Effect of nifedipine on progression of coronary artery calcification: A 3-year inquiry

M. Motro*, J. Shemesh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Coronary atherosclerosis involves the accumulation of lipid collagen, elastin, and calcium in conjunction with monocyte infiltration and proliferation. Many of these events are calcium-dependent and may be affected by calcium antagonists. Both pathologic and CT studies consistently show a direct relation between degree of calcium deposits and severity of atherosclerosis, independent of age. Calcium-channel blockers exhibit an antiatherogenic effect in rabbits and monkeys. Human trials have been based on the evaluation of sequential coronary angiograms in patients undergoing coronary angiography for symptomatic coronary artery disease (CAD). INTACT did show a reduction in the formation of new lesions in patients receiving nifedipine. However, it was limited that it revealed only the segment of the lesion protruding into lumen. Double helix computerized tomography (DHCT) is a noninvasive technique that can detect, measure, and compare coronary calcification in the coronary arteries. Our objectives are to determine whether the use of nifedipine vs. diuretics in high-risk hypertensive patients will arrest or retard progression of calcification in the coronary arteries, and to assess the effect of the two drugs on left ventricular (LV) hypertrophy, LV mass, and changes in LV function. The study is designed as a side arm of the ongoing INSIGHT study, aimed to show the efficacy of nifedipine vs. diuretics in high-risk hypertensive patients. Six hundred patients in 20 centers are expected to be recruited to the INSIGHT study in Israel. During the run-in period all will be referred to a single center for DHCT of the coronary arteries and echocardiography. Patients with evidence of coronary calcification (total calcium score ≤10) will enter the study. DHCT will be repeated at the end of each year for 3 years. The parameters to be analyzed in this side arm study are: (a) changes in total calcium score each year during a 3-year treatment period; (b) left ventricular change after 3 years of treatment; and (c) number of lesions after 3 years of treatment.

Original languageEnglish
Pages (from-to)S33-S35
JournalJournal of Cardiovascular Pharmacology
Volume28
Issue numberSUPPL. 3
StatePublished - 1996
Externally publishedYes

Keywords

  • Calcification
  • Calcium-channel blockers
  • Coronary artery disease
  • Coronary calcification
  • Nifedipine

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