARE) trial
In addition to its known properties as a competitive, nonselective beta and alpha-1 receptor blocker, carvedilol directly inhibits vascular myocyte migration and proliferation and exerts antioxidant effects that are considerably greater than those of vitamin E or probucol. This provides the basis fo...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2000-04, Vol.101 (13), p.1512-1518 |
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| creator | SERRUYS, P. W FOLEY, D. P BONNIER, H WIJNS, W BETRIU, A HAUF-ZACHARIOU, U VAN SWIJNDREGT, E. M MELKERT, R SIMON, R HÖFLING, B PUEL, J GLOGAR, H. D SEABRA-GOMES, R GOICOLEA, J COSTE, P RUTSCH, W KATUS, H |
| description | In addition to its known properties as a competitive, nonselective beta and alpha-1 receptor blocker, carvedilol directly inhibits vascular myocyte migration and proliferation and exerts antioxidant effects that are considerably greater than those of vitamin E or probucol. This provides the basis for an evaluation of carvedilol for the prevention of coronary restenosis.
In a prospective, double-blind, randomized, placebo-controlled trial, 25 mg of carvedilol was given twice daily, starting 24 hours before scheduled directional coronary atherectomy and continuing for 5 months after a successful procedure. The primary end point was the minimal luminal diameter as determined during follow-up angiography 26+/-2 weeks after the procedure. Of 406 randomized patients, 377 underwent attempted atherectomy, and in 324 (88.9%), a |
| doi_str_mv | 10.1161/01.CIR.101.13.1512 |
| format | Article |
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In a prospective, double-blind, randomized, placebo-controlled trial, 25 mg of carvedilol was given twice daily, starting 24 hours before scheduled directional coronary atherectomy and continuing for 5 months after a successful procedure. The primary end point was the minimal luminal diameter as determined during follow-up angiography 26+/-2 weeks after the procedure. Of 406 randomized patients, 377 underwent attempted atherectomy, and in 324 (88.9%), a </=50% diameter stenosis was achieved without the use of a stent. Evaluable follow-up angiography was available in 292 eligible patients (90%). No differences in minimal luminal diameter (1.99+/-0.73 mm versus 2.00+/-0.74 mm), angiographic restenosis rate (23.4% versus 23.9%), target lesion revascularization (16.2 versus 14.5), or event-free survival (79.2% versus 79.7%) between the placebo and carvedilol groups were observed at 7 months.
The maximum recommended daily dose of the antioxidant and beta-blocker carvedilol failed to reduce restenosis after successful atherectomy. These findings are in contrast to those of the Multivitamins and Probucol Trial, which raises doubts regarding the validity of the interpretation that restenosis reduction by probucol was via antioxidant effects. The relationship between antioxidant agents and restenosis remains to be elucidated.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.101.13.1512</identifier><identifier>PMID: 10747343</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adrenergic Antagonists - adverse effects ; Adrenergic Antagonists - therapeutic use ; Aged ; Antioxidants - adverse effects ; Antioxidants - therapeutic use ; Atherectomy, Coronary ; Biological and medical sciences ; Carbazoles - adverse effects ; Carbazoles - therapeutic use ; Cardiovascular system ; Carvedilol ; Coronary Angiography ; Coronary Disease - diagnostic imaging ; Coronary Disease - prevention & control ; Coronary Disease - therapy ; Double-Blind Method ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Propanolamines - adverse effects ; Propanolamines - therapeutic use ; Secondary Prevention ; Treatment Failure ; Vasodilator agents. Cerebral vasodilators</subject><ispartof>Circulation (New York, N.Y.), 2000-04, Vol.101 (13), p.1512-1518</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Apr 4, 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c349t-aa7cd081e734568dafa159afc13757a40db4e019e787bfb181bca8846d1e8a433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1306977$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10747343$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SERRUYS, P. W</creatorcontrib><creatorcontrib>FOLEY, D. P</creatorcontrib><creatorcontrib>BONNIER, H</creatorcontrib><creatorcontrib>WIJNS, W</creatorcontrib><creatorcontrib>BETRIU, A</creatorcontrib><creatorcontrib>HAUF-ZACHARIOU, U</creatorcontrib><creatorcontrib>VAN SWIJNDREGT, E. M</creatorcontrib><creatorcontrib>MELKERT, R</creatorcontrib><creatorcontrib>SIMON, R</creatorcontrib><creatorcontrib>HÖFLING, B</creatorcontrib><creatorcontrib>PUEL, J</creatorcontrib><creatorcontrib>GLOGAR, H. D</creatorcontrib><creatorcontrib>SEABRA-GOMES, R</creatorcontrib><creatorcontrib>GOICOLEA, J</creatorcontrib><creatorcontrib>COSTE, P</creatorcontrib><creatorcontrib>RUTSCH, W</creatorcontrib><creatorcontrib>KATUS, H</creatorcontrib><title>Carvedilol for prevention of restenosis after directional coronary atherectomy : Final results of the european carvedilol atherectomy restenosis (EUROCARE) trial</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>In addition to its known properties as a competitive, nonselective beta and alpha-1 receptor blocker, carvedilol directly inhibits vascular myocyte migration and proliferation and exerts antioxidant effects that are considerably greater than those of vitamin E or probucol. This provides the basis for an evaluation of carvedilol for the prevention of coronary restenosis.
