Protective effect of angiotensin II receptor blocker and calcium channel blocker on endothelial vasomotor function after everolimus-eluting stent implantation

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Abstract

Background: Endothelial dysfunction after drug-eluting stent implantation has been demonstrated. It may be associated with adverse cardiovascular events during follow-up. Olmesartan, an angiotensin II receptor antagonist, ameliorates endothelial dysfunction. The present study evaluated the protective effect of olmesartan on endothelial function after everolimus-eluting stent (EES) implantation. Methods: A total of 40 patients who underwent EES implantation were randomly assigned to the olmesartan group (20 patients with 30 lesions) or the non-olmesartan group (20 patients with 32 lesions). Endothelial function was estimated by measuring the coronary vasoreactivity in the segments 15 mm proximal and distal to EES in response to intracoronary infusion of acetylcholine (Ach; 10-8 and 10-7 mol/L) at 9-month follow-up. Endothelium-independent vasomotion was assessed after an intracoronary bolus of isosorbide dinitrate. Results: In both groups, Ach infusion did not induce significant vasoconstriction in the segment either proximal or distal to the EES. The changes in coronary diameter in response to 10-8 mol/L (-2.0 ± 4.4% vs. -0.6 ± 4.1%, p = 0.33) and 10-7 mol/L (-1.8 ± 7.9% vs. -0.3 ± 7.6%, p = 0.57) Ach infusion in the segment proximal to EES were not significantly different between the olmesartan group and the non-olmesartan group. There were no significant differences in vasoconstriction in response to 10-8 mol/L (-0.8 ± 5.8% vs. -0.9 ± 7.0%, p = 0.96) and 10-7 mol/L (1.8 ± 9.7% vs. -1.8 ± 9.7%, p = 0.16) Ach infusion in the segment distal to EES between the 2 groups. Endothelium-independent vasodilation after nitrate infusion did not differ between the 2 groups. Conclusions: Endothelial dysfunction is not observed after EES implantation. Olmesartan does not improve endothelial function after EES implantation.

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Aoki, Y., Ishikawa, K., Miura, K., Sugimoto, K., Nakayama, T., Fujimoto, Y., & Kobayashi, Y. (2016). Protective effect of angiotensin II receptor blocker and calcium channel blocker on endothelial vasomotor function after everolimus-eluting stent implantation. Journal of Cardiology, 67(3), 236–240. https://doi.org/10.1016/j.jjcc.2015.05.006

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