Calcium antagonist lercanidipine improves endothelium-dependent vasodilatation of the brachial artery in patients with proved coronary vasospasm

Abstract

Objectives: Some data show that endothelial function is impaired in coronary arteries as well as in the brachial arteries of patients with coronary vasospasm. Calcium antagonists could improve endothelium dependent vasodilatation. The main aim of our study was to assess whether treatment with dihydropyridine calcium antagonist lercanidipine can improve endothelium-dependent vasodilatation in the brachial artery in patients with proved coronary vasospasm. The second aim was to assess, whether the improvement of endothelial function can relieve patients with coronary vasospasm of chest pain attacks. Design and Methods: The study included 63 patients with coronarographically proved coronary vasospasm. Subjects were assigned to treatment with lercanidipine without changing current treatment for six months. An exercise stress test, flow-mediated dilatation (FMD), blood samples, the Seattle Angina Questionnaire were performed at baseline and after 6 months of treatment. Results: There was a significant (p = 0.0004) improvement of FMD (4.7 ± 4.0–8.1 ± 4.2) after 24-week treatment with lercanidipine compared with baseline FMD results. Also, the present study demonstrated a significant improvement of chest pain characteristics using the Seattle Angina Questionnaire (p = 0.0001). Conclusion: The present study has demonstrated that a six-month treatment with lercanidipine improves flow-mediated dilatation in the brachial artery in patients with coronary vasospasm. Improvement of endothelial function in the brachial artery under the treatment with lercanidipine is accompanied by the improvement of chest pain characteristics and stress-induced ischaemic changes.