In a prospective, double-blind, randomized, placebo-controlled trial, 25 mg of carvedilol was given twice daily, starting 24 hours before scheduled directional coronary atherectomy and continuing for 5 months after a successful procedure. The primary end point was the minimal luminal diameter as determined during follow-up angiography 26+/-2 weeks after the procedure. Of 406 randomized patients, 377 underwent attempted atherectomy, and in 324 (88.9%), a </=50% diameter stenosis was achieved without the use of a stent. Evaluable follow-up angiography was available in 292 eligible patients (90%). No differences in minimal luminal diameter (1.99+/-0.73 mm versus 2.00+/-0.74 mm), angiographic restenosis rate (23.4% versus 23.9%), target lesion revascularization (16.2 versus 14.5), or event-free survival (79.2% versus 79.7%) between the placebo and carvedilol groups were observed at 7 months.
The maximum recommended daily dose of the antioxidant and beta-blocker carvedilol failed to reduce restenosis after successful atherectomy. These findings are in contrast to those of the Multivitamins and Probucol Trial, which raises doubts regarding the validity of the interpretation that restenosis reduction by probucol was via antioxidant effects. The relationship between antioxidant agents and restenosis remains to be elucidated.</description><subject>Adrenergic Antagonists - adverse effects</subject><subject>Adrenergic Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Antioxidants - adverse effects</subject><subject>Antioxidants - therapeutic use</subject><subject>Atherectomy, Coronary</subject><subject>Biological and medical sciences</subject><subject>Carbazoles - adverse effects</subject><subject>Carbazoles - therapeutic use</subject><subject>Cardiovascular system</subject><subject>Carvedilol</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - prevention & control</subject><subject>Coronary Disease - therapy</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Propanolamines - adverse effects</subject><subject>Propanolamines - therapeutic use</subject><subject>Secondary Prevention</subject><subject>Treatment Failure</subject><subject>Vasodilator agents. Cerebral vasodilators</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNUcFq3DAQFaEl2aT9gRyKKD2kB281lmzZvQWzaQOBwNKcxVgeEQevtZXsQD6nf1qZXciehtF7b2aeHmPXINYAJfwQsG7ut2tIFeQaCsjP2AqKXGWqkPUHthJC1JmWeX7BLmN8SW0pdXHOLkBopaWSK_avwfBKXT_4gTsf-D7QK41T70fuHQ8UJxp97CNHN1HgXR_ILigO3PqQanjjOD3T8ux3b_wnv-sXMCnnYYrLkIRymoPfE47cvq87lZ0sutk8bR-b2-3mO59Cj8Mn9tHhEOnzsV6xp7vNn-Z39vD46765fcisVPWUIWrbiQoo-SrKqkOHUNToLCTLGpXoWkUCatKVbl0LFbQWq0qVHVCFSsor9vUwdx_83zndY178HJKXaHLIdSmTOJHyA8kGH2MgZ_ah36VPMCDMEooRYFIoqQUD0iyhJNGX4-S53VF3IjmkkAjfjgSMFgcXcLR9fOdJUdZay__kgpff</recordid><startdate>20000404</startdate><enddate>20000404</enddate><creator>SERRUYS, P. W</creator><creator>FOLEY, D. P</creator><creator>BONNIER, H</creator><creator>WIJNS, W</creator><creator>BETRIU, A</creator><creator>HAUF-ZACHARIOU, U</creator><creator>VAN SWIJNDREGT, E. M</creator><creator>MELKERT, R</creator><creator>SIMON, R</creator><creator>HÖFLING, B</creator><creator>PUEL, J</creator><creator>GLOGAR, H. D</creator><creator>SEABRA-GOMES, R</creator><creator>GOICOLEA, J</creator><creator>COSTE, P</creator><creator>RUTSCH, W</creator><creator>KATUS, H</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>20000404</creationdate><title>Carvedilol for prevention of restenosis after directional coronary atherectomy : Final results of the european carvedilol atherectomy restenosis (EUROCARE) trial</title><author>SERRUYS, P. W ; FOLEY, D. P ; BONNIER, H ; WIJNS, W ; BETRIU, A ; HAUF-ZACHARIOU, U ; VAN SWIJNDREGT, E. M ; MELKERT, R ; SIMON, R ; HÖFLING, B ; PUEL, J ; GLOGAR, H. D ; SEABRA-GOMES, R ; GOICOLEA, J ; COSTE, P ; RUTSCH, W ; KATUS, H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c349t-aa7cd081e734568dafa159afc13757a40db4e019e787bfb181bca8846d1e8a433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adrenergic Antagonists - adverse effects</topic><topic>Adrenergic Antagonists - therapeutic use</topic><topic>Aged</topic><topic>Antioxidants - adverse effects</topic><topic>Antioxidants - therapeutic use</topic><topic>Atherectomy, Coronary</topic><topic>Biological and medical sciences</topic><topic>Carbazoles - adverse effects</topic><topic>Carbazoles - therapeutic use</topic><topic>Cardiovascular system</topic><topic>Carvedilol</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - prevention & control</topic><topic>Coronary Disease - therapy</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Propanolamines - adverse