Losartan and end-organ protection--lessons from the RENAAL study.

Abstract:

BACKGROUND:The Reduction in ENdpoints with the Angiotensin Antagonist Losartan (RENAAL) study reported that losartan delayed the progression of renal disease in patients with type 2 diabetes and nephropathy. Diabetic or renally impaired patients are at high cardiovascular risk, a risk potentially increased in patients with both conditions. HYPOTHESIS:This post hoc analysis examined whether baseline proteinuria was predictive of cardiovascular outcomes, and whether losartan modifies the risk of cardiovascular outcomes in these patients given its renal-protective effects. METHODS:The RENAAL study compared losartan with placebo (in addition to conventional antihypertensive medications) in type 2 diabetic patients with proteinuria. Morbidity and mortality due to cardiovascular causes were ascertained, and the relationship between baseline proteinuria and cardiovascular outcome was determined. The effect of treatment with losartan was examined using three time-to-event analyses of composite cardiorenal outcomes as described below. RESULTS:Increasing baseline proteinuria was associated with significantly increased risk of myocardial infarction (MI) and all-cause or cardiovascular death, but not stroke. Losartan significantly reduced the risk for the combined endpoint of end-stage renal disease (ESRD), MI, stroke, or death by 21% (p < or = 0.005), irrespective of whether all-cause or cardiovascular death was included in the analysis. In addition, losartan reduced the risk for the composite of ESRD or cardiovascular death by 19.2% (p < 0.05). CONCLUSION:In patients with type 2 diabetes and nephropathy, there is an increased risk of MI and cardiovascular or all-cause mortality. Treatment with losartan is associated with a reduction in proteinuria, a delay in the onset of ESRD, and no increased risk of cardiovascular events in this pre-ESRD population.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Kowey PR,Dickson TZ,Zhang Z,Shahinfar S,Brenner BM,RENAAL Investigators.

doi

10.1002/clc.4960280307

subject

Has Abstract

pub_date

2005-03-01 00:00:00

pages

136-42

issue

3

eissn

0160-9289

issn

1932-8737

journal_volume

28

pub_type

临床试验,杂志文章
  • Combination therapy with nicardipine and beta-adrenergic blockade for angina pectoris.

    abstract::Nicardipine a second-generation dihidropyridine calcium antagonist, has been approved in oral formulation for use in the United States, and is under review for parenteral use. Nicardipine is the most vascular-selective agent of this class currently approved and should, on theoretical grounds, be ideal for combination ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960150403

    authors: Lambert CR

    更新日期:1992-04-01 00:00:00

  • Diagnostic value of poor R-wave progression in electrocardiograms for diabetic cardiomyopathy in type 2 diabetic patients.

    abstract:BACKGROUND:Diabetic cardiomyopathy (DCMP) is a common complication of diabetes and is associated with increased mortality. It has been suggested that a poor R-wave progression in a resting electrocardiogram (ECG) could be a sign of cardiomyopathy. HYPOTHESIS:The aim of this study was primarily to analyze the relations...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/clc.20810

    authors: Bildirici U,Ural D,Acar E,Agacdiken A,Ural E

    更新日期:2010-09-01 00:00:00

  • Effects on infarct size and left ventricular function of early intravenous injection of anistreplase in acute myocardial infarction. The APSIM Study Investigators.

    abstract::A total of 231 patients suffering from a first acute myocardial infarction were randomly allocated within 4 hours following the onset of symptoms either to anistreplase or anisoylated plasminogen streptokinase activator complex (APSAC), 30 U over 5 minutes, or to conventional heparin therapy, 5000 IU in bolus injectio...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:10.1002/clc.4960131310

    authors: Bassand JP,Bernard Y,Lusson JR,Machecourt J,Cassagnes J,Borel E

    更新日期:1990-03-01 00:00:00

  • Quantitative frame by frame analysis of regional contraction and lengthening on left ventricular cineangiograms: application to the study of normal left ventricles and left ventricles with mitral valve prolapse.

    abstract::This work attempted to study the segmental wall motion on left ventriculograms, in terms of segmental shortening, velocity of segmental shortening, and temporal sequences of various events in systole as well as in diastole. The ability of such a method to characterize patterns of normal regional wall motion and to det...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960090201

    authors: Colle JP,Le Goff G,Ohayon J,Bonnet J,Bricaud H,Besse P

    更新日期:1986-02-01 00:00:00

  • Characteristics of responders to cardiac resynchronization therapy: the impact of echocardiographic left ventricular volume.

    abstract:BACKGROUND:One-third of patients who receive cardiac resynchronization therapy (CRT) are classified as nonresponders. Characteristics of responders to CRT have been studied in multiple clinical trials. HYPOTHESIS:Independent predictors of CRT response may be identified by studying a series of patients in routine clini...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22043

    authors: Park MY,Altman RK,Orencole M,Kumar P,Parks KA,Heist KE,Singh JP,Picard MH

    更新日期:2012-12-01 00:00:00

  • Protecting the gains: What changes are needed to prevent a reversal of the downward cardiovascular disease mortality trend?

    abstract:AIMS:Cardiovascular disease (CVD) mortality has decreased over 60% over the past 50 years in the United States; however, emerging data indicate CVD incidence may be rising because of shifting demographics, increasing risk factor prevalence, and competing needs for limited resources. We projected CVD mortality from 2015...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.23097

    authors: Ortendahl JD,Diamant AL,Toth PP,Cherepanov D,Harmon AL,Broder MS

    更新日期:2019-01-01 00:00:00

  • An analysis of vascular properties using pulse wave analysis in patients with vasovagal syncope.

    abstract:BACKGROUND:Vasovagal syncope (VVS) is a common cause of recurrent syncope. Nevertheless, the exact hemodynamic mechanism has not been elucidated. Pulse wave analysis (PWA) is widely used to evaluate vascular properties, as it reflects the condition of the entire arterial system. HYPOTHESIS:Cardiovascular autonomic mod...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23380

    authors: Jang JH,Park JH,Ko KY,Baek YS,Kwon SW,Park SD,Shin SH,Woo SI,Kwan J,Kim DH

    更新日期:2020-07-01 00:00:00

  • Acute infarction of the left ventricular papillary muscle: electrocardiographic pattern and recognition of its location.

    abstract:BACKGROUND AND HYPOTHESIS:ST-segment depression during acute myocardial infarction (AMI) is known to herald serious hemodynamic complications. Since the mechanism of this dependence is not clear, we reinvestigated the old concept of papillary muscle infarction (PMI) as a cause of marked ST depression. METHODS:Autopsie...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960190514

    authors: Dabrowska B,Walczak E,Prejs R,Zdzienicki M

    更新日期:1996-05-01 00:00:00

  • N-terminal prohormone brain natriuretic peptide-proBNP levels in ventricular arrhythmias in children.

    abstract:BACKGROUND:Ventricular arrhythmias are the most common consequences of structural and functional heart diseases, but cases with no evident pathology are also observed. A parameter indicating asymptomatic circulatory failure could support decisions related to possible treatment of ventricular arrhythmias. HYPOTHESIS:Th...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20611

    authors: Mazurek B,Szydłowski L,Giec-Fuglewicz G,Markiewicz-Łoskot G

    更新日期:2009-12-01 00:00:00

  • Computer errors in electrocardiography.

    abstract::Computer interpretation of electrocardiograms is far from adequate. This paper highlights a particular type of computer error that is merely symbolic of the large number of errors the computer can make. In addition to computer errors in electrocardiography, it is likely that computer interpretation has diminished the ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960190711

    authors: Hurst JW,Treasure CB,Sathavorn CS

    更新日期:1996-07-01 00:00:00

  • Efficacy and safety of clentiazem in patients with essential hypertension: results of an early pilot test.

    abstract::The purpose of this study was to evaluate the antihypertensive effect of a new calcium antagonist, clentiazem, on inpatients or outpatients with essential hypertension. After blood pressure was stable and greater than 160/95 mmHg with placebo for at least a 2-week observation period, oral clentiazem was administered o...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/clc.4960140112

    authors: Kawakita S,Kinoshita M,Ishikawa H,Kagoshima T,Katori R,Ishikawa K,Hirota Y

    更新日期:1991-01-01 00:00:00

  • Endovascular stents: preliminary clinical results and future developments.

    abstract::At present, there is an exponential use of new interventional techniques whose proper role and value have not yet been defined. The intracoronary stent is just one example. There is no doubt that stents can be implanted with a high technical success rate associated with highly predictable immediate angiographic result...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960160503

    authors: de Jaegere PP,de Feyter PJ,van der Giessen WJ,Serruys PW

    更新日期:1993-05-01 00:00:00

  • Late recovery in peripartum cardiomyopathy.

    abstract::Full recovery occurred after 15 months of severe congestive heart failure in a patient with peripartum cardiomyopathy. Clinical improvement was noted when propranolol was added to conventional therapy. ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960030211

    authors: Moreyra AE,Kostis JB,Amendo M

    更新日期:1980-08-01 00:00:00

  • Determinants of collateral development in patients with acute myocardial infarction.

