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ESC: Aliskiren Doesn't Slow Progression of Atherosclerosis

ESC: Aliskiren Doesn't Slow Progression of Atherosclerosis

No significant difference in percent/total atheroma volume with aliskiren, placebo

TUESDAY, Sept. 3 (HealthDay News) -- For patients with coronary artery disease and prehypertension, aliskiren is not associated with improvement or slowing of coronary atherosclerosis progression, according to a study published online Sept. 3 in the Journal of the American Medical Association to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 31 to Sept. 4 in Amsterdam.

Stephen J. Nicholls, M.B.B.S., Ph.D., from the South Australian Health and Medical Research Institute in Adelaide, and colleagues examined the effects of renin inhibition with aliskiren on progression of coronary atherosclerosis in a randomized, multicenter trial. Participants with coronary artery disease and systolic blood pressure in the prehypertension range underwent coronary intravascular ultrasound (IVUS) imaging and were randomly allocated to receive aliskiren (300 mg; 305 patients) or placebo (308 patients) daily for 104 weeks. After at least 72 weeks of treatment, repeat IVUS was performed to assess disease progression.

Data were available at baseline and follow-up for 458 participants. The researchers observed no significant difference in the primary IVUS efficacy parameter, percent atheroma volume (PAV), between the aliskiren- and placebo-treated patients (between-group difference, −0.43 percent; P = 0.08). There was also no significant difference noted between the groups in the secondary IVUS efficacy parameter, normalized total atheroma volume (TAV; between-group difference, −2.04 mm³; P = 0.18). There was no significant between-group differences in the proportions of patients who demonstrated regression of PAV and TAV.

"These findings do not support the use of aliskiren for regression or prevention of the progression of coronary atherosclerosis," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Novartis Pharmaceuticals, which funded the study.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1734674#Abstract )Full Text (http://jama.jamanetwork.com/article.aspx?articleid=1734674 )Editorial (http://jama.jamanetwork.com/article.aspx?articleid=1734451 )More Information (http://www.escardio.org/ESC2013 )