Abstract 5568: Impact of Angiotensin II Receptor Blockers on Regression of Coronary Atherosclerotic Plaque -OVATION Study

Abstract

OBJECTIVES: Coronary intravascular ultrasound (IVUS) can provide an imformation of coronary atherosclerosis. Recent reports suggest that coronary plaques can be reduced by some medications. On the other hand, angiotensin II receptor blockers (ARBs) improve clinical outcomes in patients with hypertension. The aim of this multi-center study was to investigate whether blood pressure-lowering therapy with ARBs had efficacies regarding regression of coronary atherosclerosis. Methods and Results: Seventy one hypertensive patients with stable angina pectoris who underwent elective PCI were enrolled. They received one of two ABRs (olmesartan 20mg/day or valsartan 80 mg/day) after PCI. Non-target coronary lesions with mild to moderate stenosis were measured by volumetric IVUS at both baseline and 6-month follow-up period in those patients. Systolic blood pressure was significantly decreased by 16.7% after treatment with ARBs (P < 0.01 vs baseline). There were no significant differences in vessel volume (103.9±58.4 mm 3 at baseline and 98.7±57.6 mm 3 at 6-month follow-up) and lumen volume (57.2±33.6 mm 3 at baseline and 57.0±34.2 mm 3 at 6-month follow-up) between baseline and 6-month ARB treatment. However, statistically significant reduction in plaque volume was observed in examined coronary arteries (46.7±31.8 mm 3 at baseline and 41.7±28.4 mm 3 at 6-month follow-up, 10.2% decrease from baseline, P = 0.01). Interestingly, serum adiponectine levels increased from 9.0±4.2 μ g/ml to 10.7±5.4 μ g/ml (an increase of 19.4 %, P < 0.01), and serum MDA-LDL cholesterol levels decreased from 107.8±46.4 IU/l to 95.5±28.0 IU/l (a decrease of 11.4 %, P < 0.01). Conclusions: Blood pressure-lowering therapy with ARBs or 6 months significantly reduced the plaque volume at non-target coronary lesions in patients with stable angina pectoris. Furthermore, a significant increase in serum adiponectine levels and a significant decrease in serum MDA-LDL cholesterol levels were also observed after 6-month ARBs treatment.