title: Candesartan improves impaired endothelial function in the human coronary artery.
abstract: BACKGROUND
  Endothelial dysfunction is closely related to cardiovascular events. Several studies have documented that angiotensin II type 1 receptor blockers (ARB) improve peripheral endothelial dysfunction. However, the effect of ARB on coronary endothelial function remains elusive. The purpose of this study was to ascertain the beneficial effects of ARB on human coronary artery endothelial function.
  
  
  RESULTS
  Twenty-seven patients were randomly assigned to either the candesartan group (n=14) or the control group (n=13) and followed for 12 months. Coronary blood flow velocity was measured in the left anterior descending artery without stenosis using an intracoronary Doppler-tipped guide-wire. We evaluated coronary endothelial function as the coronary blood flow velocity reserve (CFR), which was defined as the percent change in the coronary blood flow velocity after an intracoronary acetylcholine infusion. At baseline, the CFR in both groups was below 300%, implying that these patients had endothelial dysfunction. After treatment with candesartan for 6 months, the CFR increased significantly from 199 ± 20 to 337 ± 27% (P<0.001), whereas the CFR did not change in the control group (194 ± 32 vs. 185 ± 41%, P=0.52). During 12 months of observation, the cardiovascular event-free survival rate of the patients with an increased CFR was significantly greater than the rate in patients with a decreased CFR (P=0.02). Moreover, the cardiovascular event-free survival rate was greater in the candesartan group than in the control group (P=0.04).
  
  
  CONCLUSIONS
  Our results suggest that candesartan improves coronary endothelial dysfunction of human coronary arteries and may prevent cardiac events.
authors.affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Hondoh, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Takako
authors.initials: T
authors.lastname: Iino
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Katsuta
authors.forename: Takashi
authors.initials: T
authors.lastname: Koyama
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kosaka
authors.forename: Gen
authors.initials: G
authors.lastname: Terui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage*; D001713:Biphenyl Compounds; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000503:physiopathology; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D003331:Coronary Vessels / Q000187:drug effects* / Q000503:physiopathology; D018572:Disease-Free Survival; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000008:administration & dosage*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan