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 Cardioljournal_title
Clinical cardiologyauthors
Kowey PR,Dickson TZ,Zhang Z,Shahinfar S,Brenner BM,RENAAL Investigators.doi
10.1002/clc.4960280307subject
Has Abstractpub_date
2005-03-01 00:00:00pages
136-42issue
3eissn
0160-9289issn
1932-8737journal_volume
28pub_type
临床试验,杂志文章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
更新日期:1992-04-01 00:00:00
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
更新日期:2010-09-01 00:00:00
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
更新日期:1990-03-01 00:00:00
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
更新日期:1986-02-01 00:00:00
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
更新日期:2012-12-01 00:00:00
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
更新日期:2019-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23380
更新日期:2020-07-01 00:00:00
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
更新日期:1996-05-01 00:00:00
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
更新日期:2009-12-01 00:00:00
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
更新日期:1996-07-01 00:00:00
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
更新日期:1991-01-01 00:00:00
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
更新日期:1993-05-01 00:00:00
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
更新日期:1980-08-01 00:00:00
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
更新日期:1999-09-01 00:00:00
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
更新日期:1991-12-01 00:00:00
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
更新日期:2008-03-01 00:00:00
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
更新日期:2021-01-01 00:00:00
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
更新日期:2004-02-01 00:00:00
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
更新日期:1987-07-01 00:00:00
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
更新日期:1990-03-01 00:00:00
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
更新日期:2005-05-01 00:00:00
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
更新日期:2001-12-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20387
更新日期:2009-05-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20383
更新日期:2009-06-01 00:00:00
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
更新日期:1994-09-01 00:00:00
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
更新日期:2001-07-01 00:00:00
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
更新日期:1991-08-01 00:00:00
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
更新日期:2002-08-01 00:00:00
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
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更新日期:2016-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22450
更新日期:2015-10-01 00:00:00