AustralieFrV1, PascalFrancis, Curation, bibRecord, 001406

Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Commentary

Identifieur interne : 001406 ( PascalFrancis/Curation ); précédent : 001405; suivant : 001407

Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Commentary

Auteurs : Philip A. Poole-Wilson [Royaume-Uni] ; Jacobus Lubsen [Pays-Bas, Suisse] ; Bridget-Anne Kirwan [Suisse] ; Fred J. Van Dalen [Suisse] ; Gilbert Wagener [Allemagne] ; Nicolas Danchin [France] ; Hanjörg Just [Allemagne] ; Keith A. A. Fox [Royaume-Uni] ; Stuart J. Pocock [Royaume-Uni] ; Tim C. Clayton [Royaume-Uni] ; Michael Motro [Israël] ; John D. Parker [Canada] ; Martial G. Bourassa [Canada] ; Anthony M. Dart [Australie] ; Per Hildebrandt [Danemark] ; Ake Hjalmarson [Suède] ; Johannes A. Kragten [Pays-Bas] ; G. Peter Molhoek [Pays-Bas] ; Jan-Erik Otterstad [Norvège] ; Ricardo Seabra-Gomes [Portugal] ; Jordi Soler-Soler [Espagne] ; Simon Weber [France] ; Bruce M. Psaty [États-Unis] ; Curt D. Furberg [États-Unis]

Source :

Lancet : (British edition) [ 0140-6736 ] ; 2004.

RBID : Pascal:04-0483358

Descripteurs français

Pascal (Inist)
- Angine poitrine, Nifédipine, Epidémiologie, Mortalité, Appareil circulatoire, Morbidité, Homme, Essai clinique, Action, Médecine.
Wicri :
- topic : Mortalité, Homme, Médecine.

English descriptors

KwdEn :
- Action, Angina pectoris, Circulatory system, Clinical trial, Epidemiology, Human, Medicine, Morbidity, Mortality, Nifedipine.

Abstract

Background Calcium antagonists are widely prescribed for angina pectoris but their effect on clinical outcome is controversial. We aimed to investigate the effect of the calcium antagonist nifedipine on long-term outcome in patients with stable angina pectoris. Methods We randomly assigned 3825 patients with treated stable symptomatic coronary disease to double-blind addition of nifedipine GITS (gastrointestinal therapeutic system) 60 mg once daily and 3840 to placebo. The primary endpoint was the combination of death, acute myocardial infarction, refractory angina, new overt heart failure, debilitating stroke, and peripheral revascularisation. Mean follow-up was 4-9 years (SD 1.1). Analysis was by intention to treat. Findings 310 patients allocated nifedipine died (1.64 per 100 patient-years) compared with 291 people allocated placebo (1.53 per 100 patient-years; hazard ratio 1.07 [95% CI 0.91-1.25], p=0.41). Primary endpoint rates were 4.60 per 100 patient-years for nifedipine and 4.75 per 100 patient-years for placebo (0.97 [0.88-1.07), p=0.54). With nifedipine, rate of death and any cardiovascular event or procedure was 9.32 per 100 patient-years versus 10.50 per 100 patient-years for placebo (0.89 [0.83-0.95], p=0.0012). The difference was mainly attributable to a reduction in the need for coronary angiography and interventions in patients assigned nifedipine, despite an increase in peripheral revascularisation. Nifedipine had no effect on the rate of myocardial infarction. Interpretation Addition of nifedipine GITS to conventional treatment of angina pectoris has no effect on major cardiovascular event-free survival. Nifedipine GITS is safe and reduces the need for coronary angiography and interventions.

