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001-es BibID:BIBFORM005636
Első szerző:Massie, Barry M.
Cím:Irbesartan in patients with heart failure and preserved ejection fraction / Massie, B. M., Carson, P. E., McMurray, J. J., Komajda, M., McKelvie, R., Zile, M. R., Anderson, S., Donovan, M., Iverson, E., Staiger, C., Ptaszynska, A., The I-PRESERVE Investigators
Dátum:2008
ISSN:1533-4406 (Electronic)
Megjegyzések:Approximately 50% of patients with heart failure have a left ventricular ejection fraction of at least 45%, but no therapies have been shown to improve the outcome of these patients. Therefore, we studied the effects of irbesartan in patients with this syndrome. METHODS: We enrolled 4128 patients who were at least 60 years of age and had New York Heart Association class II, III, or IV heart failure and an ejection fraction of at least 45% and randomly assigned them to receive 300 mg of irbesartan or placebo per day. The primary composite outcome was death from any cause or hospitalization for a cardiovascular cause (heart failure, myocardial infarction, unstable angina, arrhythmia, or stroke). Secondary outcomes included death from heart failure or hospitalization for heart failure, death from any cause and from cardiovascular causes, and quality of life. RESULTS: During a mean follow-up of 49.5 months, the primary outcome occurred in 742 patients in the irbesartan group and 763 in the placebo group. Primary event rates in the irbesartan and placebo groups were 100.4 and 105.4 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% confidence interval [CI], 0.86 to 1.05; P=0.35). Overall rates of death were 52.6 and 52.3 per 1000 patient-years, respectively (hazard ratio, 1.00; 95% CI, 0.88 to 1.14; P=0.98). Rates of hospitalization for cardiovascular causes that contributed to the primary outcome were 70.6 and 74.3 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% CI, 0.85 to 1.08; P=0.44). There were no significant differences in the other prespecified outcomes. CONCLUSIONS: Irbesartan did not improve the outcomes of patients with heart failure and a preserved left ventricular ejection fraction.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Adrenergic beta-Antagonists/therapeutic use
Aged
Angiotensin II Type 1 Receptor Blockers/adverse effects/ therapeutic use
Angiotensin-Converting Enzyme Inhibitors/therapeutic use
Biphenyl Compounds/adverse effects/ therapeutic use
Cardiovascular Diseases/epidemiology/mortality
Drug Therapy, Combination
Female
Follow-Up Studies
Heart Failure/ drug therapy/mortality/physiopathology
Hospitalization/statistics & numerical data
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Proportional Hazards Models
Quality of Life
Stroke Volume
Tetrazoles/adverse effects/ therapeutic use
Treatment Failure
Megjelenés:The New England Journal of Medicine. - 359 : 23 (2008), p. 2456-2467. -
További szerzők:Carson, Peter E. McMurray, John J. Komajda, Michel McKelvie, Robert Zile, Michael R. Anderson, Susan Donovan, Mark Iverson, Erik Staiger, Christoph Ptaszynska, Agata Édes István (1952-) (kardiológus) The I-PRESERVE Investigators
Internet cím:DOI
elektronikus változat
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2.

001-es BibID:BIBFORM010424
Első szerző:Metra, Marco
Cím:Effects of low-dose oral enoximone administration on mortality, morbidity, and exercise capacity in patients with advanced heart failure : the randomized, double-blind, placebo-controlled, parallel group ESSENTIAL trials / Marco Metra, Eric Eichhorn, William T. Abraham, Jennifer Linseman, Michael Böhm, Ramon Corbalan, David DeMets, Teresa De Marco, Uri Elkayam, Michael Gerber, Michel Komajda, Peter Liu, Vyacheslev Mareev, Sergio V. Perrone, Philip Poole-Wilson, Ellen Roecker, Jennifer Stewart, Karl Swedberg, Michal Tendera, Brian Wiens, Michael R. Bristow, The ESSENTIAL Investigators
Dátum:2009
ISSN:0195-668X (Print)
Megjegyzések:Use of inotropic agents in patients with heart failure (HF) has been limited by adverse effects on outcomes. However, administration of positive inotropes at lower doses and concomitant treatment with beta-blockers might increase benefit-risk ratio. We investigated the effects of low doses of the positive inotrope enoximone on symptoms, exercise capacity, and major clinical outcomes in patients with advanced HF who were also treated with beta-blockers and other guideline-recommended background therapy. METHODS AND RESULTS: The Studies of Oral Enoximone Therapy in Advanced HF (ESSENTIAL) programme consisted of two identical, randomized, double-blind, placebo-controlled trials that differed only by geographic location (North and South America: ESSENTIAL-I; Europe: ESSENTIAL-II). Patients with New York Heart Association class III-IV HF symptoms, left ventricular ejection fraction < or = 30%, and one hospitalization or two ambulatory visits for worsening HF in the previous year were eligible for participation in the trials. The trials had three co-primary endpoints: (i) the composite of time to all-cause mortality or cardiovascular hospitalization, analysed in the two ESSENTIAL trials combined; (ii) the 6 month change from baseline in the 6 min walk test distance (6MWTD); and (iii) the Patient Global Assessment (PGA) at 6 months, both analysed in each trial separately. ESSENTIAL-I and -II randomized 1854 subjects at 211 sites in 16 countries. In the combined trials, all-cause mortality and the composite, first co-primary endpoint did not differ between the two treatment groups [hazard ratio (HR) 0.97; 95% confidence interval (CI) 0.80-1.17; and HR 0.98; 95% CI 0.86-1.12, respectively, for enoximone vs. placebo]. The two other co-primary endpoints were analysed separately in the two ESSENTIAL trials, as prospectively designed in the protocol. The 6MWTD increased with enoximone, compared with placebo, in ESSENTIAL-I (P = 0.025, not reaching, however, the pre-specified criterion for statistical significance of P < 0.020), but not in ESSENTIAL-II. No difference in PGA was observed in either trial. CONCLUSION: Although low-dose enoximone appears to be safe in patients with advanced HF, major clinical outcomes are not improved.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Heart Journal. - 30 : 24 (2009), p. 3015-3026. -
További szerzők:Eichhorn, Eric Abraham, William T. Linseman, Jennifer Böhm, Michael Corbalan, Ramon DeMets, David De Marco, Teresa Elkayam, Uri Gerber, Michael Komajda, Michel Liu, Peter Mareev, Vyacheslev Perrone, Sergio V. Poole-Wilson, Philip A. Roecker, Ellen Stewart, Jennifer Swedberg, Karl Tendera, Michal Wiens, Brian Bristow, Michael R. Czuriga István (1948-2018) (kardiológus) Édes István (1952-) (kardiológus) The ESSENTIAL Investigators
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
DOI
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