Late lumen loss and follow-up percent diameter stenosis at different doses of oral valsartan six months after bare-metal stent implantation in type B2/C coronary lesions.
Higher doses of oral valsartan (160-320 mg) seem to reduce in-stent restenosis rate after bare-metal stent implantation. The value of 80, 160 or 320 mg valsartan should be analyzed by late lumen loss and follow-up percent diameter stenosis as surrogate parameters in a total of 60 patients with matched demographic, clinical and angiographic findings and continuous doses of valsartan. In each group 20 patients (14 males, 6 females) with a mean age of 62.1+/-9.1, 64.3+/-8.1 and 62.9+/-11.6 years after implantation of a total of 22, 33 and 27 stents in 21, 25 and 23 lesions were included. Quantitative coronary angiography was performed with an automated contour analysis system; reference diameter, minimum diameter, late lumen loss, follow-up percent diameter stenosis and restenosis rate were determined.


RESULTS
In-stent restenosis rate including persistent area was n=5/21 (24%), n=4/25 (16%) and n=2/23 (8.7%) under 80, 160 and 320 mg valsartan. Late lumen loss was 0.79+/-0.49 mm, 0.60+/-0.43 mm and 0.37+/-0.25 mm, respectively, with significant differences between 80 and 320 mg (p<0.001) and 160 and 320 mg (p<0.05). Follow-up percent diameter stenosis was 31.8+/-18.6% under 80 mg, 25.2+/-17.5% under 160 mg and 13.8+/-9.4% with significant differences between 80 mg and 320 mg (p<0.0005) and 160 and 320 mg (p<0.01).


CONCLUSIONS
Different doses of oral valsartan over six months after BMS implantation show a linear response with regard to late lumen loss and follow-up percent diameter stenosis.
Asklepios Herzkliniken GmbH Goslar, Cardiology and Intensive Care, Germany. ste.peters@asklepios.com
Stefan
S
Peters
Brigitte
B
Koehler
Heidemarie
H
Steffen
Anke
A
Rählert-Sommer
Daniela
D
Selbig
Martina
M
Trümmel
D000284:Administration, Oral; D000368:Aged; D015331:Cohort Studies; D023903:Coronary Restenosis / Q000473:pathology* / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control; D015607:Stents / Q000009:adverse effects*; D013777:Tetrazoles / Q000008:administration & dosage*; D013997:Time Factors; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000068756:Valsartan
D008670:Metals; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine