Recent clinical trials of pharmacologic cardiovascular interventions in patients with chronic kidney disease.
Identifieur interne : 000217 ( Main/Exploration ); précédent : 000216; suivant : 000218Recent clinical trials of pharmacologic cardiovascular interventions in patients with chronic kidney disease.
Auteurs : M O Kaisar [Australie] ; N M Isbel ; D W JohnsonSource :
- Reviews on recent clinical trials [ 1574-8871 ] ; 2008.
Descripteurs français
- KwdFr :
- Agents cardiovasculaires (usage thérapeutique), Agents hématologiques (usage thérapeutique), Défaillance rénale chronique (complications), Essais cliniques comme sujet (MeSH), Facteurs de risque (MeSH), Humains (MeSH), Maladies cardiovasculaires (traitement médicamenteux), Maladies cardiovasculaires (étiologie).
- MESH :
- traitement médicamenteux : Maladies cardiovasculaires.
- usage thérapeutique : Agents cardiovasculaires, Agents hématologiques, Défaillance rénale chronique.
- étiologie : Maladies cardiovasculaires.
- Essais cliniques comme sujet, Facteurs de risque, Humains.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Cardiovascular Agents, Hematologic Agents.
- complications : Kidney Failure, Chronic.
- drug therapy : Cardiovascular Diseases.
- etiology : Cardiovascular Diseases.
- Clinical Trials as Topic, Humans, Risk Factors.
Abstract
End stage kidney disease (ESKD) is associated with a 10- to 20-fold increased risk of cardiovascular mortality compared with age- and sex-matched controls without CKD. In spite of this marked increase in risk, the vast majority of cardiovascular intervention clinical trials to date have specifically excluded subjects with CKD. The aim of this paper is to critically review the recently published clinical trial evidence that cardiac outcomes in CKD patients are modified by cardiovascular risk factor interventions, including erythropoiesis stimulating agent therapy (US Normal Hematocrit, CHOIR and CREATE trials), statins (PPP, 4D and ALERT), fibrates (VA-HIT), folic acid (ASFAST, US folic acid trial, HOST), anti-oxidative stress therapy (SPACE, HOPE and ATIC), N-acetylcysteine, sevelamer (D-COR), cinacalcet (Cunningham meta-analysis), carvedilol, angiotensin converting enzyme inhibitor (FOSIDIAL), telmisartan, aspirin (HOT study re-analysis) and multidisciplinary multiple cardiovascular risk factor intervention clinics (LANDMARK). Although none of these studies could be considered conclusive, the negative trials to date should raise significant concerns about the heavy reliance of current clinical practice guidelines on extrapolation of findings from cardiovascular intervention trials in the general population. It may be that cardiovascular disease in dialysis populations is less amenable to intervention, either because of the advanced stage of CKD or because the pathogenesis of cardiovascular disease in CKD patients is different to that in the general population. Further large, well-conducted, multi-centre randomised controlled trials in this area are urgently required.
DOI: 10.2174/157488708784223853
PubMed: 18474017
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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xml:lang="en"><term>Cardiovascular Diseases</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cardiovascular Diseases</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Maladies cardiovasculaires</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Agents cardiovasculaires</term><term>Agents hématologiques</term><term>Défaillance rénale chronique</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Maladies cardiovasculaires</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Clinical Trials as Topic</term><term>Humans</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Essais cliniques comme sujet</term><term>Facteurs de risque</term><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">End stage kidney disease (ESKD) is associated with a 10- to 20-fold increased risk of cardiovascular mortality compared with age- and sex-matched controls without CKD. In spite of this marked increase in risk, the vast majority of cardiovascular intervention clinical trials to date have specifically excluded subjects with CKD. The aim of this paper is to critically review the recently published clinical trial evidence that cardiac outcomes in CKD patients are modified by cardiovascular risk factor interventions, including erythropoiesis stimulating agent therapy (US Normal Hematocrit, CHOIR and CREATE trials), statins (PPP, 4D and ALERT), fibrates (VA-HIT), folic acid (ASFAST, US folic acid trial, HOST), anti-oxidative stress therapy (SPACE, HOPE and ATIC), N-acetylcysteine, sevelamer (D-COR), cinacalcet (Cunningham meta-analysis), carvedilol, angiotensin converting enzyme inhibitor (FOSIDIAL), telmisartan, aspirin (HOT study re-analysis) and multidisciplinary multiple cardiovascular risk factor intervention clinics (LANDMARK). Although none of these studies could be considered conclusive, the negative trials to date should raise significant concerns about the heavy reliance of current clinical practice guidelines on extrapolation of findings from cardiovascular intervention trials in the general population. It may be that cardiovascular disease in dialysis populations is less amenable to intervention, either because of the advanced stage of CKD or because the pathogenesis of cardiovascular disease in CKD patients is different to that in the general population. Further large, well-conducted, multi-centre randomised controlled trials in this area are urgently required.