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Effect of transdermal nitroglycerin on inflammatory mediators in patients with peripheral atherosclerotic vascular
José R de Berrazueta1, Isabel Sampedro, M Teresa Garcia-Unzueta
1Division of Cardiology, Hospital Universitario M de Valdecilla and University of Cantabria, Santander, Spain. jose.berrazueta@unican.es
Objective:
To demonstrate that nitroglycerin improves biological markers of arterial inflammation in patients with peripheral vascular disease.
Background:
Atherosclerosis is an inflammatory disease in which there is an increase in active inflammation markers such as C-reactive protein and other factors released by endothelial cells. Nitroglycerin acts by a chemical liberation of nitric oxide. We have previously published the results from several controlled clinical trials confirming an anti-inflammatory action of nitroglycerin.
Methods:
Forty patients with peripheral vascular disease entered a randomized, double-blind, placebo-controlled pilot study for 6 weeks. Twenty-one patients were treated with continuous application of a transdermal nitroglycerin patch (15 mg/24 hours) on the anterior face of the thigh. Venous blood samples were obtained before treatment and 2 and 6 weeks after. We measured plasma levels of C-reactive protein, cGMP (also intraplatelet cGMP), E-selectin, ICAM, VCAM-1, IL-6, and nitrites/nitrates.
Results:
No biological parameter was modified in the placebo group. On the contrary, nitroglycerin significantly reduced plasma levels of C-reactive protein and sE-selectin and increased the levels of intraplatelet cGMP.
Conclusions:
The results of this preliminary study show that nitroglycerin has an anti-inflammatory action in patients with peripheral vascular disease. This may provide a new therapeutic approach to understanding the efficacy of nitrovasodilators in the improvement of atherosclerotic syndromes.
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