Current Pharmaceutical Design - Volume 10, Issue 4, 2004

Percutaneous transluminal coronary angioplasty (PTCA) has become the main method of coronary revascularization. However, despite technical advancement, restenosis with incidence rate of 30 to 50% remains a major limitation to the long-term success of PTCA. The introduction of stents has significantly improved capability of interventional cardiology in treatment and prevention of restenosis. Recent experimental studies Read More

Restenosis after stent implantation is mainly characterized by an inflammatory response to the procedural injury and an intense fibrocellular response including smooth muscle cell (SMC) proliferation. After angioplasty alone, the restenosis process also involves thrombus formation and negative remodeling. Due to the pleiotropic mode of action exerted by glucocorticoids which include profound anti-inflammatory and im Read More

Percutaneous coronary intervention has been hampered by restenosis since its inception. Many research projects including the use of various devices and systemic drug administration have shown disappointing results. The clinical data reported from trials with sirolimus- and paclitaxel- eluting stents have been very promising, such that stents with the capability of drug elution are currently attracting the medical commu Read More

Recent trials provide a wealth of data documenting the benefit of cholesterol-lowering therapy with statins in both primary and secondary prevention. A growing body of evidence indicates that statins possess pleiotropic effects - independent of, or at least in addition to their lipid-lowering capacity, including inhibition of smooth muscle cell proliferation and subsequently neointimal proliferation, platelet aggregation Read More

A growing body of evidence suggests that low molecular weight heparin (LMWH) is at least as effective as unfractionated heparin (UFH) in the medical management of acute coronary syndromes (ACS) including acute myocardial infarction. Several studies support an early invasive as compared to a conservative (non-invasive) approach utilizing percutaneous coronary intervention (PCI) in these patients. During coronar Read More

Cumulative scientific evidence gathered over the past ten years has confirmed the role of platelet GP IIb / IIIa inhibitors in reducing ischemic complications of patients undergoing percutaneous coronary intervention (PCI). Recently, mortality data available on more than 20,000 patients enrolled in randomized clinical trials suggest that GP IIb / IIIa blockade also improves short and long-term survival after PCI. Despite con Read More

Primary PCI is an effective reperfusion strategy for acute MI patients, which has evolved significantly in the last decade. While many adjunctive therapies have contributed to its success, substantial obstacles remain before optimal reperfusion can be achieved. Anti-platelet therapy with aspirin, clopidogrel and GP IIb / IIIa inhibitors reduces early ischemic complications, improves microvascular function and, potentially, aff Read More

Gene therapy is a rapidly evolving field of medicine, which potentially offers new treatments for cardiovascular diseases. With the use of gene transfer methods it is possible to modify somatic cells in blood vessels and myocardium to overexpress or inhibit pathologically important proteins and achieve therapeutic effects. Prevention of restenosis after vascular interventions such as percutanous coronary angioplasty (PTCA), Read More

Large-scale intervention trials demonstrate that treatment with statins, the most effective lipid lowering drug class, significantly reduces the risk of coronary heart disease events. Recent evidence suggests that more aggressive LDL cholesterol lowering with newly developed statins may provide greater clinical benefit, even in individuals with moderately elevated serum cholesterol levels. There is increasing evidence that statins e Read More

Retinoic acid and derivatives (retinoids) exert their anti-neoplastic action through three different, though partially overlapping mechanisms: growth-inhibition, cyto-differentiation and apoptosis. Retinoid related molecules (RRMs) are a promising class of synthetic retinoic acid derivatives endowed with selective apoptotic activity on a large variety of leukemic and solid tumor cells. The in vitro apoptotic activity of RRMs translates int Read More