Evaluation of The Effects of Nebivolol in Comparison to Atenolol on Wall Shear Stress and Rupture Prone Coronary Plaques
Status:
Completed
Trial end date:
2013-09-01
Target enrollment:
Participant gender:
Summary
Nebivolol is a novel blood pressure lowering drug with an additional effect on the inner
lining of blood vessels to release a compound called nitric oxide that can relax blood
vessels. Atenolol is a blood pressure reducing agent without the ability to release nitric
oxide and effect additional blood vessel relaxation.
The goal of this proposal is to compare Nebivolol and Atenolol with respect to the following
parameters:
- Plaque within arteries supplying the heart in terms of its volume and composition as
assessed by ultrasound within these arteries.
- Ability of small arteries in the heart to open up and deliver an enhanced blood supply
in response to drug called Adenosine (routinely used in the cardiac catheterization
laboratory) as assessed by pressure and flow detecting catheters within these arteries.
- Ability of the inner lining of arteries that supply the heart to release a relaxing
compound called nitric oxide in response to injection of Acetylcholine (also used in the
cardiac catheterization laboratory) as assessed by squirting dye into these arteries
- Local forces that affect blood flow in the arteries supplying the heart as assessed by
superimposing the above data into complex maps created offline at Georgia Institute of
Technology.
It is likely that Nebivolol causes the plaque within arteries supplying the heart to change
from the 'vulnerable' type to the 'stable' type plaque. There are several features of
"vulnerable plaques" that can be detected in arteries of the heart using intravascular
ultrasound (a small ultrasound camera that goes in the arteries of the heart). The
investigators hypothesis is that Nebivolol will prove superior to Atenolol in reducing
'vulnerable plaques', improve blood flow within the small arteries and the health of inner
lining of these arteries at the 1 year time point. The investigators plan to enroll 20
patients into the study (26 patient including dropouts) who will be randomized in a 1:1
manner to Nebivolol Vs Atenolol for 1 year and repeat evaluation at that time point.