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A11	`01`	`1`		`@1 POOLE-WILSON (Philip A.)`
A11	`02`	`1`		`@1 LUBSEN (Jacobus)`
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A11	`24`	`1`		`@1 FURBERG (Curt D.) @9 comment.`
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A14	`07`			`@1 Centre for Cardiovascular Science, University of Edinburgh @2 Edinburgh @3 GBR @Z 8 aut.`
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A14	`14`			`@1 Cardiovascular Institute, Sahlgrenska University Hospital @2 Göteborg @3 SWE @Z 16 aut.`
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A14	`19`			`@1 Department of Cardiology, Vall d'Hebron University Hospital @2 Barcelona @3 ESP @Z 21 aut.`
A14	`20`			`@1 Department of Cardiology, René Descartes University @2 Paris @3 FRA @Z 22 aut.`
A14	`21`			`@1 Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington @2 Seattle, WA 98101 @3 USA @Z 23 aut.`
A14	`22`			`@1 Department of Public Health Sciences, Wake Forest University School of Medicine @2 Winston-Salem, North Carolina @3 USA @Z 24 aut.`
A17	`01`	`1`		`@1 ACTION (A Coronary disease Trial Investigating Outcome with Nifedipine gastrointestinal therapeutic system) investigators @3 INC`
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C01	`01`		`ENG`	@0 Background Calcium antagonists are widely prescribed for angina pectoris but their effect on clinical outcome is controversial. We aimed to investigate the effect of the calcium antagonist nifedipine on long-term outcome in patients with stable angina pectoris. Methods We randomly assigned 3825 patients with treated stable symptomatic coronary disease to double-blind addition of nifedipine GITS (gastrointestinal therapeutic system) 60 mg once daily and 3840 to placebo. The primary endpoint was the combination of death, acute myocardial infarction, refractory angina, new overt heart failure, debilitating stroke, and peripheral revascularisation. Mean follow-up was 4-9 years (SD 1.1). Analysis was by intention to treat. Findings 310 patients allocated nifedipine died (1.64 per 100 patient-years) compared with 291 people allocated placebo (1.53 per 100 patient-years; hazard ratio 1.07 [95% CI 0.91-1.25], p=0.41). Primary endpoint rates were 4.60 per 100 patient-years for nifedipine and 4.75 per 100 patient-years for placebo (0.97 [0.88-1.07), p=0.54). With nifedipine, rate of death and any cardiovascular event or procedure was 9.32 per 100 patient-years versus 10.50 per 100 patient-years for placebo (0.89 [0.83-0.95], p=0.0012). The difference was mainly attributable to a reduction in the need for coronary angiography and interventions in patients assigned nifedipine, despite an increase in peripheral revascularisation. Nifedipine had no effect on the rate of myocardial infarction. Interpretation Addition of nifedipine GITS to conventional treatment of angina pectoris has no effect on major cardiovascular event-free survival. Nifedipine GITS is safe and reduces the need for coronary angiography and interventions.
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Le document en format XML

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<author><name sortKey="Wagener, Gilbert" sort="Wagener, Gilbert" uniqKey="Wagener G" first="Gilbert" last="Wagener">Gilbert Wagener</name>
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<author><name sortKey="Danchin, Nicolas" sort="Danchin, Nicolas" uniqKey="Danchin N" first="Nicolas" last="Danchin">Nicolas Danchin</name>
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<author><name sortKey="Just, Hanjorg" sort="Just, Hanjorg" uniqKey="Just H" first="Hanjörg" last="Just">Hanjörg Just</name>
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<author><name sortKey="Fox, Keith A A" sort="Fox, Keith A A" uniqKey="Fox K" first="Keith A. A." last="Fox">Keith A. A. Fox</name>
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<author><name sortKey="Pocock, Stuart J" sort="Pocock, Stuart J" uniqKey="Pocock S" first="Stuart J." last="Pocock">Stuart J. Pocock</name>
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<author><name sortKey="Clayton, Tim C" sort="Clayton, Tim C" uniqKey="Clayton T" first="Tim C." last="Clayton">Tim C. Clayton</name>
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<author><name sortKey="Motro, Michael" sort="Motro, Michael" uniqKey="Motro M" first="Michael" last="Motro">Michael Motro</name>
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<author><name sortKey="Parker, John D" sort="Parker, John D" uniqKey="Parker J" first="John D." last="Parker">John D. Parker</name>
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<country>Canada</country>
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<author><name sortKey="Bourassa, Martial G" sort="Bourassa, Martial G" uniqKey="Bourassa M" first="Martial G." last="Bourassa">Martial G. Bourassa</name>
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<country>Canada</country>
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<author><name sortKey="Dart, Anthony M" sort="Dart, Anthony M" uniqKey="Dart A" first="Anthony M." last="Dart">Anthony M. Dart</name>
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<author><name sortKey="Hildebrandt, Per" sort="Hildebrandt, Per" uniqKey="Hildebrandt P" first="Per" last="Hildebrandt">Per Hildebrandt</name>
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<author><name sortKey="Hjalmarson, Ake" sort="Hjalmarson, Ake" uniqKey="Hjalmarson A" first="Ake" last="Hjalmarson">Ake Hjalmarson</name>
<affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Cardiovascular Institute, Sahlgrenska University Hospital</s1>
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<author><name sortKey="Kragten, Johannes A" sort="Kragten, Johannes A" uniqKey="Kragten J" first="Johannes A." last="Kragten">Johannes A. Kragten</name>
<affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Atrium Medical Centre</s1>
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<author><name sortKey="Molhoek, G Peter" sort="Molhoek, G Peter" uniqKey="Molhoek G" first="G. Peter" last="Molhoek">G. Peter Molhoek</name>
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<author><name sortKey="Otterstad, Jan Erik" sort="Otterstad, Jan Erik" uniqKey="Otterstad J" first="Jan-Erik" last="Otterstad">Jan-Erik Otterstad</name>
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<author><name sortKey="Seabra Gomes, Ricardo" sort="Seabra Gomes, Ricardo" uniqKey="Seabra Gomes R" first="Ricardo" last="Seabra-Gomes">Ricardo Seabra-Gomes</name>
<affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of Cardiology, Hospital Santa Cruz</s1>
<s2>Lisbon</s2>
<s3>PRT</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Portugal</country>
</affiliation>
</author>
<author><name sortKey="Soler Soler, Jordi" sort="Soler Soler, Jordi" uniqKey="Soler Soler J" first="Jordi" last="Soler-Soler">Jordi Soler-Soler</name>
<affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Department of Cardiology, Vall d'Hebron University Hospital</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
</affiliation>
</author>
<author><name sortKey="Weber, Simon" sort="Weber, Simon" uniqKey="Weber S" first="Simon" last="Weber">Simon Weber</name>
<affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Department of Cardiology, René Descartes University</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>France</country>
</affiliation>
</author>
<author><name sortKey="Psaty, Bruce M" sort="Psaty, Bruce M" uniqKey="Psaty B" first="Bruce M." last="Psaty">Bruce M. Psaty</name>
<affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington</s1>
<s2>Seattle, WA 98101</s2>
<s3>USA</s3>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
</affiliation>
</author>
<author><name sortKey="Furberg, Curt D" sort="Furberg, Curt D" uniqKey="Furberg C" first="Curt D." last="Furberg">Curt D. Furberg</name>
<affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Department of Public Health Sciences, Wake Forest University School of Medicine</s1>
<s2>Winston-Salem, North Carolina</s2>
<s3>USA</s3>
<sZ>24 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">04-0483358</idno>
<date when="2004">2004</date>
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<idno type="RBID">Pascal:04-0483358</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">004D08</idno>
<idno type="wicri:Area/PascalFrancis/Curation">001406</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Commentary</title>
