Effects of Octreotide Treatment on Restenosis After Coronary Angioplasty

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Abstract
Background The VERAS study (VErringerung der Re- stenoserate nach Angioplastie durch ein Somatostatin-analogon [Prevention of Restenosis Following Angioplasty With a Somatostatin Analogue]) was a placebo-controlled trial to evaluate the effects of octreotide for the prevention of restenosis after coronary angioplasty. Octreotide is a somatostatin analogue with antiproliferative properties on smooth muscle cell growth in vitro that limits myointimal thickening of arteries in balloon injury models. Methods and Results Patients received either octreotide or placebo, starting 1 hour before angioplasty and continued for 3 weeks. The minimal luminal diameters before and after angioplasty and at 6-month follow-up were analyzed with a digital quantitative algorithm. Of the initial 274 patients recruited, 217 (108 in the octreotide group and 109 in the placebo group) could be analyzed after a complete 6-month evaluation: the minimal luminal diameters were 1.67±0.57 mm in the oc-treotide-treated group and 1.66±0.64 mm in the placebo group (two-paired P =.70), and the relative losses were 0.16±0.22 and 0.13±0.21 (two-paired P =.27). The restenosis rates were also identical in both treatment groups: final diameter stenosis ≥50% (34.3% versus 33.9%, two-paired P =1.0), loss of ≥50% of the initial gain (34.3% versus 33.9%, two-paired P =1.0), and absolute reduction of minimal luminal diameter >0.72 mm (29.6% versus 24.8%, two-paired P =.45). Likewise, there was no difference with regard to the incidence of clinical events (death, myocardial infarction, bypass operations, reintervention). Octreotide was well tolerated, with the exception of gastrointestinal side effects, which were three times more common than in the placebo group. Conclusions Octreotide did not reduce the angiographically determined restenosis rate or the incidence of major clinical events after coronary angioplasty.