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Comparison of the effect of enalapril and losartan in conjunction with surgical coronary revascularisation versus revascularisation alone on systemic endothelial function
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UNSPECIFIED (2005) Comparison of the effect of enalapril and losartan in conjunction with surgical coronary revascularisation versus revascularisation alone on systemic endothelial function. HEART, 91 (8). pp. 1053-1057. doi:10.1136/hrt.2004.036897 ISSN 1355-6037.
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Official URL: http://dx.doi.org/10.1136/hrt.2004.036897
Abstract
Objectives: To investigate the effect of enalapril, losartan, and surgical coronary revascularisation on endothelial function, and the role of the angiotensin converting enzyme (ACE) insertion (I)/deletion (D) polymorphism.
Design: Randomised, controlled, blinded end point study.
Setting: University tertiary referral cardiac centre.
Patients and interventions: 49 men awaiting coronary artery bypass grafting (CABG) were randomly assigned to treatment with losartan, enalapril, or control for two months before and three months after surgery.
Main outcome measures: Endothelial function was blindly analysed by brachial artery flow mediated dilatation (FMD) and ACE I/D genotype was determined.
Results: FMD was impaired at baseline ( 1.0-1.7%) and after five months had improved to 5.2% with enalapril (p = 0.015), 5.0% with losartan (p = 0.0004), and 3.0% with CABG alone (p = 0.05). Patients with the II genotype had lower baseline FMD than those with DI or DD (0.1% v 1.7%, p = 0.038) and after enalapril or losartan treatment had greater improvement in FMD ( mean (SEM) 7.1 (1.1)%) than patients with DI (3.1 (1.3)%, p = 0.024) or DD genotype ( 3.1 (1.1)%, p = 0.02).
Conclusions: Enalapril and losartan, with surgical coronary revascularisation, significantly improve systemic endothelial function. Revascularisation alone produces a quantitatively smaller, but still significant, improvement. The ACE genotype significantly modulates this response. Patients with the II genotype have a more pronounced impairment in endothelial function at baseline and a greater improvement in response to treatment with these agents.
Item Type: | Journal Article | ||||
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Subjects: | Q Science > QM Human anatomy | ||||
Journal or Publication Title: | HEART | ||||
Publisher: | B M J PUBLISHING GROUP | ||||
ISSN: | 1355-6037 | ||||
Official Date: | August 2005 | ||||
Dates: |
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Volume: | 91 | ||||
Number: | 8 | ||||
Number of Pages: | 5 | ||||
Page Range: | pp. 1053-1057 | ||||
DOI: | 10.1136/hrt.2004.036897 | ||||
Publication Status: | Published |
Data sourced from Thomson Reuters' Web of Knowledge
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