<author><name sortKey="Poole Wilson, Philip A" sort="Poole Wilson, Philip A" uniqKey="Poole Wilson P" first="Philip A." last="Poole-Wilson">Philip A. Poole-Wilson</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Cardiac Medicine, Imperial College London, Dovehouse Street</s1>
<s2>London SW3 6LY</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
</affiliation>
</author>
<author><name sortKey="Lubsen, Jacobus" sort="Lubsen, Jacobus" uniqKey="Lubsen J" first="Jacobus" last="Lubsen">Jacobus Lubsen</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Epidemiology and Biostatistics, Erasmus Medical Centre</s1>
<s2>Rotterdam</s2>
<s3>NLD</s3>
<sZ>2 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>SOCAR Research</s1>
<s2>Nyon</s2>
<s3>CHE</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
</affiliation>
</author>
<author><name sortKey="Kirwan, Bridget Anne" sort="Kirwan, Bridget Anne" uniqKey="Kirwan B" first="Bridget-Anne" last="Kirwan">Bridget-Anne Kirwan</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>SOCAR Research</s1>
<s2>Nyon</s2>
<s3>CHE</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
</affiliation>
</author>
<author><name sortKey="Van Dalen, Fred J" sort="Van Dalen, Fred J" uniqKey="Van Dalen F" first="Fred J." last="Van Dalen">Fred J. Van Dalen</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>SOCAR Research</s1>
<s2>Nyon</s2>
<s3>CHE</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
</affiliation>
</author>
<author><name sortKey="Wagener, Gilbert" sort="Wagener, Gilbert" uniqKey="Wagener G" first="Gilbert" last="Wagener">Gilbert Wagener</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Pharma Research Centre, Bayer Healthcare AG</s1>
<s2>Wuppertal</s2>
<s3>DEU</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Danchin, Nicolas" sort="Danchin, Nicolas" uniqKey="Danchin N" first="Nicolas" last="Danchin">Nicolas Danchin</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Cardiology, Georges Pompidou European Hospital</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
</affiliation>
</author>
<author><name sortKey="Just, Hanjorg" sort="Just, Hanjorg" uniqKey="Just H" first="Hanjörg" last="Just">Hanjörg Just</name>
<affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Freiburg</s1>
<s2>Freiburg</s2>
<s3>DEU</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
</affiliation>
</author>
<author><name sortKey="Fox, Keith A A" sort="Fox, Keith A A" uniqKey="Fox K" first="Keith A. A." last="Fox">Keith A. A. Fox</name>
<affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Centre for Cardiovascular Science, University of Edinburgh</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
</affiliation>
</author>
<author><name sortKey="Pocock, Stuart J" sort="Pocock, Stuart J" uniqKey="Pocock S" first="Stuart J." last="Pocock">Stuart J. Pocock</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Medical Statistics Unit, London School of Hygiene and Tropical Medicine</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
</affiliation>
</author>
<author><name sortKey="Clayton, Tim C" sort="Clayton, Tim C" uniqKey="Clayton T" first="Tim C." last="Clayton">Tim C. Clayton</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Medical Statistics Unit, London School of Hygiene and Tropical Medicine</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
</affiliation>
</author>
<author><name sortKey="Motro, Michael" sort="Motro, Michael" uniqKey="Motro M" first="Michael" last="Motro">Michael Motro</name>
<affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Ringer's Research Unit, Sheba Medical Centre, University of Tel Aviv</s1>
<s2>Tel Aviv</s2>
<s3>ISR</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Israël</country>
</affiliation>
</author>
<author><name sortKey="Parker, John D" sort="Parker, John D" uniqKey="Parker J" first="John D." last="Parker">John D. Parker</name>
<affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Division of Cardiology, University Health Network and Mount Sinai Hospitals</s1>
<s2>Toronto, ON</s2>
<s3>CAN</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Canada</country>
</affiliation>
</author>
<author><name sortKey="Bourassa, Martial G" sort="Bourassa, Martial G" uniqKey="Bourassa M" first="Martial G." last="Bourassa">Martial G. Bourassa</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Medicine, Montreal Heart Institute</s1>
<s2>Montreal, QC</s2>
<s3>CAN</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Canada</country>
</affiliation>
</author>
<author><name sortKey="Dart, Anthony M" sort="Dart, Anthony M" uniqKey="Dart A" first="Anthony M." last="Dart">Anthony M. Dart</name>
<affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Cardiovascular Medicine, Alfred Hospital</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Australie</country>
</affiliation>
</author>
<author><name sortKey="Hildebrandt, Per" sort="Hildebrandt, Per" uniqKey="Hildebrandt P" first="Per" last="Hildebrandt">Per Hildebrandt</name>
<affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Cardiology and Endocrinology, Frederiksberg University Hospital</s1>
<s2>Frederiksberg</s2>
<s3>DNK</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
</affiliation>
</author>
<author><name sortKey="Hjalmarson, Ake" sort="Hjalmarson, Ake" uniqKey="Hjalmarson A" first="Ake" last="Hjalmarson">Ake Hjalmarson</name>
<affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Cardiovascular Institute, Sahlgrenska University Hospital</s1>
<s2>Göteborg</s2>
<s3>SWE</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Suède</country>
</affiliation>
</author>
<author><name sortKey="Kragten, Johannes A" sort="Kragten, Johannes A" uniqKey="Kragten J" first="Johannes A." last="Kragten">Johannes A. Kragten</name>
<affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Atrium Medical Centre</s1>
<s2>Heerlen</s2>
<s3>NLD</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
</affiliation>
</author>
<author><name sortKey="Molhoek, G Peter" sort="Molhoek, G Peter" uniqKey="Molhoek G" first="G. Peter" last="Molhoek">G. Peter Molhoek</name>
<affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Medisch Spectrum Twente</s1>
<s2>Enschede</s2>
<s3>NLD</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
</affiliation>
</author>
<author><name sortKey="Otterstad, Jan Erik" sort="Otterstad, Jan Erik" uniqKey="Otterstad J" first="Jan-Erik" last="Otterstad">Jan-Erik Otterstad</name>
<affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Division of Cardiology, Vestfold Hospital</s1>
<s2>Toensberg</s2>
<s3>NOR</s3>
<sZ>19 aut.</sZ>
</inist:fA14>
<country>Norvège</country>
</affiliation>
</author>
<author><name sortKey="Seabra Gomes, Ricardo" sort="Seabra Gomes, Ricardo" uniqKey="Seabra Gomes R" first="Ricardo" last="Seabra-Gomes">Ricardo Seabra-Gomes</name>
<affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Department of Cardiology, Hospital Santa Cruz</s1>
<s2>Lisbon</s2>
<s3>PRT</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Portugal</country>
</affiliation>
</author>
<author><name sortKey="Soler Soler, Jordi" sort="Soler Soler, Jordi" uniqKey="Soler Soler J" first="Jordi" last="Soler-Soler">Jordi Soler-Soler</name>
<affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Department of Cardiology, Vall d'Hebron University Hospital</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
</affiliation>
</author>
<author><name sortKey="Weber, Simon" sort="Weber, Simon" uniqKey="Weber S" first="Simon" last="Weber">Simon Weber</name>
<affiliation wicri:level="1"><inist:fA14 i1="20"><s1>Department of Cardiology, René Descartes University</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>France</country>
</affiliation>
</author>
<author><name sortKey="Psaty, Bruce M" sort="Psaty, Bruce M" uniqKey="Psaty B" first="Bruce M." last="Psaty">Bruce M. Psaty</name>
<affiliation wicri:level="1"><inist:fA14 i1="21"><s1>Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington</s1>
<s2>Seattle, WA 98101</s2>
<s3>USA</s3>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
</affiliation>
</author>
<author><name sortKey="Furberg, Curt D" sort="Furberg, Curt D" uniqKey="Furberg C" first="Curt D." last="Furberg">Curt D. Furberg</name>
<affiliation wicri:level="1"><inist:fA14 i1="22"><s1>Department of Public Health Sciences, Wake Forest University School of Medicine</s1>
<s2>Winston-Salem, North Carolina</s2>
<s3>USA</s3>
<sZ>24 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
<imprint><date when="2004">2004</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Action</term>
<term>Angina pectoris</term>
<term>Circulatory system</term>
<term>Clinical trial</term>
<term>Epidemiology</term>
<term>Human</term>
<term>Medicine</term>
<term>Morbidity</term>
<term>Mortality</term>
<term>Nifedipine</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Angine poitrine</term>
<term>Nifédipine</term>
<term>Epidémiologie</term>
<term>Mortalité</term>
<term>Appareil circulatoire</term>
<term>Morbidité</term>
<term>Homme</term>
<term>Essai clinique</term>
<term>Action</term>
<term>Médecine</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Mortalité</term>
<term>Homme</term>
<term>Médecine</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background Calcium antagonists are widely prescribed for angina pectoris but their effect on clinical outcome is controversial. We aimed to investigate the effect of the calcium antagonist nifedipine on long-term outcome in patients with stable angina pectoris. Methods We randomly assigned 3825 patients with treated stable symptomatic coronary disease to double-blind addition of nifedipine GITS (gastrointestinal therapeutic system) 60 mg once daily and 3840 to placebo. The primary endpoint was the combination of death, acute myocardial infarction, refractory angina, new overt heart failure, debilitating stroke, and peripheral revascularisation. Mean follow-up was 4-9 years (SD 1.1). Analysis was by intention to treat. Findings 310 patients allocated nifedipine died (1.64 per 100 patient-years) compared with 291 people allocated placebo (1.53 per 100 patient-years; hazard ratio 1.07 [95% CI 0.91-1.25], p=0.41). Primary endpoint rates were 4.60 per 100 patient-years for nifedipine and 4.75 per 100 patient-years for placebo (0.97 [0.88-1.07), p=0.54). With nifedipine, rate of death and any cardiovascular event or procedure was 9.32 per 100 patient-years versus 10.50 per 100 patient-years for placebo (0.89 [0.83-0.95], p=0.0012). The difference was mainly attributable to a reduction in the need for coronary angiography and interventions in patients assigned nifedipine, despite an increase in peripheral revascularisation. Nifedipine had no effect on the rate of myocardial infarction. Interpretation Addition of nifedipine GITS to conventional treatment of angina pectoris has no effect on major cardiovascular event-free survival. Nifedipine GITS is safe and reduces the need for coronary angiography and interventions.</div>
