Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
ENCORE Investigators.
Effect of nifedipine and cerivastatin on coronary endothelial function in patients with coronary artery disease: the ENCORE I Study (Evaluation of Nifedipine and Cerivastatin On Recovery of coronary Endothelial function).
CIRCULATION. 2003; 107(3): 422-428.
Doi: 10.1161/01.CIR.0000046488.52939.BF
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PubMed
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- Co-Autor*innen der Med Uni Graz
- März Winfried
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- Abstract:
- BACKGROUND: Endothelial dysfunction is an important feature of atherosclerosis. Inhibition of the HMG-CoA pathway and of calcium channels improves endothelial function experimentally and in the forearm circulation. Thus, we investigated the effects of a statin and/or a calcium antagonist on coronary endothelial function in patients with coronary artery disease (CAD). METHODS AND RESULTS: In 343 patients undergoing percutaneous coronary intervention in 29 centers, acetylcholine (10(-6) to 10(-4) mol/L) was infused in a coronary segment without angiographically significant CAD. Changes in coronary diameter were measured by quantitative angiography. Endothelium-independent responses were assessed by intracoronary adenosine (1.2 mg/mL) and nitroglycerin (250 microg). Thereafter, patients were randomized in a double-blind manner to placebo, cerivastatin 0.4 mg/d, nifedipine 30 to 60 mg/d, or their combination. Studies were repeated at 6 months. In the most constricted segment, nifedipine but not cerivastatin reduced vasoconstriction to acetylcholine (18.8% versus placebo 10.0%; P<0.05). Patients not taking ACE inhibitors showed a smaller improvement in the placebo group (6.0%), but nifedipine still had an effect (17.0%; P<0.05 versus placebo). Analysis of all evaluable coronary segments revealed an 11% reduction of acetylcholine-induced vasoconstriction in patients receiving nifedipine and cerivastatin (P<0.05 versus placebo). Cerivastatin lowered LDL cholesterol by 35% (P<0.001). CONCLUSIONS: The ENCORE I trial demonstrates that multicenter studies on coronary endothelial function are feasible. After 6 months' treatment, nifedipine improved coronary endothelial function in the most constricted segment. The combination of nifedipine and cerivastatin tended to improve endothelial function; however, this only reached significance in an analysis of all coronary segments.
- Find related publications in this database (using NLM MeSH Indexing)
- Acetylcholine - pharmacology
- Adult - pharmacology
- Calcium Channel Blockers - adverse effects
- Cholesterol - blood
- Coronary Arteriosclerosis - diagnosis
- Double-Blind Method - diagnosis
- Drug Therapy, Combination - diagnosis
- Endothelium, Vascular - drug effects
- Female - drug effects
- Follow-Up Studies - drug effects
- Humans - drug effects
- Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects
- Male - adverse effects
- Middle Aged - adverse effects
- Myocardium - cytology
- Nifedipine - adverse effects
- Pyridines - adverse effects
- Vasoconstriction - drug effects
- Find related publications in this database (Keywords)
- coronary disease
- endothelium
- acetylcholine
- angiography
- drugs