Impact of Angiotensin II Receptor Blocker Therapy (Olmesartan or Valsartan) on Coronary Atherosclerotic Plaque Volume Measured by Intravascular Ultrasound in Patients With Stable Angina Pectoris

• Published in: The American journal of cardiology 2013-08, Vol.112 (3), p.363-368
• Main Authors: Ishii, Hideki, MD, PhD, Kobayashi, Masakazu, MD, PhD, Kurebayashi, Nobutake, MD, Yoshikawa, Daiji, MD, Suzuki, Susumu, MD, Ichimiya, Satoshi, MD, PhD, Kanashiro, Masaaki, MD, PhD, Sone, Takahito, MD, PhD, Tsuboi, Hideyuki, MD, PhD, Amano, Tetsuya, MD, PhD, Uetani, Tadayuki, MD, PhD, Harada, Ken, MD, PhD, Marui, Nobuyuki, MD, PhD, Murohara, Toyoaki, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Aged; Aged, 80 and over; Angina; Angina pectoris; Angina Pectoris - diagnostic imaging; Angina Pectoris - therapy; Angioplasty, Balloon, Coronary; Angiotensin II Type 1 Receptor Blockers - adverse effects; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Atherosclerosis; Blood pressure; Cardiovascular; Combined Modality Therapy; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Disease Progression; Double-Blind Method; Drug therapy; Female; Heart attacks; Humans; Hypertension - complications; Image Interpretation, Computer-Assisted; Imidazoles - adverse effects; Imidazoles - therapeutic use; Lipids; Long-Term Care; Male; Middle Aged; Tetrazoles - adverse effects; Tetrazoles - therapeutic use; Ultrasonography, Interventional; Valine - adverse effects; Valine - analogs & derivatives; Valine - therapeutic use; Valsartan; Variables
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2013.03.038

Coronary plaques can be reduced by some medications. The aim of this study was to compare the effects of 2 angiotensin II receptor blockers (olmesartan at 20 mg/day or valsartan at 80 mg/day) on coronary plaque by coronary intravascular ultrasound. One hundred hypertensive patients with stable angina pectoris who underwent elective percutaneous coronary intervention were randomly selected to receive 1 of the 2 angiotensin II receptor blockers after coronary intervention. Nontarget coronary lesions with mild to moderate stenosis were measured by volumetric intravascular ultrasound at baseline and after 6 months. After 6 months, both the olmesartan and the valsartan groups showed significant reduction of the examined coronary plaque volume (46.2 ± 24.1 mm3 at baseline vs 41.6 ± 21.1 mm3 at 6 months: 4.7% decrease, p = 0.0002; and 47.2 ± 32.7 mm3 at baseline vs 42.5 ± 30.2 mm3 at 6 months: 4.8% decrease, p = 0.002, respectively). There was no statistically significant difference of plaque regression between the 2 groups (p = 0.96). In conclusion, there was a significant decrease from baseline in the coronary plaque volume in patients with stable angina pectoris who received olmesartan or valsartan for 6 months. In addition, there was no significant difference in the reduction of plaque volume achieved by these 2 medications.