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">18474017</PMID><DateCompleted><Year>2008</Year><Month>07</Month><Day>10</Day></DateCompleted><DateRevised><Year>2019</Year><Month>11</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1574-8871</ISSN><JournalIssue CitedMedium="Print"><Volume>3</Volume><Issue>2</Issue><PubDate><Year>2008</Year><Month>May</Month></PubDate></JournalIssue><Title>Reviews on recent clinical trials</Title></Journal><ArticleTitle>Recent clinical trials of pharmacologic cardiovascular interventions in patients with chronic kidney disease.</ArticleTitle><Pagination><MedlinePgn>79-88</MedlinePgn></Pagination><Abstract><AbstractText>End stage kidney disease (ESKD) is associated with a 10- to 20-fold increased risk of cardiovascular mortality compared with age- and sex-matched controls without CKD. In spite of this marked increase in risk, the vast majority of cardiovascular intervention clinical trials to date have specifically excluded subjects with CKD. The aim of this paper is to critically review the recently published clinical trial evidence that cardiac outcomes in CKD patients are modified by cardiovascular risk factor interventions, including erythropoiesis stimulating agent therapy (US Normal Hematocrit, CHOIR and CREATE trials), statins (PPP, 4D and ALERT), fibrates (VA-HIT), folic acid (ASFAST, US folic acid trial, HOST), anti-oxidative stress therapy (SPACE, HOPE and ATIC), N-acetylcysteine, sevelamer (D-COR), cinacalcet (Cunningham meta-analysis), carvedilol, angiotensin converting enzyme inhibitor (FOSIDIAL), telmisartan, aspirin (HOT study re-analysis) and multidisciplinary multiple cardiovascular risk factor intervention clinics (LANDMARK). Although none of these studies could be considered conclusive, the negative trials to date should raise significant concerns about the heavy reliance of current clinical practice guidelines on extrapolation of findings from cardiovascular intervention trials in the general population. It may be that cardiovascular disease in dialysis populations is less amenable to intervention, either because of the advanced stage of CKD or because the pathogenesis of cardiovascular disease in CKD patients is different to that in the general population. Further large, well-conducted, multi-centre randomised controlled trials in this area are urgently required.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kaisar</LastName><ForeName>M O</ForeName><Initials>MO</Initials><AffiliationInfo><Affiliation>Center for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, QLD, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Isbel</LastName><ForeName>N M</ForeName><Initials>NM</Initials></Author><Author ValidYN="Y"><LastName>Johnson</LastName><ForeName>D W</ForeName><Initials>DW</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United Arab Emirates</Country><MedlineTA>Rev Recent Clin Trials</MedlineTA><NlmUniqueID>101270873</NlmUniqueID><ISSNLinking>1574-8871</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D002317">Cardiovascular Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006401">Hematologic Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D002317" MajorTopicYN="N">Cardiovascular Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="N">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002986" MajorTopicYN="N">Clinical Trials as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006401" MajorTopicYN="N">Hematologic Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007676" MajorTopicYN="N">Kidney Failure, Chronic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>69</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2008</Year><Month>5</Month><Day>14</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2008</Year><Month>7</Month><Day>11</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2008</Year><Month>5</Month><Day>14</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">18474017</ArticleId><ArticleId IdType="doi">10.2174/157488708784223853</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li></country></list><tree><noCountry><name sortKey="Isbel, N M" sort="Isbel, N M" uniqKey="Isbel N" first="N M" last="Isbel">N M Isbel</name><name sortKey="Johnson, D W" sort="Johnson, D W" uniqKey="Johnson D" first="D W" last="Johnson">D W Johnson</name></noCountry><country name="Australie"><noRegion><name sortKey="Kaisar, M O" sort="Kaisar, M O" uniqKey="Kaisar M" first="M O" last="Kaisar">M O Kaisar</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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