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Larios-Cárdenas M, González-Radillo OI, Trujillo-Quirós J, Cardona-Müller D, Barocio-Pantoja M, Cardona-Muñoz EG, Grover-Páez F. Tadalafil Improves Haemodynamics and Arterial Stiffness but Not Flow- Mediated Dilation in Grade 1 Obesity. A Single-dose, Placebo-controlled Clinical Trial. Curr Vasc Pharmacol 2022; 20:527-533. [PMID: 36043781 DOI: 10.2174/1570161120666220827154417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Obesity, a major health issue worldwide, is associated with increased cardiovascular risk, endothelial dysfunction, and arterial stiffness. Tadalafil has been demonstrated to improve vascular parameters. AIM To evaluate the effect of a single 20 mg dose of tadalafil on flow-mediated dilation and hemodynamic and arterial stiffness markers. METHODS A randomized, double-blind, placebo-controlled study was conducted on 80 participants (41 assigned to placebo and 39 to tadalafil) with grade 1 obesity, to evaluate the acute effect of a single dose of 20 mg of tadalafil on flow-mediated dilation and hemodynamic and arterial stiffness markers. RESULTS Tadalafil did not modify flow-mediated dilation. However, it significantly lowered systolic blood pressure (SBP) (130.6±17.1 vs. 125.0±12.7 mmHg, p=0.011), diastolic blood pressure (82.7±18.2 vs. 76.5±11.8 mmHg, p≤0.001), central systolic blood pressure (116.33±19.16 vs. 109.90±15.05 mmHg, p=0.001), the augmentation index (69.1±17.1 vs. 65.7±14.4, p=0.012), and brachial-ankle pulse wave velocity (1229.7±218.4 vs. 1164.0±181.7, p=0.001). CONCLUSION A single dose of tadalafil did not modify flow-mediated dilation in patients with grade 1 obesity but improved blood pressure and brachial-ankle pulse wave velocity.
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Affiliation(s)
- Mariana Larios-Cárdenas
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Oscar I González-Radillo
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Jhonatan Trujillo-Quirós
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - David Cardona-Müller
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Marycruz Barocio-Pantoja
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Ernesto G Cardona-Muñoz
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
| | - Fernando Grover-Páez
- Vascular Mechanics Laboratory, Experimental Therapeutic and Clinic Institute, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico.,Department of Physiology, Pharmacology, Health Sciences University Centre, University of Guadalajara, Guadalajara, Mexico
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Vlachopoulos C, Georgakopoulos C, Pietri P, Ioakeimidis N, Koutouzis M, Vaina S, Aznaouridis K, Toutouzas K, Latsios G, Terentes-Printzios D, Rigatou A, Tousoulis D. Effect of Ticagrelor Versus Clopidogrel on Aortic Stiffness in Patients With Coronary Artery Disease. J Am Heart Assoc 2019; 8:e012521. [PMID: 31165663 PMCID: PMC6645640 DOI: 10.1161/jaha.119.012521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background We compared the acute and midterm effect of ticagrelor versus clopidogrel on aortic stiffness. Methods and Results We studied 117 patients in a randomized, assessor‐blinded, parallel‐group trial. The acute effect of ticagrelor was studied in 58 patients randomized (1:1) to receive a loading dose of clopidogrel (600 mg) or ticagrelor (180 mg). Carotid‐femoral pulse wave velocity (cfPWV) was measured before, 3, and 24 hours after the loading dose. The midterm effect (30‐day treatment period) was studied in 59 subjects who underwent percutaneous coronary intervention and were randomized to either clopidogrel (75 mg, OD) or ticagrelor (90 mg BID). cfPWV was measured before and at 30 days of treatment. Circulating markers of inflammation and endothelial function were measured at all study points. Repeated‐measures analysis showed a significant main effect for treatment (P=0.03), with the ticagrelor showing a reduction in cfPWV after treatment. cfPWV at 24 hours was significantly lower in the ticagrelor group compared with the clopidogrel group (P=0.017) (maximal response reduction by 0.42±0.26 m/s). At 30 days, cfPWV decreased in the ticagrelor group, whereas there was no change with clopidogrel (−0.43±0.57 versus 0.12±0.14 m/s, P=0.004). There were no significant changes in both the acute and midterm study period in the pro‐inflammatory and endothelial function parameters. Conclusions URL: https://www.clinicaltrials.gov. Unique identifier: NCT02071212. Ticagrelor decreases cfPWV for 24 hours after the loading dose and at 1 month post–percutaneous coronary intervention compared with clopidogrel. Considering that aortic stiffness is an independent predictor of cardiovascular events, this finding may have clinical implications regarding the beneficial effect of ticagrelor. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02071212.
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Affiliation(s)
| | | | | | - Nikolaos Ioakeimidis
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | - Michael Koutouzis
- 3 Second Department of Cardiology Red Cross General Hospital Athens Greece
| | - Sophia Vaina
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | | | - Konstantinos Toutouzas
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | - George Latsios
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
| | | | - Aggeliki Rigatou
- 3 Second Department of Cardiology Red Cross General Hospital Athens Greece
| | - Dimitris Tousoulis
- 1 First Department of Cardiology Hippokration Hospital Athens Medical School Athens Greece
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3
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Andersson DP, Trolle Lagerros Y, Grotta A, Bellocco R, Lehtihet M, Holzmann MJ. Association between treatment for erectile dysfunction and death or cardiovascular outcomes after myocardial infarction. Heart 2017; 103:1264-1270. [PMID: 28280146 PMCID: PMC5537549 DOI: 10.1136/heartjnl-2016-310746] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/03/2017] [Indexed: 12/13/2022] Open
Abstract
Objective Erectile dysfunction (ED) is associated with an increased risk of cardiovascular disease in healthy men. However, the association between treatment for ED and death or cardiovascular outcomes after a first myocardial infarction (MI) is unknown. Methods In a Swedish nationwide cohort study all men <80 years of age without prior MI, or cardiac revascularisation, hospitalised for MI during 2007–2013 were included. Treatment for ED, defined as dispensed phosphodiesterase-5 inhibitors or alprostadil, was related to risk of death, MI, cardiac revascularisation or heart failure. Results Forty-three thousand one hundred and forty-five men with mean age 64 (±10) years were included, of whom 7.1% had ED medication dispensed during a mean 3.3 years (141 739 person-years) of follow-up. Men with, compared with those without treatment for ED, had a 33% lower mortality (adjusted HR 0.67 (95%CI 0.55 to 0.81)), and 40% lower risk of hospitalisation for heart failure (HR 0.60 (95% CI 0.44 to 0.82)). There was no association between treatment with alprostadil and mortality. The adjusted risk of death in men with 1, 2–5 and >5 dispensed prescriptions of phosphodiesterase-5 inhibitors was reduced by 34% (HR 0.66 (95% CI 0.38 to 1.15), 53% (HR 0.47 (95% CI 0.26 to 0.87) and 81% (HR 0.19 (95% CI 0.08 to 0.45), respectively, when compared with alprostadil treatment. Conclusions Treatment for ED after a first MI was associated with a reduced mortality and heart failure hospitalisation. Only men treated with phosphodiesterase-5 inhibitors had a reduced risk, which appeared to be dose-dependent.
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Affiliation(s)
- Daniel P Andersson
- Department of Medicine, Karolinska Institutet, Unit of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | - Alessandra Grotta
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Mikael Lehtihet
- Department of Medicine, Karolinska Institutet, Unit of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Martin J Holzmann
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden
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Ede H, Tanik S, Yaylak B, Zengın K, Albayrak S, Akkaya S, Polat C, Turan Y, Erbay A. Can Impaired Elasticity of Aorta Predict the Success of Vardenafil Treatment in Patients with Erectile Dysfunction? SCIENTIFICA 2016; 2016:4867984. [PMID: 27200210 PMCID: PMC4856895 DOI: 10.1155/2016/4867984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
Objective. Vardenafil is used in treatment of erectile dysfunction (ED) but reveals variable clinical outcomes. Here, we aimed to evaluate the role of aortic elasticity in predicting vardenafil success among patients with ED. Methods. Sixty-one consecutive male subjects with primary ED and indication for vardenafil treatment were included. All subjects fulfilled 5-item version of the International Index of Erectile Function (IIEF-5) before the vardenafil treatment. Pretreatment aortic stiffness index (ASI) and aortic distensibility (AD) were obtained echocardiographically. Following two-month vardenafil treatment, the patients were reevaluated with IIEF-5. Pretreatment, posttreatment, and ΔIIEF-5 scores and ASI values were compared. Results. Average age was 54 ± 8 years. Pretreatment and posttreatment IIEF-5 and ΔIIEF-5 scores were 9.1 ± 2.5; 18.5 ± 2.3; and 9.4 ± 3, respectively. Mean ASI and AD values were 3.10 ± 0.54 and 4.13 ± 2.55 1/(10(3) × mmHg) accordingly. ASI value of severe pretreatment ED (n = 15) was significantly higher than that of mild-moderate pretreatment ED (n = 12) (p < 0.001). All pretreatment IIEF-5 scores increased significantly compared to posttreatment IIEF-5 scores (p < 0.001). ASI values were significantly correlated to pretreatment IIEF-5 scores (p < 0.001) and ΔIIEF-5 value (p < 0.001) but not to posttreatment IIEF-5 score. Conclusion. Aortic elasticity was impaired in accordance with degree of ED. The subjects with higher ASI values obtained more benefits from vardenafil.