effects</topic><topic>Propanolamines - therapeutic use</topic><topic>Secondary Prevention</topic><topic>Treatment Failure</topic><topic>Vasodilator agents. Cerebral vasodilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SERRUYS, P. W</creatorcontrib><creatorcontrib>FOLEY, D. P</creatorcontrib><creatorcontrib>BONNIER, H</creatorcontrib><creatorcontrib>WIJNS, W</creatorcontrib><creatorcontrib>BETRIU, A</creatorcontrib><creatorcontrib>HAUF-ZACHARIOU, U</creatorcontrib><creatorcontrib>VAN SWIJNDREGT, E. M</creatorcontrib><creatorcontrib>MELKERT, R</creatorcontrib><creatorcontrib>SIMON, R</creatorcontrib><creatorcontrib>HÖFLING, B</creatorcontrib><creatorcontrib>PUEL, J</creatorcontrib><creatorcontrib>GLOGAR, H. D</creatorcontrib><creatorcontrib>SEABRA-GOMES, R</creatorcontrib><creatorcontrib>GOICOLEA, J</creatorcontrib><creatorcontrib>COSTE, P</creatorcontrib><creatorcontrib>RUTSCH, W</creatorcontrib><creatorcontrib>KATUS, H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SERRUYS, P. W</au><au>FOLEY, D. P</au><au>BONNIER, H</au><au>WIJNS, W</au><au>BETRIU, A</au><au>HAUF-ZACHARIOU, U</au><au>VAN SWIJNDREGT, E. M</au><au>MELKERT, R</au><au>SIMON, R</au><au>HÖFLING, B</au><au>PUEL, J</au><au>GLOGAR, H. D</au><au>SEABRA-GOMES, R</au><au>GOICOLEA, J</au><au>COSTE, P</au><au>RUTSCH, W</au><au>KATUS, H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carvedilol for prevention of restenosis after directional coronary atherectomy : Final results of the european carvedilol atherectomy restenosis (EUROCARE) trial</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2000-04-04</date><risdate>2000</risdate><volume>101</volume><issue>13</issue><spage>1512</spage><epage>1518</epage><pages>1512-1518</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>In addition to its known properties as a competitive, nonselective beta and alpha-1 receptor blocker, carvedilol directly inhibits vascular myocyte migration and proliferation and exerts antioxidant effects that are considerably greater than those of vitamin E or probucol. This provides the basis for an evaluation of carvedilol for the prevention of coronary restenosis.
In a prospective, double-blind, randomized, placebo-controlled trial, 25 mg of carvedilol was given twice daily, starting 24 hours before scheduled directional coronary atherectomy and continuing for 5 months after a successful procedure. The primary end point was the minimal luminal diameter as determined during follow-up angiography 26+/-2 weeks after the procedure. Of 406 randomized patients, 377 underwent attempted atherectomy, and in 324 (88.9%), a </=50% diameter stenosis was achieved without the use of a stent. Evaluable follow-up angiography was available in 292 eligible patients (90%). No differences in minimal luminal diameter (1.99+/-0.73 mm versus 2.00+/-0.74 mm), angiographic restenosis rate (23.4% versus 23.9%), target lesion revascularization (16.2 versus 14.5), or event-free survival (79.2% versus 79.7%) between the placebo and carvedilol groups were observed at 7 months.
The maximum recommended daily dose of the antioxidant and beta-blocker carvedilol failed to reduce restenosis after successful atherectomy. These findings are in contrast to those of the Multivitamins and Probucol Trial, which raises doubts regarding the validity of the interpretation that restenosis reduction by probucol was via antioxidant effects. The relationship between antioxidant agents and restenosis remains to be elucidated.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10747343</pmid><doi>10.1161/01.CIR.101.13.1512</doi><tpages>7</tpages></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2000-04, Vol.101 (13), p.1512-1518 |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adrenergic Antagonists - adverse effects Adrenergic Antagonists - therapeutic use Aged Antioxidants - adverse effects Antioxidants - therapeutic use Atherectomy, Coronary Biological and medical sciences Carbazoles - adverse effects Carbazoles - therapeutic use Cardiovascular system Carvedilol Coronary Angiography Coronary Disease - diagnostic imaging Coronary Disease - prevention & control Coronary Disease - therapy Double-Blind Method Female Humans Male Medical sciences Middle Aged Pharmacology. Drug treatments Propanolamines - adverse effects Propanolamines - therapeutic use Secondary Prevention Treatment Failure Vasodilator agents. Cerebral vasodilators |
| title | Carvedilol for prevention of restenosis after directional coronary atherectomy : Final results of the european carvedilol atherectomy restenosis (EUROCARE) trial |
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