Heparin and Cilazapril Together Inhibit Injury-Induced Intimal Hyperplasia

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 18; no. 4 Suppl II; pp. II-65 - II-69
• Main Authors: Clowes, Alexander W, Clowes, Monika M, Vergel, Selina C, Muller, Rita K.M, Powell, Jerry S, Hefti, Fridolin, Baumgartner, Hans R
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.10.1991; Hagerstown, MD Lippincott
• Subjects: Angiotensin-Converting Enzyme Inhibitors - pharmacology; Animals; Biological and medical sciences; Cardiovascular system; Carotid Arteries - drug effects; Carotid Arteries - pathology; Cell Division - drug effects; Cilazapril; Drug Synergism; Endothelium, Vascular - drug effects; Endothelium, Vascular - pathology; Heparin - administration & dosage; Heparin - pharmacology; Hyperplasia; Male; Medical sciences; Miscellaneous; Muscle, Smooth, Vascular - drug effects; Muscle, Smooth, Vascular - pathology; Pharmacology. Drug treatments; Pyridazines - administration & dosage; Pyridazines - pharmacology; Rats; Rats, Inbred Strains
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.hyp.18.4_suppl.ii65

Both heparin and the angiotensin converting enzyme inhibitor cilazapril inhibit intimal thickening in rat carotid arteries injured by the passage of a balloon catheter. The purpose of this study was to determine if combinations of the two drugs were more effective than either drug alone and whether the effect could be accounted for by inhibition of smooth muscle cell proliferation. Heparin (0.1-03 mg/kg/hr) administered by continuous intravenous infusion with or without cilazapril (0-25 mg/kg/day p.o.) produced a dose-dependent inhibition of smooth muscle accumulation at 14 days after rat carotid ballooning. At the lower doses, the inhibitory effects of heparin and cilazapril were additive when the drugs were used together. This overall effect on growth was reflected in decreased smooth muscle cell proliferation at 2 and 7 days. A 7-day course of heparin combined with cilazapril, a regimen that might be applicable in the clinical setting, produced an 80% inhibition of intimal thickening at 28 days. These results provide evidence that heparin and cilazapril together might prove to be more effective than either drug alone in the control of intimal hyperplasia after arterial injury.