Abstract 11387: Dose Angiotensin II Receptor Blocker Have Adverse Effects on Coronary Collateral Function After Drug-Eluting Stent Implantation in Hypertensive Patients?
Background: Drug-eluting stents (DES) were reported to have an inhibitory effect on coronary collateral growth. Furthermore, there is a concern that this adverse effect would be enhanced by angiotensin II receptor blocker (ARB) due to its suppressive effects on angiogenic cytokines, chemotactic proteins, and growth factors. This prospective, randomized study was conducted to evaluate the effects of ARB on coronary collateral function after DES implantation in hypertensive patients, compared to a calcium channel blocker (CCB).
Method: Forty-three hypertensive patients with coronary artery stenosis treated with sirolimus-eluting stents were randomly assigned to either ARB (Telmisartan) or CCB (Amlodipine) treatment group (ARB: n=20, CCB: n=23). Coronary collateral function was assessed by simultaneous aortic and coronary wedge pressure during vascular balloon occlusion. Collateral flow index (CFI) is calculated by dividing mean distal coronary occlusive pressure by mean aortic pressure. Differences of CFI before and 3 months after procedure (ΔCFI) were evaluated for each stented vessel.
Results: There were no significant differences in patient demographics and quantitative angiographic data between the groups. CFI before procedure were similar between the groups (ARB vs. CCB; 0.16±0.07 vs. 0.16±0.06). Although CFI 3 months after procedure were significantly decreased in both groups in comparison with those before procedure(0.10±0.09 vs. 0.16±0.06; p<0.001), ΔCFI were similar in both groups(ARB vs. CCB; −0.06±0.07 vs. −0.05±0.08; p=0.7, see figure).
Conclusions: ARB would not have adverse effects on coronary collateral function after DES implantation, compared to CCB.
- © 2010 by American Heart Association, Inc.