Impact of olmesartan on progression of coronary atherosclerosis a serial volumetric intravascular ultrasound analysis from the OLIVUS (impact of OLmesarten on progression of coronary atherosclerosis: evaluation by intravascular ultrasound) trial.
OBJECTIVE
The aim of this study was to evaluate the impact of olmesartan on progression of coronary atherosclerosis.


BACKGROUND
Prior intravascular ultrasound (IVUS) trial results suggest slowing of coronary atheroma progression with some medicines but have not shown convincing evidence of regression with angiotension-II receptor blocking agents.


METHODS
A prospective, randomized, multicenter trial-OLIVUS (Impact of OLmesartan on progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound)-was performed in 247 stable angina pectoris patients with native coronary artery disease. When these patients underwent percutaneous coronary intervention for culprit lesions, IVUS was performed in their nonculprit vessels (without angiographically documented coronary stenosis [<50%]). Patients were randomly assigned to receive 10 to 40 mg of olmesartan or control and treated with a combination of beta-blockers, calcium channel blockers, diuretics, nitrates, glycemic control agents, and/or statins per physician's guidance. Serial IVUS examinations (baseline and 14-month follow-up) were performed to assess coronary atheroma volume. Volumetric IVUS analyses included lumen, plaque, vessel volume, percent atheroma volume (PAV), percent change in total atheroma volume (TAV) and PAV.


RESULTS
Patient characteristics and blood pressure control were identical between the 2 groups. However, follow-up IVUS showed significantly decreased TAV and percent change in PAV in the olmesartan group (5.4% vs. 0.6 % for TAV and 3.1% vs. -0.7% for percent change in PAV, control vs. olmesartan, p < 0.05 for all).


CONCLUSIONS
These observations suggest a positive role in a potentially lower rate of coronary atheroma progression through the administration of olmesartan, an angiotension-II receptor blocking agent, for patients with stable angina pectoris.
Hirohata
Atsushi
A
Sakakibara Heart Institute of Okayama, Okayama, Japan. hirohata@tg7.so-net.ne.jp
Yamamoto
Keizo
K
Miyoshi
Toru
T
Hatanaka
Kunihiko
K
Hirohata
Satoshi
S
Yamawaki
Hitoshi
H
Komatsubara
Issei
I
Murakami
Masaaki
M
Hirose
Eiki
E
Sato
Shinji
S
Ohkawa
Keisuke
K
Ishizawa
Makoto
M
Yamaji
Hirosuke
H
Kawamura
Hiroshi
H
Kusachi
Shozo
S
Murakami
Takashi
T
Hina
Kazuyoshi
K
Ohe
Tohru
T
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D015906:Angioplasty, Balloon, Coronary; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000187:drug effects*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy; D011446:Prospective Studies; D015996:Survival Rate; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D018084:Ultrasonography, Interventional / Q000379:methods*
D047228:Angiotensin II Type 1 Receptor Blockers; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan