title: Beneficial effects of valsartan on target lesion revascularization after percutaneous coronary interventions with bare-metal stents.
abstract: BACKGROUND
  Angiotensin II receptor blockers (ARB) have been shown to reduce cardiovascular events in patients at risk. The effect of valsartan on outcomes after percutaneous coronary interventions (PCI) with bare-metal stents (BMS) was investigated.
  
  
  RESULTS
  The prospective, randomized study included 191 patients at 5 participating institutions, who were randomly assigned to either a 40-80 mg valsartan add-on or non-ARB treatment. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, and target lesion revascularization (TLR) at 18 months. Enrollment was stopped when the use of drug-eluting stents has been expanded in Japan. No significant differences existed between the groups in terms of primary endpoint (18.9% vs. 24.8%; hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.61-1.14; P = 0.26). In the valsartan group, as compared with the non-ARB group, the secondary endpoint of TLR was significantly reduced at a median follow-up 4.4 years; the rate of TLR was from 27.8% to 14.5% (HR, 0.69; 95%CI, 0.49-0.96; P = 0.024).
  
  
  CONCLUSIONS
  Valsartan treatment was not superior to non-ARB treatment in reducing the primary endpoint after PCI at 18 months. The pre-specified secondary endpoint of TLR was lower in the valsartan group, but this needs to be proved statistically with an adequate study sampling.
authors.affiliation: Department of Cardiovascular Medicine, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Okada
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Okimoto
authors.forename: Masaya
authors.initials: M
authors.lastname: Otsuka
authors.forename: Ken
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Dohi
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujii
authors.forename: Futoshi
authors.initials: F
authors.lastname: Tadehara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D008670:Metals; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine