Heart disease clinical trials

Hamano K, Nishida M, Hirata K, Mikamo A, Li TS, Harada M, Miura T, Matsuzaki M, Esato K. Local implantation of autologous bone marrow cells for therapeutic angiogenesis in patients with ischemic heart disease clinical trial and preliminary results. Jpn Circ / 2001 65 845-847. 

ACE inhibitors do not completely block aldosterone synthesis. Since this steroid hormone is a potent inducer of fibrosis in the heart, specific antagonists, such as spironolactone and eplerenone, have recently been very successfully used in clinical trials in addition to ACE inhibitors to treat congestive heart failure [5]. Formerly, these drugs have only been applied as potassium-saving diuretics in oedematous diseases, hypertension, and hypokalemia as well as in primary hyperaldosteronism. Possible side effects of aldosterone antagonists include hyperkalemia and, in case of spironolactone, which is less specific for the mineralocorticoid receptor than eplerenone, also antiandrogenic and progestational actions. 

Heart failure is more prevalent and associated with a worse prognosis in African-Americans compared to the general population.1 Unfortunately, deficiencies in disease prevention, detection, and access to treatment are well documented in minority populations. African-Americans and other races are underrepresented in clinical trials, compromising the extrapolation of results from these studies to ethnic subpopulations. The influence of race on efficacy and safety of medications used in HF treatment has received additional attention with... 

In spite of a high reactivity of 3-carotene in free radical reactions and marked antioxidant effects in in vitro systems, 3-carotene did not show itself as an effective in vivo antioxidant. Furthermore, recent clinical trials suggested that the administration of 3-carotene may be useless or even harmful to patients with heart and some other diseases, especially to smokers. One might suspect that one of the major reasons of toxic in vivo effects of 3-carotene might be the formation of prooxidative compounds during 3-carotene oxidation. In contrast to... 

For some of these diseases, such as hypertension and heart disease, drugs such as ACE inhibitors and beta-blockers are available for treatment. For some other diseases, such as Alzheimer s disease, more effective drugs have yet to be discovered. For stroke, two late stage (Phase III) trials of NXY-059 and desmoteplase failed to meet the trial criteria. Other clinical trials in progress for ischemic stroke are presented in Table 11.1. 

The adverse effects of saturated fats on the plasma Upid profile translate into adverse effects on human health. It has been demonstrated in clinical trials that there is a clear correlation between the percent of dietary energy as saturated fats and the incidence of coronary heart disease and mortality." It follows that limiting your intake of saturated fats is a prudent course of action. 

The important point for patients is not so much that plasma cholesterol decreases but that the clinical endpoints decrease nonfatal heart attacks, coronary artery disease deaths, surgery for coronary artery disease, and total mortality. Subsequent to the approval of statins based on reduction of plasma cholesterol levels, several large, controlled clinical trials have been carried out to establish the effects of statin use on these clinical endpoints. ... 

The results of the WHI (Women s Health Initiative) Estrogen Plus Progesterone clinical trial revealing increased incidence of breast cancer, heart disease, stroke, and dementia are provided in J. E. Rossouw et al., JAMA 288 321-333 (2002). 

The symptom of syncope in a patient with ischemic heart disease and heart failure should initially prompt concern about ventricular dysrhythmias. Based on the results of recent clinical trials of sudden death prevention in heart failure [27, 28], most patients with low ejection fraction and advanced ischemic heart disease will likely be treated with an... 

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