</front>
</TEI>
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<fA08 i1="01" i2="1" l="ENG"><s1>Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Commentary</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>POOLE-WILSON (Philip A.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>LUBSEN (Jacobus)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>KIRWAN (Bridget-Anne)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>VAN DALEN (Fred J.)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>WAGENER (Gilbert)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>DANCHIN (Nicolas)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>JUST (Hanjörg)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>FOX (Keith A. A.)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>POCOCK (Stuart J.)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>CLAYTON (Tim C.)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>MOTRO (Michael)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>PARKER (John D.)</s1>
</fA11>
<fA11 i1="13" i2="1"><s1>BOURASSA (Martial G.)</s1>
</fA11>
<fA11 i1="14" i2="1"><s1>DART (Anthony M.)</s1>
</fA11>
<fA11 i1="15" i2="1"><s1>HILDEBRANDT (Per)</s1>
</fA11>
<fA11 i1="16" i2="1"><s1>HJALMARSON (Ake)</s1>
</fA11>
<fA11 i1="17" i2="1"><s1>KRAGTEN (Johannes A.)</s1>
</fA11>
<fA11 i1="18" i2="1"><s1>MOLHOEK (G. Peter)</s1>
</fA11>
<fA11 i1="19" i2="1"><s1>OTTERSTAD (Jan-Erik)</s1>
</fA11>
<fA11 i1="20" i2="1"><s1>SEABRA-GOMES (Ricardo)</s1>
</fA11>
<fA11 i1="21" i2="1"><s1>SOLER-SOLER (Jordi)</s1>
</fA11>
<fA11 i1="22" i2="1"><s1>WEBER (Simon)</s1>
</fA11>
<fA11 i1="23" i2="1"><s1>PSATY (Bruce M.)</s1>
<s9>comment.</s9>
</fA11>
<fA11 i1="24" i2="1"><s1>FURBERG (Curt D.)</s1>
<s9>comment.</s9>
</fA11>
<fA14 i1="01"><s1>Cardiac Medicine, Imperial College London, Dovehouse Street</s1>
<s2>London SW3 6LY</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Epidemiology and Biostatistics, Erasmus Medical Centre</s1>
<s2>Rotterdam</s2>
<s3>NLD</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>SOCAR Research</s1>
<s2>Nyon</s2>
<s3>CHE</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Pharma Research Centre, Bayer Healthcare AG</s1>
<s2>Wuppertal</s2>
<s3>DEU</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Department of Cardiology, Georges Pompidou European Hospital</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>University of Freiburg</s1>
<s2>Freiburg</s2>
<s3>DEU</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Centre for Cardiovascular Science, University of Edinburgh</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Medical Statistics Unit, London School of Hygiene and Tropical Medicine</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Ringer's Research Unit, Sheba Medical Centre, University of Tel Aviv</s1>
<s2>Tel Aviv</s2>
<s3>ISR</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Division of Cardiology, University Health Network and Mount Sinai Hospitals</s1>
<s2>Toronto, ON</s2>
<s3>CAN</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>Department of Medicine, Montreal Heart Institute</s1>
<s2>Montreal, QC</s2>
<s3>CAN</s3>
<sZ>13 aut.</sZ>
</fA14>
<fA14 i1="12"><s1>Cardiovascular Medicine, Alfred Hospital</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>14 aut.</sZ>
</fA14>
<fA14 i1="13"><s1>Department of Cardiology and Endocrinology, Frederiksberg University Hospital</s1>
<s2>Frederiksberg</s2>
<s3>DNK</s3>
<sZ>15 aut.</sZ>
</fA14>
<fA14 i1="14"><s1>Cardiovascular Institute, Sahlgrenska University Hospital</s1>
<s2>Göteborg</s2>
<s3>SWE</s3>
<sZ>16 aut.</sZ>
</fA14>
<fA14 i1="15"><s1>Atrium Medical Centre</s1>
<s2>Heerlen</s2>
<s3>NLD</s3>
<sZ>17 aut.</sZ>
</fA14>
<fA14 i1="16"><s1>Medisch Spectrum Twente</s1>
<s2>Enschede</s2>
<s3>NLD</s3>
<sZ>18 aut.</sZ>
</fA14>
<fA14 i1="17"><s1>Division of Cardiology, Vestfold Hospital</s1>
<s2>Toensberg</s2>
<s3>NOR</s3>
<sZ>19 aut.</sZ>
</fA14>
<fA14 i1="18"><s1>Department of Cardiology, Hospital Santa Cruz</s1>
<s2>Lisbon</s2>
<s3>PRT</s3>
<sZ>20 aut.</sZ>
</fA14>
<fA14 i1="19"><s1>Department of Cardiology, Vall d'Hebron University Hospital</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>21 aut.</sZ>
</fA14>
<fA14 i1="20"><s1>Department of Cardiology, René Descartes University</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>22 aut.</sZ>
</fA14>
<fA14 i1="21"><s1>Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington</s1>
<s2>Seattle, WA 98101</s2>
<s3>USA</s3>
<sZ>23 aut.</sZ>
</fA14>
<fA14 i1="22"><s1>Department of Public Health Sciences, Wake Forest University School of Medicine</s1>
<s2>Winston-Salem, North Carolina</s2>
<s3>USA</s3>
<sZ>24 aut.</sZ>
</fA14>
<fA17 i1="01" i2="1"><s1>ACTION (A Coronary disease Trial Investigating Outcome with Nifedipine gastrointestinal therapeutic system) investigators</s1>
<s3>INC</s3>
</fA17>
<fA20><s2>817-818,849-857 [11 p.]</s2>
</fA20>
<fA21><s1>2004</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>5004</s2>
<s5>354000120255170140</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2004 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>36 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>04-0483358</s0>
