Impact of Olmesartan on Progression of Coronary Atherosclerosis A Serial Volumetric Intravascular Ultrasound Analysis From the OLIVUS (Impact of OLmesarten on progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound) Trial

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:55

Article

Hirohata, Atsushi¹  Yamamoto, Keizo¹  Miyoshi, Toru²  Hatanaka, Kunihiko²  Hirohata, Satoshi²  Yamawaki, Hitoshi³  Komatsubara, Issei⁴  Murakami, Masaaki¹  Hirose, Eiki¹  Sato, Shinji¹  Ohkawa, Keisuke¹  Ishizawa, Makoto¹  Yamaji, Hirosuke¹  Kawamura, Hiroshi¹  Kusachi, Shozo⁵  Murakami, Takashi¹  Hina, Kazuyoshi¹  Ohe, Tohru¹ 

[1] Sakakibara Heart Inst Okayama, Okayama 7000823, Japan

[2] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Okayama 7008530, Japan

[3] Tottori City Hosp, Tottori, Japan

[4] Tsuyama Cent Hosp, Tsuyama, Japan

[5] Okayama Univ, Grad Sch Hlth Sci, Okayama 7008530, Japan

关键词: angiotensin;    arteriosclerosis;    atherosclerosis;    prevention;    ultrasonics;   

DOI  :  10.1016/j.jacc.2009.09.062

来源: Elsevier

【 摘 要 】

Objectives The aim of this study was to evaluate the impact of olmesartan on progression of coronary atherosclerosis. Background Prior intravascular ultrasound (IVUS) trial results suggest slowing of coronary atheroma progression with some medicines but have not shown convincing evidence of regression with angiotension-II receptor blocking agents. Methods A prospective, randomized, multicenter trial-OLIVUS (Impact of OLmesartan on progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound)-was performed in 247 stable angina pectoris patients with native coronary artery disease. When these patients underwent percutaneous coronary intervention for culprit lesions, IVUS was performed in their nonculprit vessels (without angiographically documented coronary stenosis [<50%]). Patients were randomly assigned to receive 10 to 40 mg of olmesartan or control and treated with a combination of beta-blockers, calcium channel blockers, diuretics, nitrates, glycemic control agents, and/or statins per physician's guidance. Serial IVUS examinations (baseline and 14-month follow-up) were performed to assess coronary atheroma volume. Volumetric IVUS analyses included lumen, plaque, vessel volume, percent atheroma volume (PAV), percent change in total atheroma volume (TAV) and PAV. Results Patient characteristics and blood pressure control were identical between the 2 groups. However, follow-up IVUS showed significantly decreased TAV and percent change in PAV in the olmesartan group (5.4% vs. 0.6% for TAV and 3.1% vs. -0.7% for percent change in PAV, control vs. olmesartan, p < 0.05 for all). Conclusions These observations suggest a positive role in a potentially lower rate of coronary atheroma progression through the administration of olmesartan, an angiotension-II receptor blocking agent, for patients with stable angina pectoris. (J Am Coll Cardiol 2010; 55: 976-82) (C) 2010 by the American College of Cardiology Foundation

【 授权许可】

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