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Cardiovascular Disease
Probucol and Multivitamins in the Prevention of Restenosis
The long-term effectiveness of
coronary angioplasty is limited by the high incidence of restenosis (recurrent narrowing
of the treated artery).
Since oxidizing metabolites generated at the site of angioplasty
can induce chain reactions tha may lead to restenosis, it has been suggested that
antioxidants may prevent its occurrence.
In a double-blind trial conducted at the Montreal Heart Institute, 317 patients with
coronary artery disease were randomly assigned to receive one of the following:
the antioxidant drug probucol;
a combination of antioxidant nutrients (30,000 IU Vitamin E);
both treatments;
or placebo daily;
for one month before and six months after angioplasty.
Follow-up angiographies showed that probucol therapy significantly reduced the rate of
restenosis, but the antioxidant nutrients had no significant effect. T
he researchers who
conducted the study speculate that the effect of probucol may have been due to some
mechanism of action other than its antioxidant activity, since the nutrients, which are
also antioxidants, had no effect.
However, Hodis et al (1995) noted an association between
supplementary Vitamin E intake (100 IU or more daily) and
angiographically demonstrated reduction in coronary artery lesion progression in 156 men
receiving a cholesterol-lowering drug.
No benefit of Vitamin E
was found in the placebo group, indicating that supplementation with Vitamin E
may be of value as adjunctive therapy in patients who are receiving drug therapy for
existing coronary artery disease.
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