The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease: a combined analysis of individual data of ADVANCE, EUROPA, and PROGRESS trials
Identifieur interne : 007C88 ( Main/Exploration ); précédent : 007C87; suivant : 007C89The consistency of the treatment effect of an ACE-inhibitor based treatment regimen in patients with vascular disease or high risk of vascular disease: a combined analysis of individual data of ADVANCE, EUROPA, and PROGRESS trials
Auteurs : Jasper J. Brugts [Pays-Bas] ; Toshiharu Ninomiya [Australie] ; Eric Boersma [Pays-Bas] ; Willem J. Remme [Pays-Bas] ; Michel Bertrand [France] ; Roberto Ferrari [Italie] ; Kim Fox [Royaume-Uni] ; Stephen Macmahon [Australie] ; John Chalmers [Australie] ; Maarten L. Simoons [Pays-Bas]Source :
- European Heart Journal [ 0195-668X ] ; 2009-06.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
Abstract
Aims Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce cardiovascular risk in different groups of patients. Whether these effects can be generalized to the broad group of patients with vascular disease is unknown. Therefore, we undertook a combined analysis using individual data from ADVANCE, EUROPA, and PROGRESS to determine the consistency of the treatment effect of perindopril-based regimen in patients with vascular disease or at high risk of vascular disease. Methods and results We studied all-cause mortality and major cardiovascular outcomes during a follow-up of about 4 years in the 29 463 patients randomly assigned a perindopril-based treatment regimen or placebo. The perindopril-based regimens were associated with a significant reduction in all-cause mortality [hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.82–0.96; P = 0.006], cardiovascular mortality (HR 0.85; 95% CI 0.76–0.95; P = 0.004), non-fatal myocardial infarction (HR 0.80; 95% CI 0.71–0.90; P < 0.001), stroke (HR 0.82; 95% CI 0.74–0.92; P = 0.002), and heart failure (HR 0.84; 95% CI 0.72–0.96; P = 0.015). Results were consistent in subgroups with different clinical characteristics, concomitant medication use, and across all strata of baseline blood pressure. Conclusion This study provides strong evidence for a consistent cardiovascular protection with an ACE-inhibitor treatment regimen (perindopril–indapamide) by improving survival and reducing the risk of major cardiovascular events across a broad spectrum of patients with vascular disease.
Url:
DOI: 10.1093/eurheartj/ehp103
Affiliations:
- Australie, France, Italie, Pays-Bas, Royaume-Uni
- Angleterre, Grand Londres, Hauts-de-France, Hollande-Méridionale, Nord-Pas-de-Calais, Nouvelle-Galles du Sud
- Lille, Londres, Rotterdam, Sydney
- Université de Sydney
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Brugts</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, 's Gravendijkwal 230, 3015CE, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></affiliation><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></affiliation></author><author><name sortKey="Ninomiya, Toshiharu" sort="Ninomiya, Toshiharu" uniqKey="Ninomiya T" first="Toshiharu" last="Ninomiya">Toshiharu Ninomiya</name><affiliation wicri:level="4"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Cardiovascular Medicine, The George Institute, Royal Prince Alfred, Hospital and Institutes for Health and Medical Research, University of Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Boersma, Eric" sort="Boersma, Eric" uniqKey="Boersma E" first="Eric" last="Boersma">Eric Boersma</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, 's Gravendijkwal 230, 3015CE, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Remme, Willem J" sort="Remme, Willem J" uniqKey="Remme W" first="Willem J." last="Remme">Willem J. Remme</name><affiliation wicri:level="1"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>STICARES Cardiovascular Research Institute, Rhoon</wicri:regionArea><wicri:noRegion>Rhoon</wicri:noRegion></affiliation></author><author><name sortKey="Bertrand, Michel" sort="Bertrand, Michel" uniqKey="Bertrand M" first="Michel" last="Bertrand">Michel Bertrand</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Lille Heart Institute, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name><affiliation wicri:level="1"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Cardiology, University of Ferrara, and Salvatore Maugeri, Foundation, IRCCS, Ferrara</wicri:regionArea><wicri:noRegion>Ferrara</wicri:noRegion></affiliation></author><author><name sortKey="Fox, Kim" sort="Fox, Kim" uniqKey="Fox K" first="Kim" last="Fox">Kim Fox</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Cardiology, Royal Brompton Hospital and National Heart Institute, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Macmahon, Stephen" sort="Macmahon, Stephen" uniqKey="Macmahon S" first="Stephen" last="Macmahon">Stephen Macmahon</name><affiliation wicri:level="4"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Cardiovascular Medicine, The George Institute, Royal Prince Alfred, Hospital and Institutes for Health and Medical Research, University of Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><affiliation wicri:level="4"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Cardiovascular Medicine, The George Institute, Royal Prince Alfred, Hospital and Institutes for Health and Medical