Document Detail


Aldosterone inhibition and coronary endothelial function in women without obstructive coronary artery disease: an ancillary study of the national heart, lung, and blood institute-sponsored women's ischemia syndrome evaluation.
MedLine Citation:
PMID:  24890531     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
METHODS: In a double-blind, parallel-group, repeated-measures study, women with symptoms and signs of ischemia, no significant CAD, and coronary endothelial dysfunction receiving an angiotensin-converting enzyme inhibitor or receptor blocker were randomized to aldosterone blockade or placebo. The primary outcome at 16 weeks was percent change in coronary diameter to acetylcholine, and secondary outcome, coronary flow reserve to adenosine, both adjusted for baseline reactivity.
RESULTS: Forty-one women completed the treatment period with repeat coronary reactivity testing. Their mean age was 54 ± 10 years; body mass index, 30 ± 7.4 kg/m2; 12% had diabetes; and 15% had metabolic syndrome. There were no significant differences between treatment groups. At baseline, the percent change in reference vessel coronary diameter to acetylcholine was -5.0% in the aldosterone blockade group and -3.4% in the placebo group and, at 16 weeks, -7.2% in the aldosterone blockade group versus -14.3% in the placebo group (P = .15). At 16 weeks, the change in coronary flow reserve to intracoronary adenosine was -0.13 in the aldosterone blockade group versus -0.25 in the placebo group (P = .66).
CONCLUSION: Adding aldosterone receptor blockade to angiotensin II inhibition did not improve coronary endothelial or microvascular function among women with signs and symptoms of ischemia in the setting of nonobstructive CAD.
Authors:
Anthony A Bavry; Eileen M Handberg; Tianyao Huo; Amir Lerman; Arshed A Quyyumi; Chrisandra Shufelt; Barry Sharaf; C Noel Bairey Merz; Rhonda M Cooper-DeHoff; George Sopko; Carl J Pepine
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2014-03-01
Journal Detail:
Title:  American heart journal     Volume:  167     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-06-03     Completed Date:  2014-07-15     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  826-32     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2014 Mosby, Inc. All rights reserved.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00187889
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / pharmacology*
Adult
Aged
Angiotensin Receptor Antagonists / therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Cardiac Catheterization
Coronary Angiography
Coronary Artery Disease / drug therapy*,  radiography
Coronary Vessels / drug effects,  radiography
Double-Blind Method
Drug Therapy, Combination
Endothelium, Vascular / drug effects*
Female
Humans
Middle Aged
Mineralocorticoid Receptor Antagonists / therapeutic use*
National Heart, Lung, and Blood Institute (U.S.)
Spironolactone / analogs & derivatives*,  therapeutic use
Treatment Outcome
United States
Vasodilation
Vasodilator Agents / pharmacology*
Grant Support
ID/Acronym/Agency:
N01 HV068161/HV/NHLBI NIH HHS; N01 HV068162/HV/NHLBI NIH HHS; N01 HV068163/HV/NHLBI NIH HHS; N01 HV068164/HV/NHLBI NIH HHS; R03 AG032631/AG/NIA NIH HHS; T32 HL069751/HL/NHLBI NIH HHS; U01 HL064829/HL/NHLBI NIH HHS; U01 HL064914/HL/NHLBI NIH HHS; U01 HL064924/HL/NHLBI NIH HHS; UL1 TR000064/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Mineralocorticoid Receptor Antagonists; 0/Vasodilator Agents; 27O7W4T232/Spironolactone; 6995V82D0B/eplerenone; N9YNS0M02X/Acetylcholine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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