Journal
FRONTIERS IN CARDIOVASCULAR MEDICINE
Volume 7, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fcvm.2020.580419
Keywords
oral drug; coronary microvascular; microvascular function; coronary flow reserve (CFR); therapy
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Funding
- Capital Health Development Research Project [2018-2-2063, SOS-moral NCT 03372785]
- Coronary Microvascular Innovation Foundation [2018-CCA-CMVD-01]
- 2020 Beijing Municipal Education Commission Science and Technology Plan [KM202010025016]
- 2018 Beijing Excellent Talent Fund [2018000021469G241]
- National Natural Science Foundation of China [81670324, 81971569, 81671650]
- Beijing Lab for Cardiovascular Precision Medicine [PXM2017_014226_000037]
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Objective: This study aims to investigate the impact of cardiovascular medications on the coronary flow reserve (CFR) in patients without obstructive coronary artery disease (CAD). Methods: We searched PubMed, EMBASE, and Cochrane databases from inception to 15 November 2019. Studies were included if they reported CFR from baseline to follow-up after oral drug therapy of patients without obstructive CAD. Data was pooled using random-effects modeling. The primary outcome was change in CFR from baseline to follow-up after oral drug therapy. Results: A total of 46 studies including 845 subjects were included in this study. Relative to baseline, the CFR was improved by angiotensin-converting enzymes (ACEIs), aldosterone receptor antagonists (ARBs) [standard mean difference (SMD): 1.12; 95% CI: 0.77-1.47], and statins treatments (SMD: 0.61; 95%CI: 0.36-0.85). Six to 12 months of calcium channel blocker (CCB) treatments improved CFR (SMD: 1.04; 95% CI: 0.51-1.58). Beta-blocker (SMD: 0.24; 95% CI: -0.39-0.88) and ranolazine treatment (SMD: 0.31; 95% CI: -0.39-1.01) were not associated with improved CFR. Conclusions: Therapy with ACEIs, ARBs, and statins was associated with improved CFR in patients with confirmed or suspicious CMD. CCBs also improved CFR among patients followed for 6-12 months. Beta-blocker and ranolazine had no impact on CFR.
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