The antiatherogenic effect of calcium antagonists demonstrated in experimental animal models has stimulated clinical trials to determine whether they might beneficially affect the evolution of human atherosclerosis. Three clinical trials that assess the effects of calcium antagonists are reviewed here. The Montreal Heart Institute Study and the International Nifedipine Trial on Antiatherosclerotic Therapy (INTACT) study demonstrated that neither nicardipine nor nifedipine has a significant effect on established coronary artery lesions in patients with life-threatening diseases after 24 or 36 months of therapy, respectively. However, both studies showed a statistically significant effect on early stages of plaque evolution. Retrospective data analyses in the Montreal Study showed that nicardipine retarded the progression of minimal (≤20% stenosis) lesions, and the INTACT study prospectively demonstrated that nifedipine significantly (P = 0.034) reduced the number of new lesions. The ongoing Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS) was designed specifically to compare the efficacy of isradipine and hydrochlorothiazide in retarding the progression of mild to moderate atherosclerosis in extracranial carotid arteries as assessed by B-mode ultrasonography. The results will be helpful in better understanding whether, and to what extent, isradipine beneficially affects atherosclerosis at the level of the arterial wall.
|Original language||English (US)|
|Number of pages||10|
|Journal||Journal of Vascular Medicine and Biology|
|State||Published - Dec 1 1991|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine