Angiotensin-converting enzyme clinical trials

Shekelle PG et al Efficacy of angiotensin-converting enzyme inhibitors and beta blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status A meta-analysis of major clinical trials. J Am Coll Cardiol 2003 41 1529. [PMID 12742294]... 

Clinical effects In HF patients, digoxin has been proven to reduce symptoms, improve NYHA class, increase exercise time, modestly increase LVEE enhance cardiac output, and decrease HF hospitalizations (56,57). The Randomized Assessment of Digoxin on Inhibitors of the Angiotensin-Converting Enzyme (RADIANCE) (58) and Prospective Randomized study Of Ventricular Failure and the Efficacy of Digoxin (PROVED) (59) trials demonstrated that these beneficial effects are lost when digoxin is withdrawn from the medical therapy. Digoxin withdrawal has been associated... 

Kober L, Torp-Pedersen C, Carlsen JE, et al. A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in... 

Apart from the valuable benefit of aldosterone antagonism in hypertension, MR blockade has been shown to substantially reduce both morbidity and mortality among patients with severe chronic heart failure (CHF) and post-myocardial infarction (MI) in clinical trials [17, 18]. The Randomized Aldactone Evaluation Study (RALES) has shown that 26 mg spironolactone on average per day on top of existing standard therapy [i.e. an angiotensin-converting enzyme (ACE) inhibitor, aspirin and a loop diuretic] given to patients with severe heart failure (New York Heart Association class III or IV, left ventricular ejection fraction <35%) results in 30%... 

K0ber L, Torp-Pedersen C, Carlsen JE, et al. A clinical trial of the Angiotensin-Converting-Enzyme Inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. The Trandolapril Cardiac Evaluation (TRACE) study group. N Engl J Med 1995 333(25) 1670—6. 

Losartan blocks the vascular constrictor effect of Ang II, the Ang Il-induced aldosterone synthesis and/or release, and the All-induced cardiovascular growth. In various models of experimental hypertension, losartan prevents or reverses the elevated blood pressure and the associated cardiovascular hypertrophy similar to angiotensin converting enzyme (ACE) inhibitors. Subsequently con-tolled clinical trials revealed that losartan is a new and valuable drug for treatment of hyper-... 

Domanski, M.J., et al., Effect of angiotensin converting enzyme inhibition on sudden cardiac death in patients following acute myocardial infarction. A meta-analysis of randomized clinical trials. J Am Coll Cardiol, 1999. 33(3) p. 598-604. 

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