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The Role of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Postangioplasty Restenosis

Liu, Ying MD, PhD1; Carrey, Zev MD1; Aronow, Wilbert S. MD2,*; Alaie, Daruish MD1; Petrillo, Richard L. MD1; Frishman, William H. MD2

doi: 10.1097/MJT.0b013e3182979b59
Therapeutic Reviews

Postangioplasty restenosis remains a clinical problem, and various strategies have been used to minimize or eliminate this complication. Stimulation of the renin–angiotensin system has been shown to cause vascular smooth muscle migration, matrix deposition, and endothelial dysfunction, which are possible causes of postangioplasty restenosis, suggesting that the use of angiotensin-converting enzyme (ACE) inhibitors and/or angiotensin receptor blockers might ameliorate or prevent restenosis. However, data obtained to date in both animal and human studies of various designs show conflicting results regarding the benefit or lack of benefit of angiotensin inhibition strategies. It has also been shown that the type of ACE genotype may influence the effects of drugs on restenosis, suggesting that in the future, a pharmacogenetic approach might be of use for augmenting the benefit in patients from inhibitors of the angiotensin system. As of now, there are no supportive data to suggest a benefit of using routine ACE inhibitors or angiotensin receptor blockers to prevent postangioplasty restenosis in the general population.

1Department of Medicine, Mount Vernon Hospital, Mount Vernon, NY; and

2Cardiology Division, New York Medical College/Westchester Medical Center, Valhalla, NY.

Address for correspondence: Wilbert S. Aronow, Cardiology Division, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY 10595. E-mail:

The authors have no conflicts of interest to declare.

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