    abstract:BACKGROUND:The presence or absence of collateral circulation to the infarct-related coronary artery in acute myocardial infarction (AMI) significantly impacts on infarct size and resulting left ventricular function. However, the determinants of collateral development have not been clarified. HYPOTHESIS:The purpose of ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960220911

    authors: Fujita M,Nakae I,Kihara Y,Hasegawa K,Nohara R,Ueda K,Tamaki S,Otsuka K,Sasayama S

    更新日期:1999-09-01 00:00:00

  • Improvement of exercise capacity after nifedipine in patients with Eisenmenger syndrome complicating ventricular septal defect.

    abstract::We investigated the potential benefit of a preferential pulmonary vasodilatory effect of nifedipine in 4 patients with Eisenmenger syndrome complicating ventricular septal defect. First-pass radionuclide scan was performed at rest to measure intracardiac shunting before and after nifedipine. Two hours after 20 mg subl...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章

    doi:10.1002/clc.4960141205

    authors: Wong CK,Yeung DW,Lau CP,Cheng CH,Leung WH

    更新日期:1991-12-01 00:00:00

  • Update on atrial fibrillation: part II.

    abstract::Antiarrhythmic drugs are an essential tool in the management of atrial fibrillation (AF). Although we are already on the threshold of a large expansion in the use of ablation therapies, these will not, however, be appropriate for all patients, and pharmacological therapies will continue to have an important place in t...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.20136

    authors: Savelieva I,Camm J

    更新日期:2008-03-01 00:00:00

  • Fluoroscopy usage in contemporary interventional electrophysiology: Insights from a European registry.

    abstract:BACKGROUND:Fluoroscopy has been an essential part of every electrophysiological procedure since its inception. However, till now no clear standards regarding acceptable x-ray exposure nor recommendation how to achieve them have been proposed. HYPOTHESIS:Current norms and quality markers required for optimal clinical r...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23411

    authors: Kosiuk J,Fiedler L,Ernst S,Duncker D,Pavlović N,Guarguagli S,Stegmann C,Miskowiec D,Garcia R,Russo V,Yakushev A,Szegedi N,De Potter T

    更新日期:2021-01-01 00:00:00

  • When should patients with chest pain be referred for coronary angiography?

    abstract::When evaluating patients with possible coronary artery disease, it is necessary to combine physiologic assessment (measurements of ischemia) with anatomic pathologic assessment (coronary angiography). Coronary angiography currently is the only way to assess the anatomic pathology of the coronary circulation with preci...

    journal_title:Clinical cardiology

    pub_type: 社论

    doi:10.1002/clc.4960270202

    authors: Conti CR

    更新日期:2004-02-01 00:00:00

  • Effectiveness of intravenous streptokinase on infarct size and left ventricular function in acute myocardial infarction. Prospective and randomized study.

    abstract::Within 3 h after the onset of symptoms of myocardial infarction, 64 patients were randomly assigned to receive either a 1-h intravenous infusion of 1,500,000 IU of streptokinase (SK) or a conventional therapy. Infarct size was estimated in CK gram equivalent (CKg) by measurement of CK-MB every 3 hours during a 48-h pe...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/clc.4960100704

    authors: Durand P,Asseman P,Pruvost P,Bertrand ME,LaBlanche JM,Thery C

    更新日期:1987-07-01 00:00:00

  • Clinical approach to paroxysmal atrial fibrillation.

    abstract::In addition to the role of the electrophysiological substrate, paroxysmal atrial fibrillation depends on the modulation of the atrial tissues by the autonomic nervous system. Experimentally, models of atrial fibrillation can be based on either adrenergic or vagal stimulations that provoke the arrhythmia by disturbing ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960130311

    authors: Coumel P

    更新日期:1990-03-01 00:00:00

  • The effects of prior beta-blocker therapy on serum C-reactive protein levels after percutaneous coronary intervention.

    abstract:BACKGROUND:There are no studies in the literature related to the effect of beta blockers (BB) on changes in C-reactive protein (CRP) levels after percutaneous coronary intervention (PCI). HYPOTHESIS:We designed a prospective randomized study to investigate the impact of BB therapy on CRP in patients who underwent elec...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/clc.4960280509

    authors: Atar I,Gülmez O,Atar A,Bozbas H,Yildirir A,Ozin B,Korkmaz ME,Müderrisoglu H

    更新日期:2005-05-01 00:00:00

  • Correlates of bundle-branch block in patients undergoing primary angioplasty for acute myocardial infarction.

    abstract:BACKGROUND:Early reperfusion therapy has reduced the infarct size and mortality rate in patients with acute myocardial infarction (AMI). The occurrence of bundle-branch block in AMI is related to the amount of myocardial damage and the insult to the conduction system. HYPOTHESIS:To evaluate the clinical and angiograph...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960241204

    authors: Sugiura T,Yamasaki F,Hatada K,Nakamura S,Iwasaka T

    更新日期:2001-12-01 00:00:00

  • Coronary flow slows as renal function worsens.

