Effect of Losartan in Treatment of Exercise-Induced Myocardial Ischemia

Giancarlo Longobardi, Graziamaria Corbi, Francesco Cacciatore, Pasquale Abete, Giuseppe Furgi, Dino Franco Vitale, Franco Rengo, Nicola Ferrara

Research output: Contribution to journalArticlepeer-review

Abstract

Because no controlled clinical studies are available about the possible role of angiotensin II receptor blockers in preventing effort myocardial ischemia, we evaluated the effect of angiotensin II receptor blocker/losartan in preventing exercise-induced myocardial ischemia in patients with coronary artery disease. Twenty-four sedentary patients with chronic stable ischemia were prospectively randomized to 28 days (double blind) of losartan 100 mg or losartan placebo in 2 divided doses. In each patient the treatment was crossed over to the alternative regimen (28 days, double blind) after a 1-week placebo period (single blind). At the end of each phase a new exercise stress test was performed. At baseline, systolic blood pressure was significantly decreased after losartan 100 mg compared with losartan placebo. At submaximal exercise, systolic blood pressure and rate-pressure product were lower after losartan 100 mg administration compared with losartan placebo, and these findings remained significant at 1-mm ST depression and at peak exercise. Losartan 100 mg administration versus losartan placebo significantly delayed the time to 1-mm ST-depression onset and decreased ST-segment depression at peak exercise and time to recovery of ST-segment depression. Losartan 100 mg administration compared with losartan placebo was able to significantly increase exercise duration and maximal workload during exercise stress testing. In conclusion, in our study, losartan decreased electrocardiographic parameters of myocardial ischemia in patients with coronary artery disease, suggesting a possible role of this drug in treatment of patients with effort myocardial ischemia.

Original languageEnglish
Pages (from-to)1517-1521
Number of pages5
JournalThe American Journal of Cardiology
Volume100
Issue number10
DOIs
Publication statusPublished - Nov 15 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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