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Predictors of candesartan's effect on vascular reactivity in patients with coronary artery disease

So-Ryoung Lee1, In-Ho Chae2, Hack-Lyoung Kim3

  • 1Division of Cardiology, Department of Internal Medicine/Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.

Cardiovascular Therapeutics
|August 11, 2017
PubMed

Insights

Candesartan improved vascular reactivity in coronary artery disease patients, particularly those with severe endothelial dysfunction and arterial stiffness. Baseline measurements predicted treatment response, with poor responders showing higher rates of prior myocardial infarction.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Vascular Biology

Background:

  • Endothelial dysfunction and arterial stiffness are key predictors of adverse outcomes in coronary artery disease (CAD).
  • Assessing vascular reactivity is crucial for managing CAD patients.
  • Candesartan is a commonly used medication for cardiovascular conditions.

Purpose of the Study:

  • To evaluate the efficacy of candesartan on vascular reactivity in CAD patients.
  • To identify predictors of candesartan's effect on flow-mediated dilation (FMD) and pulse wave velocity (PWV).

Main Methods:

  • Prospective enrollment of 124 CAD patients treated with candesartan for 6 months.
  • Vascular reactivity assessed by changes in FMD and PWV.
  • Receiver operating characteristic analysis used to identify predictive factors.

Main Results:

  • Patients with more severe baseline endothelial dysfunction (FMD <7.5%) showed a better response to candesartan.
  • Greater blood pressure reduction and higher baseline PWV were observed in better PWV responders.
  • Poor responders in both FMD and PWV had a higher prevalence of previous myocardial infarction.

Conclusions:

  • Candesartan's vascular reactivity benefits are more significant in CAD patients with pronounced endothelial dysfunction and arterial stiffness.
  • Baseline vascular parameters predict response to candesartan therapy.
  • Identifying poor responders may help stratify risk for adverse cardiovascular events.
Abstract

Keywords:
Angiotensin II type 1 receptor blockersArterial stiffnessEndothelial dysfunctionFlow-mediated dilationPulse wave velocity

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