| ǥ :
|
ȣ - 480161 100 |
| The Long-term Clinical Outcomes of Combination Therapy with Angiotensin II Type 1 Receptor Blocker and Statin After Percutaneous Coronary Intervention |
| Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea |
| Young Joon Hong, Young Keun Ahn, Dong Ku Kang, Yeon Sang Lee, Kyung Ho Yoon, Kye Hun Kim, Sang Hyun Lee, Seo Na Hong, Hyung Wook Park, Ju Han Kim, Weon Kim, MD, Myung Ho Jeong, MD, Jeong Gwan Cho, MD, Jong Chun Park, MD and Jung Chaee Kang |
Background: It has been known that angiotensin II type 1 receptor blocker (ARB) attenuated neointimal formation and vascular smooth muscle cell proliferation, with a decrease in inflammation. Recent studies have demonstrated that statin may contribute to the beneficial effects of ARB on vascular diseases. The aim of this study was to evaluate the beneficial effects of the combination therapy of statin and ARB compared with those of statin and angiotensin converting enzyme inhibitor (ACEI) in acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI). Methods: A total of 322 patients with ACS who underwent PCI between June 2001 and December 2002 were divided into two groups: Group I (n=155, 61.5±11.3 years, male 70.1%) treated with ARB (Cozaar® 50 mg) and simvastatin (Zocor® 40 mg) and Group II (n=167, 60.9±10.3 years, male 74.0%) treated with ACEI (Tritace® 5 mg) and simvastatin after PCI. Results: There were no significant differences in baseline clinical characteristics, laboratory findings, and angiographic findings and PCI-success rate and PCI-related complications. There were no significant differences in major adverse cardiac events during hospital admission. At six-month follow-up angiogram, the incidence of restenosis rate (Group I: 28/109, 25.7% vs. Group II: 33/119, 27.7%) and repeat PCI rate (Group I: 27/109, 24.8% vs. Group II: 31/119, 26.1%) were not different significantly between the groups. QCA analysis of stented coronary segments disclosed no differences in reference vessel diameter (2.88±0.26 mm in Group I vs. 2.85±0.24 mm in Group II), in minimum lumen diameter (2.01±0.57 mm in Group I and 1.95±0.48 mm in Group II), and in late loss (0.78±0.38 mm in Group I and 0.81±0.44 mm in Group II). There were no significant differences in the incidence of nonfatal myocardial infarction and death at one-year clinical follow-up between the groups. The event-free survival rate was 80.6% in Group I (125/155) and 79.0% in Group II (132/167). Conclusions: The combination therapy of ARB with statin did not show more beneficial effects compared with ACEI with statin in ACS patients who underwent PCI.
|
|
|
|
|
