Long-term endothelin receptor antagonism attenuates coronary plaque progression in patients with early atherosclerosis

详细信息    查看全文

• 作者：Myeong Ho Yoon ; Martin Reriani ; G?ssl Mario ; Charanjit Rihal ; Rajiv Gulati ; Ryan Lennon ; Jonella M. Tilford ; Lilach O. Lerman ; Amir Lerman
• 关键词：Endothelial function ; Endothelin receptor (ETA) antagonist ; Normalized mean total atheroma volume (TAVMEAN) ; Percent atheroma volume (PAV) ; Intravascular ultrasound (IVUS)
• 刊名：International Journal of Cardiology
• 出版年：2013
• 出版时间：30 September, 2013
• 年：2013
• 卷：168
• 期：2
• 页码：1316-1321
• 全文大小：374 K

文摘

Aim

The purpose of the current study was to determine if long term treatment with an endothelin-A (ET_A) receptor antagonist attenuates the progression of coronary plaques in patients with coronary endothelial dysfunction.

Methods

Thirty-five patients with non-obstructive coronary disease and coronary endothelial dysfunction were randomized in a double blind manner to treatment with placebo or ET_A receptor antagonist Atrasentan (10 mg) for six months. Endothelial function was assessed by the change in coronary blood flow and coronary artery diameter in response to intracoronary acetylcholine. Normalized mean total atheroma volume (TAV_MEAN), percent atheroma volume (PAV) and changes of atheroma volume were assessed by intravascular ultrasound (IVUS) at baseline and 6-month follow-up.

Results

In segments with coronary endothelial dysfunction, there was a significant decrease in normalized TAV_MEAN and PAV at six months from baseline in the Atrasentan group compared to the placebo group median (IQR) ? 2.00 mm³ (? 7.28, 2.53.) vs 9.11 mm³ (1.23, 14.05), p = 0.0024 and 0.955 % (? 3.43, 1.70) vs 3.85 % (? 0.39, 14.59) p = 0.010. There was no change in normalized TAV or PAV in the segments with normal endothelial function.

Conclusion

This study demonstrates that 6-month treatment with Atrasentan attenuates progression of coronary plaque in segments with endothelial dysfunction.