Comparison of Vascular Remodeling Between Different Antianginal Medication Evaluated by Noninvasive ECG-gated Fundus Photographic Evaluation

Study Overview
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Brief Summary
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Treatments for stable angina includes drug therapy such as calcium-channel blocker, beta blocker, and ACEI/ARB. To obtain good prognosis in patients with coronary artery disease,preventing or correcting the progression of atherosclerosis and dyslipidemia is more important than relieving angina symptom. Dysfunction of microvessel is one of the most important factor in patients with coronary artery disease. Recently, we developed the new non-invasive method of evaluating the microvessel in fundus. With this methods, we will compare the effect of each drug (beta blocker, CCB, ARB).

Official Title
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Comparison of Vascular Remodeling Between Different Antianginal Medication Evaluated by Noninvasive ECG-gated Fundus Photographic Evaluation

Conditions
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Stable Angina

Intervention / Treatment
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* Drug: Diltiazem treated group
* Drug: Bisoprolol treated group
* Drug: Candesartan treated group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stable angina patients whose coronary lesions is confirmed by angiography or receives PCI Unstable Angina/NSTEMI patients who completed PCI for main lesions Either systolic > 130mmHg or diastolic > 80mmHg, or patients with anti-hypertensive drugs Exclusion Criteria: STEMI patients within one month Variant Angina Liver function abnormality or renal failure History of Hypersensitivity to testing drugs Severe heart failure(NYHA class>3) or uncorrectable hematologic disease Woman possible to be pregnant Uncontrolled diabetes Expected life span < one year

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Diltiazem treated group<br>Diltiazem 180mg treated group | Drug: Diltiazem treated group<br>* Diltiazem 180mg for 9 months<br>|
| Active Comparator: Bisoprolol treated group<br>Bisoprolol 5mg treated group | Drug: Bisoprolol treated group<br>* Bisoprolol 5mg for 9 months<br>|
| Active Comparator: Candesartan treated group<br>Candesartan 32mg treated group | Drug: Candesartan treated group<br>* Candesartan 32mg for 9 months<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wall to lumen ratio of fundus vessel | Measurement of change in the ratio of wall thickness to lumen of the fundus vessel from baseline to 9 month follow up | baseline, 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lipid parameter | Measurement of change in total cholesterol, triglyceride, LDL, small dense LDL, and HDL | baseline, 9 months | 
| Serum markers of inflammation | CRP | baseline, 9 months | 
| Change of nitrate need | Measure of change of nitrate need | baseline, 1 months, and 3 months |