Vascular remodeling agent

Abstract

Probucol exerts a positive effect on vascular remodeling. By using probucol to promote vascular remodeling by the method of the invention, favorable results can be obtained in treating such diseases and conditions as restenosis following transluminal coronary angioplasty, intimal smooth muscle cell hyperplasia, vascular occlusion, or restenosis following transluminal angioplasty or atherectomy procedures performed on the coronary, iliac, femoral, renal or carotid arteries. This effect was determined based upon an IVUS substudy from the MVP trial. Beginning 30 days before PTCA, 317 patients were randomly assigned to receive either probucol, multivitamins, the combination of drugs, or placebo. Patients were then treated for six months after PTCA. 96 patients (111 segments) underwent IVUS examination immediately after angioplasty and at follow-up. The anatomic cross-section selected for serial analysis was the one at the angioplasty site with the smallest lumen area at follow-up. Quantitative analysis consisted in measurements of lumen area and the area within the external elastic membrane (EEM). Wall area was calculated as the difference between EEM and lumen areas. Results. In the placebo group, lumen area at follow-up decreased by −1.21±1.88 mm,, and wall and EEM areas increased by 1.50±2.50 mm,and 0.29±2.93 mm,. The change in lumen area correlated more strongly, however, with the change in EEM area (r=0.53, p=0.002) than with the change in wall area (r=−0.13, p=0.49). Lumen loss was −1.21±1.88 mm,in the placebo group, −0.83±1.22 mm,for vitamins alone, −0.25±1.17 mm,for combined treatment and −0.15±1.70 mm,for probucol alone (p=0.002 for probucol versus no probucol and p=0.85 for vitamins versus no vitamins). The change in wall area was similar in all groups. EEM area increased at follow-up by 0.29±2.93 mm,in the placebo group, 0.09±2.33 mm,for vitamins only, 1.17±1.61 mm,for combined treatment and 1.74±1.80 mm,for probucol only (p=0.006 for probucol versus no probucol).