A randomized placebo-controlled study on the effect of nifedipine on coronary endothelial function and plaque formation in patients with coronary artery disease: The ENCORE II study
Felix T et al. – The ENCORE II trial shows that calcium channel blockade with nifedipine for up to 2 yrs improves coronary endothelial function added to statin treatment; results did not show an effect of nifedipine on plaque volume. Methods- Study of effects of a calcium antagonist on coronary endothelial function and plaque size in stable coronary artery disease (CAD)
- In 454 PCI pts, acetylcholine (10–6 to 10–4 M) infused in a coronary segment without significant CAD
- Measurement of changes in coronary diameter
- Intravascular ultrasound examination (IVUS)
- In addition to statin therapy, pts randomized in a double-blind fashion to placebo or nifedipine GITS 30–60 mg/day and followed for 18–24 mo
Results- Blood pressure lower with nifedipine vs placebo by 5.8/2.1 mmHg
- Total and LDL cholesterol lower with nifedipine vs placebo
- HDL higher cholesterol with nifedipine vs placebo
- In the most constricting segment, nifedipine reduced vasoconstriction to acetylcholine (14.0% vs placebo 7.7%)
- Percentage change in plaque volume: 1.0% nifedipine vs 1.9% placebo
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