Effects of lacidipine on vascular responses in patients with coronary artery disease

Background To evaluate the effects of the calcium channel blocker lacidipine on vascular responses, such as endothelial function and carotid intima-media thickness (IMT), and on levels of high-sensitivity C-reactive protein (hs-CRP) in patients with coronary artery disease (CAD). Methods Endothelial function was assessed by measuring the flow-mediated vasodilation (FMD) of the brachial artery and IMT was measured in the common, bifurcating, and in the internal carotid artery by using high-resolution ultrasound. The study population consisted of 96 consecutive patients [mean age 60 years, male (n)=70] who showed at least one coronary artery narrowed by more than 50% (coronary angiography). These patients were randomly assigned to lacidipine treatment (4 mg/day, n=48) or to a placebo (n=48). We measured FMD, IMT, and hs-CRP prior to and after 6 months of treatment and following coronary angiography in all patients. Results Clinical and medical history revealed no significant differences between the groups. IMT of the common carotid artery was significantly diminished from 0.92±0.15 to 0.87±0.15 mm 6 months after treatment with lacidipine (p<0.005). However, IMT of any region in the carotid artery did not show any significant changes in the placebo group. Endothelial function and hs-CRP levels were slightly improved (insignificant) in the lacidipine group. In the placebo group, there were no significant changes. Conclusion Lacidipine leads to a significant reduction of the common carotid artery IMT as well as to a decrease in markers of inflammation in patients with CAD during a relatively short period (6 months).