The Role of Angiotensin Antagonism in Coronary Plaque Regression: Insights from the Glagovian Model.

IF 2.5 Q2 PERIPHERAL VASCULAR DISEASE International Journal of Vascular Medicine Pub Date : 2021-04-05 eCollection Date: 2021-01-01 DOI:10.1155/2021/8887248
Abdul H Alkatiri, Dony Firman, Amir A Alkatiri, Paskalis I Suryajaya, Albert Sudharsono
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引用次数: 4

Abstract

The benefit of antagonizing the effect of the renin angiotensin aldosterone system (RAAS), notably by the use of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II type 1 receptor blocker (ARB) for coronary artery disease (CAD), has been demonstrated in multiple studies, which may be attributed to their ability to inhibit the deleterious effect of RAAS to the cardiovascular system. It is well known that angiotensin II (Ang II) plays a vital role in atheromatous plaque formation and progression through multiple pathways, including inflammatory and arterial remodeling aspects. Significant coronary atheromatous plaque regression has been previously demonstrated in various studies using statin agents. Similar results have been reported in different studies using angiotensin inhibitor agents, notably ARB agents. Analysis from various trials utilizing ARB showed a significant plaque regression using olmesartan and telmisartan as evaluated by IVUS studies. In contrary, the use of ACEi did not demonstrated significant plaque regression, which may be attributed to the heavy plaque calcification in respective studies. On this review, we aim to present the basic mechanism on the role of RAAS in plaque modulation and its arterial remodeling aspect, which is then integrated with the clinical evidence based on the available intravascular ultrasonography (IVUS) studies on coronary arteries.

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血管紧张素拮抗剂在冠状动脉斑块消退中的作用:来自格拉戈维模型的见解。
在多项研究中已经证明,通过使用血管紧张素转换酶抑制剂(ACEi)和血管紧张素II型1受体阻滞剂(ARB),可以拮抗肾素血管紧张素醛固酮系统(RAAS)的作用,特别是冠状动脉疾病(CAD),这可能是由于它们能够抑制RAAS对心血管系统的有害作用。众所周知,血管紧张素II (angii)通过多种途径,包括炎症和动脉重塑方面,在动脉粥样硬化斑块的形成和进展中起着至关重要的作用。在使用他汀类药物的各种研究中,已经证明了显著的冠状动脉粥样硬化斑块消退。在使用血管紧张素抑制剂,特别是ARB药物的不同研究中也报道了类似的结果。利用ARB的各种试验分析显示,IVUS研究评估了奥美沙坦和替米沙坦的显著斑块消退。相反,使用ACEi并没有显示出明显的斑块消退,这可能是由于在各自的研究中斑块钙化严重。在这篇综述中,我们旨在介绍RAAS在斑块调节及其动脉重塑方面的作用的基本机制,并结合现有冠状动脉血管内超声(IVUS)研究的临床证据。
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来源期刊
International Journal of Vascular Medicine
International Journal of Vascular Medicine PERIPHERAL VASCULAR DISEASE-
CiteScore
3.50
自引率
0.00%
发文量
7
审稿时长
16 weeks
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