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Affiliation(s)
- Hüseyin Ede
- Department of Cardiology, Faculty of Medicine, Bozok University, 66020 Yozgat, Turkey
| | - Serhat Tanik
- Department of Urology, Faculty of Medicine, Bozok University, 66020 Yozgat, Turkey
| | - Barış Yaylak
- Cardiology Clinic, Diyarbakır Gazi Yaşargil Education and Research Hospital, 21010 Diyarbakır, Turkey
| | - Kürşad Zengın
- Department of Urology, Faculty of Medicine, Bozok University, 66020 Yozgat, Turkey
| | - Sebahattin Albayrak
- Department of Urology, Faculty of Medicine, Bozok University, 66020 Yozgat, Turkey
| | - Suleyman Akkaya
- Cardiology Clinic, Diyarbakır Gazi Yaşargil Education and Research Hospital, 21010 Diyarbakır, Turkey
| | - Cegergun Polat
- Department of Cardiology, Memorial Diyarbakir Hospital, 21070 Diyarbakir, Turkey
| | - Yaşar Turan
- Department of Cardiology, Faculty of Medicine, Bozok University, 66020 Yozgat, Turkey
| | - Alirıza Erbay
- Department of Cardiology, Faculty of Medicine, Bozok University, 66020 Yozgat, Turkey
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Vlachopoulos C, Xaplanteris P, Aboyans V, Brodmann M, Cífková R, Cosentino F, De Carlo M, Gallino A, Landmesser U, Laurent S, Lekakis J, Mikhailidis DP, Naka KK, Protogerou AD, Rizzoni D, Schmidt-Trucksäss A, Van Bortel L, Weber T, Yamashina A, Zimlichman R, Boutouyrie P, Cockcroft J, O'Rourke M, Park JB, Schillaci G, Sillesen H, Townsend RR. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation. Atherosclerosis 2015; 241:507-32. [DOI: 10.1016/j.atherosclerosis.2015.05.007] [Citation(s) in RCA: 476] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/29/2015] [Accepted: 05/14/2015] [Indexed: 02/07/2023]
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Future Treatment of Hypertension: Shifting the Focus from Blood Pressure Lowering to Arterial Stiffness Modulation? Curr Hypertens Rep 2015; 17:67. [DOI: 10.1007/s11906-015-0569-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Acute effect of sildenafil on inflammatory markers/mediators in patients with vasculogenic erectile dysfunction. Int J Cardiol 2014; 182:98-101. [PMID: 25577741 DOI: 10.1016/j.ijcard.2014.12.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 12/21/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is associated with an incremental inflammatory activation. Evidence suggests that chronic phosphodiesterase 5 (PDE-5) inhibition may have a favorable effect on inflammatory activation and surrogate markers of ED. The aim of this study is to investigate the acute effect of sildenafil on circulating pro-inflammatory markers/mediators in ED patients. METHODS The study comprised a randomized, double-blind, crossover trial carried out on two separate arms: one with sildenafil 100mg, and one with placebo. Twenty-seven subjects participated in the study (seven in the pilot and 20 in the main phase). In the main phase, blood samples were collected at baseline and at 2 and 4h after sildenafil or placebo administration to determine fibrinogen, high sensitivity C-reactive protein (hsCRP), high sensitivity interleukin-6 (hsIL-6) and tumor necrosis factor α (TNF-α). RESULTS Administration of sildenafil produced a significant sustained reduction of fibrinogen, hsCRP and hsIL-6 (maximal absolute response of -44mg/dl, 0.42mg/l and 0.68pg/ml at 4h). Likewise, TNF-α was acutely decreased after sildenafil (maximal response of -13pg/ml, 2h). The effect of sildenafil on fibrinogen, hsCRP and hsIL-6 and TNF-α was independent of the baseline values of these markers/mediators or the baseline testosterone level (all P<0.05). Soluble vascular cell adhesion molecule 1 (sVCAM-1) levels remained unchanged. CONCLUSIONS The present study shows for the first time the acute effect of sildenafil administration on pro-inflammatory markers/mediators in men with vasculogenic ED. This finding may have important implications in ED patients who are considered to be at increased cardiovascular risk.
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