EFFECTIVENESS OF TRANILAST ON RESTENOSIS AFTER DIRECTIONAL CORONARY ATHERECTOMY

Tranilast is an antiallergic drug used widely in Japan that also inhib its the migration and proliferation of vascular smooth muscle cells. T his pilot study was undertaken to determine the effectiveness of trani last on restenosis after successful directional coronary atherectomy. After the procedure, 40 patients (56 lesions, tranilast group) were tr eated with oral tronilast for 3 months, and 152 patients (188 lesions, control group) did not receive tranilast. Angiographic and clinical v ariables were compared between the two groups. The minimal lumen diame ter was significantly larger in the tranilast group than in the contro l group at both 3-month (2.08 vs 1.75 mm, p = 0.004) and 6-month follo w-up (2.04 vs 1.70 mm, p = 0.003). The diameter stenosis in the tranil ast group was smaller than that in the control group both 3 months (28 % vs 40%, p = 0.0007) and 6 months (30% vs 43%, p = 0.0001) after the procedure, with a lower restenosis rate (percent diameter stenosis gre ater than or equal to 50) in the tranilast group at 3 months (11% vs 2 6%, p = 0.03). The number of clinical events over the la-month period after the procedure was significantly reduced by tranilast administrat ion (p = 0.013). These findings suggest that the oral administration o f tranilast strongly prevents restenosis after directional coronary at herectomy.