Document Detail

Low-dose spironolactone: effects on artery-to-artery vein grafts and percutaneous coronary intervention sites.
MedLine Citation:
PMID:  19454859     Owner:  NLM     Status:  MEDLINE    
The efficacy of vein grafts used in coronary and peripheral artery bypass is limited by excessive hyperplasia and fibrosis that occur early after engraftment. In the present study, we sought to determine whether low-dose spironolactone alleviates maladaptive vein graft arterialization and alters intimal reaction to coronary artery stenting. Yorkshire pigs were randomized to treatment with oral spironolactone 25 mg daily or placebo. All animals underwent right carotid artery interposition grafting using a segment of external jugular vein and, 5 days later, underwent angiography of carotid and coronary arteries. At that time, a bare metal stent was placed in the left anterior descending artery and balloon angioplasty was performed on the circumflex coronary artery. Repeat carotid and coronary angiograms were performed before euthanasia and graft excision at 30 days. Angiography revealed that venous grafts of spironolactone-treated animals had lumen diameters twice the size of controls at 5 days, a finding that persisted at 30 days. However, neointima and total vessel wall areas also were 2- to 3-fold greater in spironolactone-treated animals, and there were no differences in vessel wall layer thicknesses or collagen and elastin densities. In the coronary circulation, there were no differences between treatment groups in any vessel wall parameters in either stented or unstented vessels. Taken together, these observations suggest that low-dose spironolactone may exert a novel protective effect on remodeling in venous arterial grafts that does not depend on the reduction of hyperplastic changes but may involve dilatation of the vessel wall.
Matthew D Bacchetta; Arash Salemi; Federico Milla; Mun K Hong; Fermin Tio; Ying Zhou; Rong Chen; Edward Southard; Leonard Y Lee; Charles A Mack; Karl H Krieger; O Wayne Isom; Wilson Ko; Jeffrey S Borer; Daniel F Catanzaro
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of therapeutics     Volume:  16     ISSN:  1536-3686     ISO Abbreviation:  Am J Ther     Publication Date:    2009 May-Jun
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-14     Citation Subset:  IM    
Department of Cardiothoracic Surgery, Weill Cornell Medical College, Cornell University, New York, NY 10021, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Angiotensin II Type 1 Receptor Blockers / pharmacology
Angiotensin-Converting Enzyme Inhibitors / pharmacology
Carotid Arteries / radiography,  surgery*
Coronary Angiography
Coronary Vessels / pathology
Jugular Veins / transplantation*
Spironolactone / therapeutic use*
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 52-01-7/Spironolactone

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