Comparison of effect between nitrates and calcium channel antagonist on vascular function in patients with normal or mildly diseased coronary arteries

Yuichi Ninomiya, Shuichi Hamasaki, Keishi Saihara, Sanemasa Ishida, Tetsuro Kataoka, Masakazu Ogawa, Koji Orihara, Naoya Oketani, Tsuyoshi Fukudome, Hideki Okui, Tomoko Ichiki, Takuro Shinsato, Takuro Kubozono, Etsuko Mizoguchi, Hitoshi Ichiki, Chuwa Tei

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

The comparative long-term antianginal efficacy of long-acting nitrates versus calcium channel antagonists remains unclear. The goal of the present study was to compare the coronary endothelial cell function and coronary artery vasoconstriction between patients with normal or mildly diseased coronary arteries treated with long-acting nitrates or calcium channel antagonists. Forty-two patients suspected to have angina pectoris and with normal or mildly diseased coronary arteries underwent Doppler flow study of the left anterior descending coronary artery. All patients were suspected to have angina pectoris and were receiving either long-acting nitrates (n = 18; Nitrates group) or calcium channel antagonists (n = 24; Ca-antagonists group) for at least 1 year. Vascular reactivity was assessed by intracoronary administration of papaverine, acetylcholine (Ach), and nitroglycerin using a Doppler guidewire. Segments that showed the greatest constrictive response to Ach were used for assessment of vasoconstriction. The percent increase in coronary blood flow (CBF) and coronary artery diameter (CAD) induced by Ach was significantly smaller in the Nitrates group than in the Ca-antagonists group (33% ± 74% vs 83% ± 77%, P < 0.05; -3% ± 16% vs 11% ± 12%, P < 0.01, respectively). The percent diameter reduction in the region of greatest constrictive response to Ach was significantly greater in the Nitrates group than in the Caantagonists group (44% ± 39% vs 15% ± 32%, P < 0.02). Long-term treatment with long-acting nitrates may produce less favorable effects on coronary endothelial function and the constrictive response to Ach when compared with long-acting calcium channel antagonists in patients with normal or mildly diseased coronary arteries.

Original languageEnglish (US)
Pages (from-to)83-90
Number of pages8
JournalHeart and vessels
Volume23
Issue number2
DOIs
StatePublished - Mar 1 2008

Keywords

  • Endothelial function
  • Nitrates
  • Shear stress
  • Vasoconstriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ninomiya, Y., Hamasaki, S., Saihara, K., Ishida, S., Kataoka, T., Ogawa, M., Orihara, K., Oketani, N., Fukudome, T., Okui, H., Ichiki, T., Shinsato, T., Kubozono, T., Mizoguchi, E., Ichiki, H., & Tei, C. (2008). Comparison of effect between nitrates and calcium channel antagonist on vascular function in patients with normal or mildly diseased coronary arteries. Heart and vessels, 23(2), 83-90. https://doi.org/10.1007/s00380-007-1019-4