Cardiology Research and Practice

Review Article

Impact of Medical Therapy on Atheroma Volume Measured by Different Cardiovascular Imaging Modalities

Table 1

Summary of trials highlighting the nonhemodynamic effects of different classes of antihypertensive medications.


Study		Medication	Imaging modality	Follow-up (months)	Outcome	Result		P-value

PREVENT [9]	825	Amlodipine versus placebo	QCA	36	Progression of coronary atherosclerosis (mm)	−0.095 versus −0.084		.38^‡

PREVENT-substudy [9]	377	Amlodipine versus placebo	B-mode ultrasound	36	CIMT (mm)	−0.013 versus +0.033		.007^‡

CAMELOT- NORMALIZE [13, 29]	274	Amlodipine versus placebo	IVUS	24	PAV (%)	−0.8; P = .12	+0.3% (Favors Amlodipine)	.59^‡
CAMELOT- NORMALIZE [13, 29]	274	Enalapril versus placebo	IVUS	24	PAV (%)	−0.5; P = .32	+0.3% (Favors Amlodipine)	.59^‡

	617		B-mode ultrasound	24	Carotid wall thickness (mm)	0.82 versus 0.81		0.58^‡
				24	Plaque score	11.1 versus 11.7		.93^‡
Part-2 [15]		Ramipril versus placebo		48	Carotid wall thickness (mm)	0.83 versus 0.81		.58^‡
				48	Plaque score	12 versus 13		.93^‡

CAPARES [12]	635	Amlodipine versus Placebo	QCA	4	MLD (mm)	−0.30 ± 0.45 versus −0.29 ± 0.45		.84^‡

SECURE [16]	732	Ramipril versus placebo	B-mode ultrasound	52	CIMT (mm/yr)	0.0180 versus 0.0137 versus 0.0217		.033*

QUIET [17]	450	Quinapril versus placebo	QCA	36	Stenosis progression (%)	49 versus 47		NS^‡
					MLD index	−0.21 ± 0.03 versus −0.18 ± 0.03		NS
					in % diameter stenosis index	+5.1 ± 1.0 versus 3.5 ± 1.0		NS

	394	Enalapril versus placebo	QCA	47.8	mean diameter (mm)	−0.11 versus −0.11		NS
SCAT [18]					minimum diameter (mm)	−0.12 versus −0.12		NS
					% diameter stenosis (%)	+2.80 versus +2.90		NS

Waseda et. al. [21]	64	Olmesartan	IVUS	7	Vessel volume index (mm²)	9.9 ± 3.1 to 9.1 ± 2.7		<.01^¶

MORE [20].	64	Olmesartan versus atenolol	B-ultrasound	24	CIMTin plaques >33.7 l (l)	−11.5 ± 4.4 versus +0.6 ± 2.5		.023

Nissen et. al. [14]	1515	Beta-blockers versus No BB	IVUS	18–24	Change in atheroma volume/yr (mm³/yr)	−2.4 ± 0.5 versus −0.4 ± 0.8		.034

Ramipril 2.5 mg versus Ramipril 10 mg versus Placebo; P-value calculated across groups;
Baseline versus Followup;
intimal index (plaque area/vessel area);
difference between groups