Cardiology Online - International Academy of Cardiology
»search site
The International Academy of Cardiology is dedicated to the advancement of global research in cardiovascular medicine through the support of scientific meetings and publications.
   Home Page
   Discussion Groups
   Job Opportunities
   Contact Us





18th World Congress on Heart Disease



Mitsuyasu Terashima, M.D., Toyohashi, Japan


Objectives: The aim of this prospective, randomized study was to evaluate the effects of telmisartan on endothelial function after coronary drug-eluting stent (DES) implantation in hypertensive patients, compared to a calcium channel blocker, amlodipine.

Background: DES implantation impairs local endothelial function, which may be associated with future cardiovascular events. Telmisartan, which has unique proliferator- activated-receptor-gamma mediated effects in addition to its renin-angiotensin system inhibition effects, has favorable effects on endothelial function.

Methods: Fifty-one hypertensive patients with coronary artery stenosis but without coronary artery spasm, treated with a sirolimus-eluting stent, were randomly assigned to either the telmisartan (25 cases) or amlodipine (26 cases) treatment group. At baseline and at 3 months after DES implantation, endothelium-dependent and –independent vasomotion were evaluated by quantitative coronary angiography under the condition of medication withdrawal. The mean luminal diameter of a 20-mm coronary segment, beginning 5 mm distal to the stent, was measured before and after infusion of intracoronary acetylcholine (ACh: 10-7 mol/L, 10-6 mol/L) and then again after infusion of nitroglycerin.

Results: Blood pressure was comparable between groups at baseline and after 3 months. Vasoconstriction after ACh infusion at 3 months (impaired endothelial function) was less pronounced in the telmisartan-group than in the amlodipine-group (p<0.0001), although there was no significant difference between the two groups before DES implantation. The response to nitroglycerin did not differ between groups before or at 3 months after DES implantation.

Conclusions: Telmisartan significantly ameliorated endothelial dysfunction after DES implantation in terms of vasoconstriction induced by ACh compared to amlodipine.




©1998-2014 Cardiology Online, Inc. All rights reserved.
Cardiology Online is a registered trademark of Cardiology Online, Inc.