Late lumen loss and follow-up percent diameter stenosis at different doses of oral valsartan six months after bare-metal stent implantation in type B2/C coronary lesions

Higher doses of oral valsartan (160-320 mg) seem to reduce in-stent restenosis rate after bare-metal stent implantation. The value of 80, 160 or 320 mg valsartan should be analyzed by late lumen loss and follow-up percent diameter stenosis as surrogate parameters in a total of 60 patients with matched demographic, clinical and angiographic findings and continuous doses of valsartan. In each group 20 patients (14 males, 6 females) with a mean age of 62.1 +/- 9.1, 64.3 +/- 8.1 and 62.9 +/- 11.6 years after implantation of a total of 22, 33 and 27 stents in 21, 25 and 23 lesions were included. Quantitative coronary angiography was performed with an automated contour analysis system; reference diameter, minimum diameter, late lumen loss, follow-up percent diameter stenosis and restenosis rate were determined. Results: In-stent restenosis rate including persistent area was n=5/21 (24%), n=4/25 (16%) and n=2/23 (8.7%) under 80, 160 and 320 mg valsartan. Late lumen loss was 0.79 +/- 0.49 mm, 0.60 +/- 0.43 mm and 0.37 +/- 0.25 mm, respectively, with significant differences between 80 and 320 mg (p<0.001) and 160 and 320 mg (p<0.05). Follow-up percent diameter stenosis was 31.8 +/- 18.6% under 80 mg, 25.2 +/- 17.5% under 160 mg and 13.8 +/- 9.4% with significant differences between 80 mg and 320 mg (p<0.0005) and 160 and 320 mg (p<0.01). Conclusions: Different doses of oral valsartan over six months after BMS implantation show a linear response with regard to late lumen loss and follow-up percent diameter stenosis. (C) 2009 Elsevier Ireland Ltd. All rights reserved.