The Effects of Probucol Combined with Antiplatelets on the Coronary Stented Patients

ABSTRACT

BACKGROUND: An antioxidant, probucol, prevents endothelial dysfunction and low density lipoprotein oxidation and also inhibits the secretion of interleukin-1 by macrophages. These effects of probucol may result in decreased production of matrix metalloproteinases by smooth muscle cells and thus modify remodeling of the extracellular matrix. METHODS AND MATERIALS We analyzed clinical events at 1 month and 6 months in 337 patients with 363 coronary arterial lesions after coronary stenting at Chonnam National University Hospital between January 1998 and May 1999. The patients were assigned to following four modalities 500 mg of tilcipidine daily (Group I), 200 mg of cilostazol daily (Group II), 500 mg of probucol in addition to 500 mg of ticlipidine daily (Group III), and 500 mg of probucol in addition to 200 mg of cilostazol daily (Group IV). All patients received aspirin. RESULTS: Group I comprised of 149 (104 M, 45 F, 62+/-10 years), Group II 96 (73 M, 23 F, 60+/-10 years), Group III 50 (32 M, 18 F, 61+/-10 years), and Group IV 42 (32 M, 10 F, 62+/-10 years) patients. Clinical diagnosis was not different among four groups. Major adverse cardiac events, including myocardial infarction, cardiac death, and repeated intervention, at 1 month were 7 (4.7%) in Group I, 2 (2.1%) in Group II, 0 (0%) in Group III, 2 patients (4.8%) in Group IV, and those at 6 months were 29 (19.5%) in Group I, 17 (17.7%) in Group II, 9 (18.0%) in Group III, and 6 patients (14.3%) in Group IV. CONCLUSIONS: Probucol combined with aspirin and cilostazol has a tendency reducing the major cardiac events compared with aspirin and ticlopidine or cilostazol after stenting.