Effects of amlodipine on ischemia after percutaneous transluminal coronary angioplasty: Secondary results of the Coronary Angioplasty Amlodipine Restenosis (CAPARES) study

Background Despite successful coronary angioplasty (PTCA), patients may have ischemia after the procedure because of the overall coronary disease and luminal renarrowing at the lesion sites. The aim of this study was to examine the effects of the calcium-channel blocker amlodipine on post-PTCA ischemia. Methods In a prospective, double-blind design, patients were randomized to receive10 mg of amlodipine or placebo 2 weeks before angioplasty. Exercise tests and 48-hour ambulatory electrocardiography recordings were performed in 405 patients, 2 weeks before and 2 and 20 weeks (early and late) after PTCA. Results There were no differences in clinical and angiographic baseline characteristics between the treatment groups. Ischemia and angina were equally distributed before PTCA, and no difference in restenosis was found between the groups at follow-up. The incidence of angina was significantly lower in the amlodipine group compared with the placebo group both early and late after PTCA (P = .04 and .03). Exercise-induced ischemia was reduced by 40% (P = .009) early and 34% (P = .02) late after PTCA in the amlodipine group, and ischemia on ambulatory electrocardiography was reduced by 18% early and 28% late after PTCA compared with placebo (P = .06 and P = .009). Conclusion Ischemia and angina occurred after successful PTCA and were significantly reduced by amlodipine.