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Collaborative meta-analysis of randomized trials reported that ACEI or ARB is beneficial in patients with atherosclerotic disease even if their systolic pressure is less than 130mm Hg before treatment. However, whether the therapy of ACEI or ARB has an effect on the progression of atherosclerosis is unknown.
69 patients who had coronary artery disease with 97 lipid-rich plaques were enrolled in the present study. Among them, 31 patients with 46 plaques entered into the group of ACEI/ARB and the other 38 patients with 51 plaques entered into the counterpart group. All the patients were under the therapy of statin, but the distribution of type and dosage were not different among the two groups. Optical coherence tomography was used to evaluate the fibrous cap thickness (FCT) and the mean lipid arc. Besides, Intravascular ultrasound was used to evaluate the volume of the atherosclerotic plaques at baseline and follow-ups (6 months and 12 months).
Low-density lipoprotein cholesterol (LDL-C) significantly reduced from baseline to 6-month follow-up but remained stable till 12-month follow-up in both groups. However, the extent of the reduction for LDL-C did not show difference between the two groups. Fibrous cap became thicker under the therapy of statin in both groups. However, the absolute and percent change in FCT in ACEI group and its counterpart group were not that discrepant both at 6-months and 12-months follow-up. For the absolute and percent change in mean lipid arc, we also did not find difference both at 6-months and 12-months between the two groups. Furthermore, IVUS also has shown that the absolute and percent change in normalized total atheroma volume and percent atheroma volume has no obvious difference among the two groups.
The progression of coronary atherosclerosis was not discrepant between patients who have taken ACEI/ARB and their counterparts. The present study did not find that ACEI/ARB has an effect on the regression of coronary plaques under the therapy of statin.