Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea.
Heart. 2011 Sep;97(17):1425-32. doi: 10.1136/hrt.2011.225193. Epub 2011 Jun 23.
Telmisartan is a peroxisome proliferator-activated receptor-γ activator with potent anti-inflammatory and antiatherogenic effects. The authors compared the effects of telmisartan and valsartan on neointima volume, atherosclerosis progression and brachial-ankle pulse wave velocity (baPWV) after stenting in hypertensive type 2 diabetes.
This was a prospective, randomised, 8-month follow-up study that included patients with significant coronary stenosis who received telmisartan (n=36) or valsartan (n=37).
University hospital.
Neointima volume and atherosclerosis progression 10 mm proximal and distal to the stented segment were analysed using repeat intravascular ultrasonography. baPWV and inflammatory markers such as interleukin 6, tumour necrosis factor α, C-reactive protein and adiponectin were compared.
Neointima volume at 8 months was significantly lower in the telmisartan group than the valsartan group (1.9±1.0 vs 2.6±1.4 mm(3)/1 mm, p=0.007, respectively). Total plaque volumes 10 mm proximal (7.1±1.5 vs 7.8±1.6 mm(3)/1 mm, p=0.032, respectively) and distal (3.5±1.4 vs 4.1±1.3 mm(3)/1 mm, p=0.028, respectively) to the stent were significantly lower in the telmisartan group than the valsartan group at 8 months. The decrease from baseline in baPWV was significantly greater in the telmisartan group than the valsartan group (-52±104 vs 30±113 cm/s, p=0.002, respectively). The increase from baseline in adiponectin levels and the decreases from baseline in interleukin 6 and tumour necrosis factor α levels were significantly greater in the telmisartan group at 8 months. Retinol-binding protein-4, homeostasis model of assessment index, hemoglobin A(1c) and low-density lipoprotein cholesterol levels decreased significantly in both groups without differences in changes from baseline between the two groups.
Telmisartan reduced neointima volume; atherosclerosis progression 10 mm proximal and distal to the stented segment and baPWV independent of blood pressure, glucose and lipid control in hypertensive type 2 diabetes. Clinical trial no NCT00599885 (clinicaltrials.gov.).
替米沙坦是一种过氧化物酶体增殖物激活受体-γ激动剂，具有强大的抗炎和抗动脉粥样硬化作用。作者比较了替米沙坦和缬沙坦对高血压 2 型糖尿病患者支架置入术后新生内膜体积、动脉粥样硬化进展和肱踝脉搏波速度（baPWV）的影响。
这是一项前瞻性、随机、8 个月随访研究，纳入了接受替米沙坦（n=36）或缬沙坦（n=37）治疗的有明显冠状动脉狭窄的患者。
大学医院。
使用重复血管内超声分析支架段近端和远端 10mm 处的新生内膜体积和动脉粥样硬化进展。比较 baPWV 和炎症标志物，如白细胞介素 6、肿瘤坏死因子-α、C 反应蛋白和脂联素。
8 个月时，替米沙坦组新生内膜体积明显低于缬沙坦组（1.9±1.0 与 2.6±1.4mm3/1mm，p=0.007）。支架近端 10mm 总斑块体积（7.1±1.5 与 7.8±1.6mm3/1mm，p=0.032）和支架远端 10mm 总斑块体积（3.5±1.4 与 4.1±1.3mm3/1mm，p=0.028）也显著低于替米沙坦组。8 个月时，替米沙坦组的 baPWV 从基线的下降幅度明显大于缬沙坦组（-52±104 与 30±113cm/s，p=0.002）。8 个月时，替米沙坦组脂联素水平的升高幅度以及白细胞介素 6 和肿瘤坏死因子-α水平的降低幅度均明显大于缬沙坦组。两组的视黄醇结合蛋白-4、评估指数、血红蛋白 A1c 和低密度脂蛋白胆固醇水平均显著下降，两组间从基线的变化无差异。
替米沙坦可减少高血压 2 型糖尿病患者支架置入术后新生内膜体积、支架段近端和远端 10mm 处的动脉粥样硬化进展和 baPWV，而与血压、血糖和血脂控制无关。临床试验注册号：NCT00599885（clinicaltrials.gov）。
