Impact of Angiotensin II Receptor Blocker Therapy (Olmesartan or Valsartan) on Coronary Atherosclerotic Plaque Volume Measured by Intravascular Ultrasound in Patients With Stable Angina Pectoris

Ishii, Hideki; Kobayashi, Masakazu; Kurebayashi, Nobutake; Yoshikawa, Daiji; Suzuki, Susumu; Ichimiya, Shingo; Kanashiro, Masaaki; Sone, Toshio; Tsuboi, Hideyuki; Amano, Tetsuya; Uetani, Tadayuki; Harada, Ken; Marui, Nobuyuki; Murohara, Toyoaki

doi:10.1016/j.amjcard.2013.03.038

Cited by 7 publications

(1 citation statement)

References 25 publications

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“…In a rabbit plaque model, ACE-Is and ARBs increased collagen content, VSMCs, and the thickness of TCFA (140). Clinical studies have shown that coronary atherosclerotic plaque volume, as measured by IVUS, significantly decreased after ARB treatment (141)(142)(143). ARBs have potential to decrease inflammatory infiltration, increase collagen content and stabilize human carotid plaques (144).…”

Section: Hypertensionmentioning

confidence: 99%

Stabilization of high-risk plaques

Takata¹,

Imaizumi²,

Zhang³

et al. 2016

Cardiovasc. Diagn. Ther.

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Section: Hypertensionmentioning

confidence: 99%

Stabilization of high-risk plaques

Takata¹,

Imaizumi²,

Zhang³

et al. 2016

Cardiovasc. Diagn. Ther.

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Renin angiotensin aldosterone inhibition in the treatment of cardiovascular disease

Ferrario

Mullick

2017

Pharmacological Research

101

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A collective century of discoveries establishes the importance of the renin angiotensin aldosterone system in maintaining blood pressure, fluid volume and electrolyte homeostasis via autocrine, paracrine and endocrine signaling. While research continues to yield new functions of angiotensin II and angiotensin-(1-7), the gap between basic research and clinical application of these new findings is widening. As data accumulates on the efficacy of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers as drugs of fundamental importance in the treatment of cardiovascular and renal disorders, it is becoming apparent that the achieved clinical benefits is suboptimal and surprisingly no different than what can be achieved with other therapeutic interventions. We discuss this issue and summarize new pathways and mechanisms effecting the synthesis and actions of angiotensin II. The presence of renin-independent non-canonical pathways for angiotensin II production are largely unaffected by agents inhibiting renin angiotensin system activity. Hence, new efforts should be directed to develop drugs that can effectively block the synthesis and/or action of intracellular angiotensin II. Improved drug penetration into cardiac or renal sites of disease, inhibiting chymase –the primary angiotensin II forming enzyme in the human heart–, and/or inhibiting angiotensinogen synthesis would all be more effective strategies to inhibit the system. Additionally, given the role of angiotensin II in the maintenance of renal homeostatic mechanisms, any new inhibitor should possess greater selectivity of targeting pathogenic angiotensin II signaling processes and thereby limit inappropriate inhibition.

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The Role of Angiotensin Antagonism in Coronary Plaque Regression: Insights from the Glagovian Model

Alkatiri

Firman

Alkatiri

et al. 2021

International Journal of Vascular Medicine

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The benefit of antagonizing the effect of the renin angiotensin aldosterone system (RAAS), notably by the use of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II type 1 receptor blocker (ARB) for coronary artery disease (CAD), has been demonstrated in multiple studies, which may be attributed to their ability to inhibit the deleterious effect of RAAS to the cardiovascular system. It is well known that angiotensin II (Ang II) plays a vital role in atheromatous plaque formation and progression through multiple pathways, including inflammatory and arterial remodeling aspects. Significant coronary atheromatous plaque regression has been previously demonstrated in various studies using statin agents. Similar results have been reported in different studies using angiotensin inhibitor agents, notably ARB agents. Analysis from various trials utilizing ARB showed a significant plaque regression using olmesartan and telmisartan as evaluated by IVUS studies. In contrary, the use of ACEi did not demonstrated significant plaque regression, which may be attributed to the heavy plaque calcification in respective studies. On this review, we aim to present the basic mechanism on the role of RAAS in plaque modulation and its arterial remodeling aspect, which is then integrated with the clinical evidence based on the available intravascular ultrasonography (IVUS) studies on coronary arteries.

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Impact of Angiotensin II Receptor Blocker Therapy (Olmesartan or Valsartan) on Coronary Atherosclerotic Plaque Volume Measured by Intravascular Ultrasound in Patients With Stable Angina Pectoris

Cited by 7 publications

References 25 publications

Stabilization of high-risk plaques

Stabilization of high-risk plaques

Renin angiotensin aldosterone inhibition in the treatment of cardiovascular disease

The Role of Angiotensin Antagonism in Coronary Plaque Regression: Insights from the Glagovian Model

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