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奥美沙坦可降低接受经皮冠状动脉介入治疗的稳定型冠心病患者的炎症生物标志物:OLIVUS试验结果

Olmesartan reduces inflammatory biomarkers in patients with stable coronary artery disease undergoing percutaneous coronary intervention: results from the OLIVUS trial.

作者信息

Miyoshi Toru, Hirohata Atsushi, Usui Shinichi, Yamamoto Keizo, Murakami Takashi, Komatsubara Issei, Kusachi Shozo, Ohe Tohru, Nakamura Kazufumi, Ito Hiroshi

机构信息

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan,

出版信息

Heart Vessels. 2014 Mar;29(2):178-85. doi: 10.1007/s00380-013-0343-0. Epub 2013 Apr 7.

DOI:10.1007/s00380-013-0343-0
PMID:23563752
Abstract

The OLmesartan on the progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound (OLIVUS) trial demonstrated that an angiotensin II receptor blocker, olmesartan, reduces the rate of coronary atheroma progression as evaluated by intravascular ultrasound in patients with stable angina pectoris undergoing percutaneous coronary intervention. This substudy examined the impact of olmesartan on serum biomarkers and the relationship between biomarker changes and atheroma progression. Patients in the OLIVUS trial (n = 247) were randomly assigned to a control group or the olmesartan group. A subgroup of these patients (n = 135, 55 %) was analyzed at baseline and at 14 months. Patients' characteristics and blood-pressure control were identical between the control group (n = 65) and the olmesartan group (n = 70), and also between the subpopulation and total population. The change in the level of high-sensitivity C-reactive protein (hs-CRP) (mg/l) and adiponectin (μg/ml) was significantly greater in the olmesartan group than in the control group (between-group differences: 0.5 and -0.7; 95 % confidence interval: 0.2-0.8 and -1.3 to -0.1; P = 0.001 and 0.02, respectively). Multiple regression analysis revealed that the nominal changes in total atheroma volume and percent atheroma volume were significantly associated with the nominal change in hs-CRP in the olmesartan group but not in the control group. Olmesartan reduced hs-CRP in patients with stable angina, and this correlated with the change in coronary atheroma.

摘要

奥美沙坦对冠状动脉粥样硬化进展的影响

血管内超声评估(OLIVUS)试验表明,血管紧张素II受体阻滞剂奥美沙坦可降低经皮冠状动脉介入治疗的稳定型心绞痛患者的冠状动脉粥样硬化进展速率,该速率通过血管内超声评估得出。这项子研究检测了奥美沙坦对血清生物标志物的影响以及生物标志物变化与动脉粥样硬化进展之间的关系。OLIVUS试验中的患者(n = 247)被随机分配至对照组或奥美沙坦组。其中一个亚组患者(n = 135,55%)在基线和14个月时接受了分析。对照组(n = 65)和奥美沙坦组(n = 70)之间,以及亚组人群和总体人群之间,患者的特征和血压控制情况均相同。奥美沙坦组中高敏C反应蛋白(hs-CRP)(mg/l)和脂联素(μg/ml)水平的变化显著大于对照组(组间差异:0.5和 -0.7;95%置信区间:0.2 - 0.8和 -1.3至 -0.1;P分别为0.001和0.02)。多元回归分析显示,奥美沙坦组中总粥样硬化体积和粥样硬化体积百分比的名义变化与hs-CRP的名义变化显著相关,而对照组中则无此关联。奥美沙坦可降低稳定型心绞痛患者的hs-CRP水平,且这与冠状动脉粥样硬化的变化相关。

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Low dose of hydrochlorothiazide, in combination with angiotensin receptor blocker, reduces blood pressure effectively without adverse effect on glucose and lipid profiles.低剂量氢氯噻嗪与血管紧张素受体阻滞剂联合使用可有效降低血压,且对血糖和血脂水平无不良影响。
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Four-year clinical outcomes of the OLIVUS-Ex (impact of Olmesartan on progression of coronary atherosclerosis: evaluation by intravascular ultrasound) extension trial.OLIVUS-Ex(奥美沙坦对冠状动脉粥样硬化进展的影响:血管内超声评估)扩展试验的 4 年临床结果。
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无症状日本受试者中心脏-脚踝血管指数(CAVI)与血清淀粉样蛋白A之间的相关性。
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