Efficacy and acceptability of perindopril in mild to moderate chronic congestive heart failure

Lechat, Philippe; Garnham, Simon P.; Desché, P.; Bounhoure, Jean-Paul

doi:10.1016/0002-8703(93)90933-z

Cited by 37 publications

(7 citation statements)

References 24 publications

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“…It is known that drug treatment of hypertension through ACE inhibition or angiotensin-receptor blockade leads to a reduction in CTR 21 and left ventricular hypertrophy. 22 In essential hypertension, a reduction in left ventricular mass during treatment is a favourable prognostic marker that predicts a lesser risk for subsequent cardiovascular morbid events, 23 whereas in patients with baseline ECG left ventricular hypertrophy in addition, lower left ventricular mass during antihypertensive treatment was associated with lower rates of clinical end points, additional to effects of blood pressure lowering and treatment modality.…”

Section: Discussionmentioning

confidence: 99%

Cardiothoracic ratio within the "normal" range independently predicts mortality in patients undergoing coronary angiography

Zaman

Sanders²,

Crook³

et al. 2007

Heart

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Objective: To determine whether cardiothoracic ratio (CTR), within the range conventionally considered normal, predicted prognosis in patients undergoing coronary angiography. Design: Cohort study with a median of 7-years follow-up. Setting: Consecutive patients undergoing coronary angiography at Barts and The London National Health Service (NHS) Trust. Subjects: 1005 patients with CTRs measured by chest radiography, and who subsequently underwent coronary angiography. Of these patients, 7.3% had a CTR >0.5 and were excluded from the analyses. Outcomes: All-cause mortality and coronary event (non-fatal myocardial infarction or coronary death). Adjustments were made for age, left ventricular dysfunction, ACE inhibitor treatment, body mass index, number of diseased coronary vessels and past coronary artery bypass graft. Results: The risk of death was increased among patients with a CTR in the upper part of the normal range. In total, 94 (18.9%) of those with a CTR below the median of 0.42 died compared with 120 (27.8%) of those with a CTR between 0.42 and 0.49 (log rank test p,0.001). After adjusting for potential confounders, this increased risk remained (adjusted HR 1.45, 95% CI 1.03 to 2.05). CTR, at values below 0.5, was linearly related to the risk of coronary event (test for trend p = 0.024). Conclusion : In patients undergoing coronary angiography, CTR between 0.42 and 0.49 was associated with higher mortality than in patients with smaller hearts. There was evidence of a continuous increase in risk with higher CTR. These findings, along with those in healthy populations, question the conventional textbook cutoff point of >0.5 being an abnormal CTR.

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Section: Discussionmentioning

confidence: 99%

Cardiothoracic ratio within the "normal" range independently predicts mortality in patients undergoing coronary angiography

Zaman

Sanders²,

Crook³

et al. 2007

Heart

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“…Thus, out of the 49 published studies only 29 studies were retained. Further 11 studies evaluating the effect of ACE inhibitor vs. placebo [11,17–27], three studies evaluating 1‐year treatment [9,28,30], and two studies evaluating low vs. high dose without placebo arm [36,37] were also excluded. These 16 studies were characterised by small populations (<50 patient, the vast majority included 10–30 patients) and had a wide range of confidence interval for effect size inducing significant heterogeneity ( P =0.0009) together with the large multi‐centre studies and possible publication bias (fig.…”

Section: Methodsmentioning

confidence: 99%

A meta‐analysis of the effect of angiotensin‐converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction

Abdulla

Abildstrøm

Christensen

et al. 2004

European J of Heart Fail

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Aim: To determine by meta-analysis whether angiotensin-converting enzyme (ACE) inhibitors improve exercise tolerance in patients with symptomatic left ventricular systolic dysfunction (LVSD). Methods and results: After literature search 13 multi-centre double blind parallel group trials that evaluated the effect of ACE inhibitors vs. placebo on exercise duration were selected. Ninety-four percent of patients were in New York Heart Association class II -IV. The studies were combined using the Cochrane meta-analysis program (Review manager version 4.1). Analyses according to treatment period, exercise protocols and publication periods were performed. Treatment with ACE inhibitor over 4 -12 weeks resulted in a beneficial effect on exercise duration (P = 0.003 and P = 0.0008 for 4-and 12-weeks treatment, respectively), but the magnitude of improvements did not exceed 30 s corresponding to only 5% compared with placebo. Conclusion: In addition to the pronounced effect on mortality and morbidity in patients with symptomatic LVSD, ACE inhibitors have improving effect on functional capacity measured as exercise tolerance time.

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“…Another possible explanation implies that APLs stimulate the immune system in order to regulate the MS related T-cells [23]. Two phase II trials using an APL designed based on the human immunodominant MBP [83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99] peptide have been reported [24,25]. Both were stopped prematurely due to hypersensitivity reactions in one and disease exacerbation in the other.…”

Section: Linear and Cyclic Apls Against Msmentioning

confidence: 99%

“…In an attempt to correlate the antagonistic activity of linear APLs of MBP [87][88][89][90][91][92][93][94][95][96][97][98][99] with their conformation, full molecular dynamics studies of their complexes with HLA-DR2b in aqueous solvent have been performed [36]. It was found that once bound to the MHC, significant changes occur in the orientation of the amino acids that serve as TCR anchors, compared to their conformation in solution.…”

Section: Linear and Cyclic Apls Against Msmentioning

confidence: 99%

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Peptides as Therapeutic Agents or Drug Leads for Autoimmune, Hormone Dependent and Cardiovascular Diseases

Mantzourani¹,

Laimou²,

Matsoukas³

et al. 2008

AIAAMC

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Peptides regulate most physiological processes, mainly by binding to specific receptors located on the cell surface and inducing a series of signals, neurotransmissions or the release of growth factors. There has been a rapid expansion in the use of peptides as therapeutic agents after the 1960s, but a series of unfortunate side effects present in Phase I and II clinical studies combined with their low bioavailability, led to the introduction of the idea of peptidomimetics as alternative compounds that mimic the biological activity of peptides, while offering the advantages of increased bioavailability, biostability, bioefficiency, and bioselectivity. Since then new peptides with promising in vitro results, involving the monoclonal antibody expansion, as well as the newly launched research field for novel formulations for increasing peptides' bioavailability, redirected the interest on the peptide market. In this report we will highlight three areas where the use of peptides has shown promising results, with products that are either currently used as drugs or included into Phase III clinical studies.

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Efficacy and acceptability of perindopril in mild to moderate chronic congestive heart failure

Cited by 37 publications

References 24 publications

Cardiothoracic ratio within the "normal" range independently predicts mortality in patients undergoing coronary angiography

Cardiothoracic ratio within the "normal" range independently predicts mortality in patients undergoing coronary angiography

A meta‐analysis of the effect of angiotensin‐converting enzyme inhibitors on functional capacity in patients with symptomatic left ventricular systolic dysfunction

Peptides as Therapeutic Agents or Drug Leads for Autoimmune, Hormone Dependent and Cardiovascular Diseases

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