</fA47>
<fA60><s1>P</s1>
<s3>AR</s3>
<s3>CT</s3>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Lancet : (British edition)</s0>
</fA64>
<fA66 i1="01"><s0>GBR</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Background Calcium antagonists are widely prescribed for angina pectoris but their effect on clinical outcome is controversial. We aimed to investigate the effect of the calcium antagonist nifedipine on long-term outcome in patients with stable angina pectoris. Methods We randomly assigned 3825 patients with treated stable symptomatic coronary disease to double-blind addition of nifedipine GITS (gastrointestinal therapeutic system) 60 mg once daily and 3840 to placebo. The primary endpoint was the combination of death, acute myocardial infarction, refractory angina, new overt heart failure, debilitating stroke, and peripheral revascularisation. Mean follow-up was 4-9 years (SD 1.1). Analysis was by intention to treat. Findings 310 patients allocated nifedipine died (1.64 per 100 patient-years) compared with 291 people allocated placebo (1.53 per 100 patient-years; hazard ratio 1.07 [95% CI 0.91-1.25], p=0.41). Primary endpoint rates were 4.60 per 100 patient-years for nifedipine and 4.75 per 100 patient-years for placebo (0.97 [0.88-1.07), p=0.54). With nifedipine, rate of death and any cardiovascular event or procedure was 9.32 per 100 patient-years versus 10.50 per 100 patient-years for placebo (0.89 [0.83-0.95], p=0.0012). The difference was mainly attributable to a reduction in the need for coronary angiography and interventions in patients assigned nifedipine, despite an increase in peripheral revascularisation. Nifedipine had no effect on the rate of myocardial infarction. Interpretation Addition of nifedipine GITS to conventional treatment of angina pectoris has no effect on major cardiovascular event-free survival. Nifedipine GITS is safe and reduces the need for coronary angiography and interventions.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B01</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B12A03</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Angine poitrine</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Angina pectoris</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Angina pectoris</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Nifédipine</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Nifedipine</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Nifedipino</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Epidémiologie</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Epidemiology</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Epidemiología</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Mortalité</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Mortality</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Mortalidad</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Appareil circulatoire</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Circulatory system</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Aparato circulatorio</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Morbidité</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Morbidity</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Morbilidad</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Homme</s0>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Human</s0>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Hombre</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Essai clinique</s0>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Clinical trial</s0>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Ensayo clínico</s0>
<s5>11</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Action</s0>
<s5>12</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Action</s0>
<s5>12</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Acción</s0>
<s5>12</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Médecine</s0>
<s5>14</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Medicine</s0>
<s5>14</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Medicina</s0>
<s5>14</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Antagoniste calcium</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Calcium antagonist</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Antagonista calcio</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Dihydropyridine dérivé</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Dihydropyridine derivatives</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Dihidropiridine derivado</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Appareil circulatoire pathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Cardiovascular disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Cardiopathie coronaire</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Coronary heart disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Cardiopatía coronaria</s0>
<s5>40</s5>
</fC07>
<fN21><s1>271</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>

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Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Commentary

Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION trial): randomised controlled trial. Commentary

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