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 that 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 (30,000i.u. of beta carotene, 500mg of Vitamin C, and 700i.u. of 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.

    The 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 i.u. 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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