Why the study?
Does combination therapy with cilnidipine and captopril improve endothelial function and arterial stiffness compared to cilnidipine alone in patients with stable angina pectoris?
RCT (n=87)
Open-label
Randomized
No
Does combination therapy with cilnidipine and captopril improve endothelial function and arterial stiffness compared to cilnidipine alone in patients with stable angina pectoris?
Absolute Event Rate: 8.8% vs 8.2%
p-value: p=<0.001
Combination therapy with a calcium channel blocker and an ACE inhibitor significantly improves endothelial function, arterial stiffness, and microalbuminuria compared to calcium channel blocker monotherapy in patients with stable angina pectoris.
Supports cilnidipine-captopril for endothelial and stiffness gains in stable angina; extends CCB-ACEI data to vascular surrogates.
To evaluate the effects of calcium channel blocker (CCB) and angiotensin converting enzyme inhibitor (ACEI) on endothelial function and arterial stiffness in stable angina pectoris (SAP), 87 patients with SAP (57.6+/-10.0 yr, 52 males) were divided into two groups; CCB group (group I: n=44, 57.9+/-9.7 yr, 23 males) vs. CCB plus ACEI group (group II: n=43, 57.2+/-10.5 yr, 29 males). Flow mediated vasodilation (FMD) of the brachial artery, pulse wave velocity (PWV), urinary albumin excretion (UAE), and high sensitivity C-reactive protein (hsCRP) were compared. FMD, PWV, UAE, and hsCRP were not different between the groups at baseline. After 6 months of treatment, FMD were significantly improved in group II (7.5+/-3.7 to 8.8+/-2.7%, p<0.001), but not in group I (7.9+/-2.7 to 8.2+/-2.8%, p=0.535). Brachial-ankle PWV were significantly improved in both groups (1,621.3+/-279.4 to 1,512.1+/-225.0 cm/sec in group I, p<0.001, 1,586.8+/-278.5 to 1,434.5+/-200.5 cm/sec in group II, p<0.001). However, heart-femoral PWV were significantly improved (1,025.7+/-145.1 to 946.2+/-112.2 cm/sec, p<0.001) and UAE were significantly decreased (20.19+/-29.92 to 13.03+/-16.42 mg/g Cr, p=0.019) in group II only. In conclusion, combination therapy with CCB and ACEI improves endothelial function, arterial stiffness, and UAE than CCB mono-therapy more effectively in patients with SAP.
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Kim et al. (2009) conducted an RCT in Stable angina pectoris (n=87). Cilnidipine plus captopril vs. Cilnidipine 10 mg/day was evaluated on Flow-mediated vasodilation (FMD) at 6 months (p=<0.001).
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