缬沙坦预防冠脉支架术后再狭窄的研究进展

Advances in Valsartan for Prevention of Coronary In-stent Restenosis

冠状动脉介入治疗是目前冠状动脉性心脏病治疗的重要方法,主要包括经皮腔内血管成形术和支架植入术,但术后再狭窄成为另一个难以解决的问题。研究发现,新生内膜过度增长是支架植入术后再狭窄的主要原因,主要与血管平滑肌细胞的过度增殖与迁移以及分泌大量的细胞外基质有关,而且,血管紧张素Ⅱ能促进再狭窄的发展。目前的一些研究显示血管紧张素Ⅱ受体拮抗剂缬沙坦可能降低支架术后的再狭窄率。现对缬沙坦预防冠状动脉支架术后再狭窄的最新进展作一综述。

Percutaneous coronary intervention is important in the treatment of coronary heart disease, this includes percutaneous transluminal coronary angioplasty and stent implantation. The rates of restenosis following percutaneous coronary intervention, however, could be 15% - 50%. Studies have shown that neointimal hyperplasia is the major mechanism of in-stent restenosis, mainly related to the proliferation and migration of vascular smooth muscle cells, and secondly to the production of abundant extracellular matrix. Angiotensin Ⅱ could enhance the development of restenosis. Some studies have indicated that the angiotensin Ⅱ receptor blocker valsartan might reduce the rate of in-stent restenosis. This article summarizes the latest advances in the use of valsartan in the prevention of coronary in-stent restenosis.