    abstract:BACKGROUND:Slow coronary flow in patients without obstructive coronary artery disease is an angiographic finding that could easily be detected by thrombolysis in myocardial infarction (TIMI) frame counts. On the other hand, impaired renal function is a frequent problem. We searched the association between the 2 entitie...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20387

    authors: Yilmaz MB,Yalta K

    更新日期:2009-05-01 00:00:00

  • Aortic dissection in childhood and adolescence: an analysis of occurrences over a 10-year interval in New York State.

    abstract:BACKGROUND:Rarely occurring in the pediatric and adolescent population, aortic dissection is a condition with many predisposing factors. Previous studies have suggested that congenital cardiovascular disorders are the most common predisposing conditions. Trauma-associated aortic dissection is considered a rare occurren...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20383

    authors: Fikar CR,Fikar R

    更新日期:2009-06-01 00:00:00

  • The clinical distinction between regional postinfarction pericarditis and other causes of postinfarction chest pain: ancillary observations regarding the effect of lytic therapy upon the frequency of postinfarction pericarditis, postinfarction angina, and

    abstract::Recently two types of atypical T-wave evolution were recognized as electrocardiographic (ECG) markers of regional postinfarction pericarditis. The sensitivity and specificity of these changes for this condition were 100 and 77%, respectively. The major purpose of this investigation is to show how these ECG changes can...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960170903

    authors: Oliva PB,Hammill SC

    更新日期:1994-09-01 00:00:00

  • Successful external cardioversion of atrial fibrillation in patients referred to an electrophysiologist for internal cardioversion.

    abstract:BACKGROUND:Internal cardioversion of atrial fibrillation with direct current energy has become an increasingly employed technique for patients who fail external cardioversion. HYPOTHESIS:The purpose of this study was to determine whether internal cardioversion could be avoided by careful attention to cardioversion tec...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960240716

    authors: Verdino RJ,Teuteberg JJ,Burke MC,Kopp DE,Johnson CT,Lin AC,Alberts M,Kall JG,Wilber DJ

    更新日期:2001-07-01 00:00:00

  • Safety profile of benazepril in essential hypertension.

    abstract::Data from clinical trials with benazepril suggest that the safety profile of benazepril is similar to that of other angiotensin-converting enzyme (ACE) inhibitors. Treatment-related side effects occurred in 20% of benazepril-treated patients and in 18% of patients receiving placebo. The most commonly reported side eff...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960141805

    authors: MacNab M,Mallows S

    更新日期:1991-08-01 00:00:00

  • Detection of viable myocardium using coronary angiography and ventriculography.

    abstract::In 2002, coronary angiography is the only way to assess precisely the combination of proximal stenoses, distal target vessels, collaterals, microcirculation, and TIMI antegrade flow. At the time of coronary angiography, global LV function is best determined using biplane ventriculography in order to correlate wall mot...

    journal_title:Clinical cardiology

    pub_type: 社论

    doi:10.1002/clc.4950250802

    authors: Conti CR

    更新日期:2002-08-01 00:00:00

  • Clinical Outcome of First- vs Second-Generation DES According to DAPT Duration: Results of ARCTIC-Generation.

    abstract::There is an apparent benefit with extension of dual antiplatelet therapy (DAPT) beyond 1 year after implantation of drug-eluting stents (DES). Assessment by a Double Randomization of a Conventional Antiplatelet Strategy vs a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation, and of Treatment Interruption ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1002/clc.22512

    authors: Collet JP,Silvain J,Kerneis M,Cuisset T,Meneveau N,Boueri Z,Barthélémy O,Rangé G,Cayla G,Belle EV,Elhadad S,Carrié D,Caussin C,Rousseau H,Aubry P,Monségu J,Sabouret P,O'Connor SA,Abtan J,Saint-Etienne C,Beygui F,

    更新日期:2016-04-01 00:00:00

  • Incidence and Predictors of Left Ventricular Thrombus After Primary Percutaneous Coronary Intervention for Anterior ST-Segment Elevation Myocardial Infarction.

    abstract:BACKGROUND:The role of warfarin in anterior ST-segment elevation myocardial infarction (STEMI) complicated by left ventricular (LV) dysfunction in patients treated with primary percutaneous coronary intervention (PCI) and dual antiplatelet therapy is unclear. Warfarin may prevent cardioembolic events but significantly ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22450

    authors: Driesman A,Hyder O,Lang C,Stockwell P,Poppas A,Abbott JD

    更新日期:2015-10-01 00:00:00