Angiotensin-converting enzyme trials

Chymostatin-sensitive Il-generating enzyme Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction Trial Collaborative Study Captopril Trial ( The Effect of Angiotensin-Converting Enzyme Inhibition on Diabetic Nephropathy ) calcium channel blocking agents Candesartan in Heart Failure Assessment of Reduction in Morbidity and Mortality Trial congestive heart failure, but the latest recommendations use HF for heart failure chronic kidney disease cardiac output... 

Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002 288(23) =2981-2997. 

Bjorck JE. (1999) Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension The Captopril Prevention Project (CAPPP) randomised trial. Lancet 353 611-616. 

Because the above trials showed a >50% relative reduction in total mortality with ICD therapy, MADIT II used broader entry criteria for primary prevention of SCD, removing the criteria for NSVT and EPS 1,232 patients with a history of MI > 30 days prior and an EF < 30% were randomized to conventional therapy or ICD implantation [10]. Conventional therapy was comparable in both arms and included a high rate of use of beta blockers, angiotensin-converting enzyme inhibitors, and statins (over two thirds for all medications in both arms). The trial was stopped early at 20 months because the relative reduction in total mortality... 

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]... 

Multicenter European Research Trial with Cilazapril after Angioplasty to Prevent Transluminal Coronary Obstruction and Restenosis (MERCATOR) Study Group. Does the new angiotensin converting enzyme inhibitor cilazapril prevent restenosis after percutaneous transluminal coronary angioplasty Results of the MERCATOR study a multicenter, randomized, double-blind placebo-controlled trial, Circulation 1992 86(1) 100-1 10. 

Table 1 Angiotensin-converting enzyme inhibitor trials...

Abbreviations ACE, angiotensin-converting enzyme CHARM, candesartan in heart failure assessment of reduction in mortality and morbidity ELITE, evaluation of losartan in the elderly HF, heart failure LVEF, left ventricular ejection fraction Ml. myocardial infarction NYHA. New York Heart Association OFTIMAAL. optimal trial in myocardial infarction with angiotensin II antagonist losartan Val-HeFT, valsartan in heart failure trial VALIANT, valsartan in acute myocardial infarction trial. 

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... 

Granger CB, McMurray JJ, Yusuf S, et al, Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors the CHARM-Alternative trial, Lancet 2003 362 ... 

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

Braunwald E, Domanski M), Fowler SE etal. PEACE Trial Investigators (2004) Angiotensin-converting-enzyme inhibition in stable coronary artery disease. New England journal of Medicine 351(20) 2058-68. 

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