Comparison of Effects of Telmisartan and Valsartan on Neointima Volume in Diabetes
Status:
Completed
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
People with diabetes mellitus are more prone to coronary heart disease, stroke, and
peripheral vascular disease, and diabetes mellitus has been regarded as an independent risk
factor for the progression of coronary artery disease. Several studies have been reported
that diabetes increased the risk of cardiovascular mortality in both men and women. With the
introduction of drug-eluting stents (DESs), the angiographic rates of restenosis at later
months have reduced dramatically in several studies. However, even with DESs, diabetic
patients showed increased rates of restenosis and late loss index compared with nondiabetic
patients. Diabetes has been considered to be a predictor of poor prognosis after percutaneous
coronary intervention with drug-eluting stents. Long-term clinical and angiographic outcomes
after percutaneous coronary intervention (PCI) with drug-metal stents (DESs) have been
demonstrated to be worse in diabetic patients compared with nondiabetic patients. In the era
of DESs, no study has compared the effects of telmisartan and valsartan on neointima volume
with intravascular ultrasound (IVUS) at 8 months after zotarolimus-eluting stent implantation
in hypertensive type 2 diabetic patients. Telmisartan, which is well-known for its selective
peroxisome proliferator-activated receptor (PPAR)-γ activity with its anti-inflammatory and
antiproliferative properties, could be an appropriate therapeutic option for treating
hypertensive diabetic patients with significant coronary artery diseases requiring stent
implantation. In contrast, valsartan is an angiotensin receptor blocker with negligible
PPAR-γ activity. Increasing interest remains in the identification of systemic
pharmacological therapies to prevent coronary restenosis especially in diabetic patients.