Research, University of Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Simoons, Maarten L" sort="Simoons, Maarten L" uniqKey="Simoons M" first="Maarten L." last="Simoons">Maarten L. Simoons</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Cardiology, Erasmus University Medical Center, Thoraxcenter, 's Gravendijkwal 230, 3015CE, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">European Heart Journal</title><idno type="ISSN">0195-668X</idno><idno type="eISSN">1522-9645</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-06">2009-06</date><biblScope unit="volume">30</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1385">1385</biblScope><biblScope unit="page" to="1394">1394</biblScope></imprint><idno type="ISSN">0195-668X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0195-668X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ACE inhibitor</term><term>Analysis</term><term>Cardiology</term><term>Circulatory system</term><term>Consistency</term><term>Coronary heart disease</term><term>Data</term><term>Diabetes mellitus</term><term>High risk</term><term>Human</term><term>Individual</term><term>Perindopril</term><term>Prevention</term><term>Risk factor</term><term>Stroke</term><term>Treatment</term><term>Vascular disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Accident cérébrovasculaire</term><term>Analyse</term><term>Appareil circulatoire</term><term>Cardiologie</term><term>Cardiopathie coronaire</term><term>Consistance</term><term>Diabète</term><term>Donnée</term><term>Facteur risque</term><term>Homme</term><term>Individu</term><term>Inhibiteur angiotensin converting enzyme</term><term>Pathologie des vaisseaux sanguins</term><term>Prévention</term><term>Périndopril</term><term>Risque élevé</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Diabète</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Aims Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce cardiovascular risk in different groups of patients. Whether these effects can be generalized to the broad group of patients with vascular disease is unknown. Therefore, we undertook a combined analysis using individual data from ADVANCE, EUROPA, and PROGRESS to determine the consistency of the treatment effect of perindopril-based regimen in patients with vascular disease or at high risk of vascular disease. Methods and results We studied all-cause mortality and major cardiovascular outcomes during a follow-up of about 4 years in the 29 463 patients randomly assigned a perindopril-based treatment regimen or placebo. The perindopril-based regimens were associated with a significant reduction in all-cause mortality [hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.82–0.96; P = 0.006], cardiovascular mortality (HR 0.85; 95% CI 0.76–0.95; P = 0.004), non-fatal myocardial infarction (HR 0.80; 95% CI 0.71–0.90; P < 0.001), stroke (HR 0.82; 95% CI 0.74–0.92; P = 0.002), and heart failure (HR 0.84; 95% CI 0.72–0.96; P = 0.015). Results were consistent in subgroups with different clinical characteristics, concomitant medication use, and across all strata of baseline blood pressure. Conclusion This study provides strong evidence for a consistent cardiovascular protection with an ACE-inhibitor treatment regimen (perindopril–indapamide) by improving survival and reducing the risk of major cardiovascular events across a broad spectrum of patients with vascular disease.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Hauts-de-France</li><li>Hollande-Méridionale</li><li>Nord-Pas-de-Calais</li><li>Nouvelle-Galles du Sud</li></region><settlement><li>Lille</li><li>Londres</li><li>Rotterdam</li><li>Sydney</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Brugts, Jasper J" sort="Brugts, Jasper J" uniqKey="Brugts J" first="Jasper J." last="Brugts">Jasper J. Brugts</name></region><name sortKey="Boersma, Eric" sort="Boersma, Eric" uniqKey="Boersma E" first="Eric" last="Boersma">Eric Boersma</name><name sortKey="Brugts, Jasper J" sort="Brugts, Jasper J" uniqKey="Brugts J" first="Jasper J." last="Brugts">Jasper J. Brugts</name><name sortKey="Brugts, Jasper J" sort="Brugts, Jasper J" uniqKey="Brugts J" first="Jasper J." last="Brugts">Jasper J. Brugts</name><name sortKey="Remme, Willem J" sort="Remme, Willem J" uniqKey="Remme W" first="Willem J." last="Remme">Willem J. Remme</name><name sortKey="Simoons, Maarten L" sort="Simoons, Maarten L" uniqKey="Simoons M" first="Maarten L." last="Simoons">Maarten L. Simoons</name></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Ninomiya, Toshiharu" sort="Ninomiya, Toshiharu" uniqKey="Ninomiya T" first="Toshiharu" last="Ninomiya">Toshiharu Ninomiya</name></region><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><name sortKey="Macmahon, Stephen" sort="Macmahon, Stephen" uniqKey="Macmahon S" first="Stephen" last="Macmahon">Stephen Macmahon</name></country><country name="France"><region name="Hauts-de-France"><name sortKey="Bertrand, Michel" sort="Bertrand, Michel" uniqKey="Bertrand M" first="Michel" last="Bertrand">Michel Bertrand</name></region></country><country name="Italie"><noRegion><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Fox, Kim" sort="Fox, Kim" uniqKey="Fox K" first="Kim" last="Fox">Kim Fox</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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