December 21, 2017Open Access
View Full PaperEvidence for the use of mineralocorticoid receptor antagonists in the treatment of coronary artery disease and post-angioplasty restenosis
Key Result
Mineralocorticoid receptor antagonists are reviewed for their potential role in treating acute or chronic vascular remodeling processes, including atherosclerosis and post-angioplasty restenosis.
Structured PICO
Do mineralocorticoid receptor antagonists (MRAs) improve vascular remodeling processes such as atherosclerosis and post-angioplasty restenosis in patients with coronary artery disease?
P
Population
Patients with coronary artery disease (CAD) and post-angioplasty restenosis, as well as preclinical models of vascular remodeling.
I
Intervention
Mineralocorticoid receptor antagonists (MRAs) such as spironolactone and eplerenone
O
Outcome
Acute or chronic vascular remodeling processes, such as atherosclerosis and post-angioplasty restenosis
MRAs may have therapeutic potential in preventing atherosclerosis progression and post-angioplasty restenosis by targeting vascular remodeling.
Abstract
Mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone have an established role in the treatment of heart failure. However, many experimental and clinical studies have shown that aldosterone also plays a pivotal role in a variety of other pathophysiological conditions within the cardiovascular system. Aldosterone has been suggested to promote inflammation, endothelial dysfunction and smooth muscle cell hyperplasia during the development of atherosclerosis, thereby promoting the development of coronary artery disease (CAD). Since CAD and subsequent ischemic cardiomyopathy are the major causes of heart failure, it is of major interest, whether pharmacological therapy with MRAs among heart failure patients will also affect the common underlying conditions, namely, atherosclerosis and subsequent coronary vessel narrowing/rarefication. Therefore, in this article, we reviewed and discussed the preclinical and clinical evidence of MRAs for the treatment of acute or chronic vascular remodeling processes, such as atherosclerosis and post-angioplasty restenosis, which determine the progression of CAD and subsequent ischemic cardiomyopathy.