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美国心脏病学会会议临床试验最新消息:心脏再同步治疗-心力衰竭研究(CARE-HF)与心力衰竭缓解、妇女健康研究、治疗达新目标(TNT)研究、COMPASS-HF研究、VERITAS研究、加拿大睡眠呼吸暂停与心血管疾病研究(CANPAP)、PEECH研究和PRIME研究。

Clinical trials update from the American College of Cardiology meeting: CARE-HF and the remission of heart failure, Women's Health Study, TNT, COMPASS-HF, VERITAS, CANPAP, PEECH and PREMIER.

作者信息

Cleland John G F, Coletta Alison P, Freemantle Nick, Velavan Periaswamy, Tin Lwin, Clark Andrew L

机构信息

Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, Kingston-upon-Hull, HU15 5JQ, UK.

出版信息

Eur J Heart Fail. 2005 Aug;7(5):931-6. doi: 10.1016/j.ejheart.2005.04.002.

Abstract

This article provides information and a commentary on landmark trials presented at the American College of Cardiology meeting held in March 2005, relevant to the pathophysiology, prevention and treatment of heart failure. All reports should be considered as preliminary data, as analyses may change in the final publication. CARE-HF showed that Cardiac Re-synchronisation Therapy, administered in addition to expert pharmacological management, reduced all cause mortality and CV hospitalisation in patients with moderate or severe heart failure and cardiac dyssynchrony. The Women's Health Study showed no benefit of vitamin E supplementation or aspirin in the primary prevention of CV disease. The TNT study showed that reducing LDL cholesterol to levels lower than currently recommended, produced a 22% reduction in the incidence of major cardiovascular events. In COMPASS, an implantable device that continuously monitors intra-cardiac pressures was shown to be safe and to improve care in patients with chronic heart failure. Tezosentan failed to show benefit in patients with acute heart failure in the VERITAS study. The CANPAP study failed to show a benefit of continuous positive airway pressure on mortality and heart transplantation in heart failure patients with central sleep apnoea. EECP therapy improved exercise capacity but had no effect on peak VO2 in heart failure patients in the PEECH study. In the PREMIER study the matrix metalloproteinase inhibitor PG-116800 failed to prevent LV remodelling following myocardial infarction.

摘要

本文提供了在2005年3月举行的美国心脏病学会会议上发表的具有里程碑意义的试验的相关信息及评论,这些试验与心力衰竭的病理生理学、预防和治疗相关。所有报告均应视为初步数据,因为最终发表时分析可能会有所变化。“心脏再同步治疗心力衰竭试验(CARE-HF)”表明,在专家药物治疗基础上进行心脏再同步治疗,可降低中重度心力衰竭且伴有心脏不同步的患者的全因死亡率和心血管住院率。“妇女健康研究”表明,补充维生素E或服用阿司匹林对心血管疾病的一级预防无益处。“治疗新目标研究(TNT)”表明,将低密度脂蛋白胆固醇水平降至低于当前推荐水平,可使主要心血管事件的发生率降低22%。在“COMPASS研究”中,一种可连续监测心内压力的植入式装置被证明是安全的,且可改善慢性心力衰竭患者的护理。在“VERITAS研究”中,替唑生坦对急性心力衰竭患者未显示出益处。“加拿大持续气道正压通气治疗心力衰竭研究(CANPAP)”未能证明持续气道正压通气对伴有中枢性睡眠呼吸暂停的心力衰竭患者的死亡率和心脏移植有何益处。在“外周血管疾病增强型体外反搏治疗研究(PEECH)”中,增强型体外反搏(EECP)治疗改善了心力衰竭患者的运动能力,但对峰值摄氧量无影响。在“PREMIER研究”中,基质金属蛋白酶抑制剂PG-116800未能预防心肌梗死后的左心室重构。

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