| pathology | treatment | patient | Demonstrated benefit and harm | k | | | |
|---|
| heart failure | candesartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| CHARM preserved, 2003 | candesartan vs placebo | | | |
| Trial | Treatments | Patients | Method |
|---|
| CHARM preserved, 2003 | candesartan target dose 32 mg once daily (n=1514) vs. placebo (n=1509) | patients with NYHA II-IV heart failure and LVEF higher than 40% | double blind Parallel groups Sample size: 1514/1509 Primary endpoint: cardiovascular death or admission to FU duration: 36.6 months |
|
| heart failure | irbesartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| I-PRESERVE (McMurray), 2008 | ibesartan vs placebo | | | Death from Any Cause, Cardiac Arrest with Resuscitation, Hospitalization for Worsening Heart Failure, or Therapy with Intravenous Inotropes or Vasodilators 0.97 [0.89; 1.05] all cause death 1.02 [0.91; 1.14] Cardiovascular death 1.03 [0.89; 1.19] hospital admission for heart failure 0.96 [0.84; 1.11] hospital admission for any reason 1.02 [0.97; 1.08] death or CV hospitalization 0.97 [0.89; 1.05] Cardiovascular death or hospital admission for CHF 0.97 [0.87; 1.10] |
| Trial | Treatments | Patients | Method |
|---|
| I-PRESERVE (McMurray), 2008 | ibersatan 300mg daily (n=2067) vs. placebo (n=2061) | patients with NYHA
II, III, or IV heart failure and an ejection fraction of at least 45% | double blind Parallel groups Sample size: 2067/2061 Primary endpoint: FU duration: 49.5 months |
|
| heart failure | perindopril | not classified | versus placebo or no treatment No demonstrated result for efficacy perindopril inferior to placebo in terms of Hospitalisation in PEP CHF, 2006 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| PEP CHF, 2006 | perindopril vs placebo | | Hospitalisation 0.64 [0.43; 0.97] | Death 0.90 [0.47; 1.71] Long term death (1 year) 0.90 [0.47; 1.71] all cause death or hospitalisation 0.69 [0.47; 1.02] |
| Trial | Treatments | Patients | Method |
|---|
| PEP CHF, 2006 | perindopril, 4 mg/day (n=424) vs. placebo (n=426) | patients aged >=70 years with a diagnosis of heart failure, treated with diuretics and an echocardiogram
suggesting diastolic dysfunction and excluding substantial LV systolic dysfunction or valve disease | double blind Parallel groups Sample size: 424/426 Primary endpoint: all-cause mortality and unplanned heart failure related hospitalization FU duration: 26.2 months (range 12-54.2m) |
|
| patients at high risk for cardiovascular events | enalapril | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| CAMELOT (enalapril), 2004 | enalapril vs placebo | | | Crit principaux 0.88 [0.71; 1.08] Mortalité totale 1.30 [0.45; 3.72] Décès cardiovasculaires 2.43 [0.47; 12.50] revascularisation 0.90 [0.69; 1.16] Infarctus non mortel 0.56 [0.27; 1.17] AVC mortels et non mortels 0.65 [0.27; 1.58] Ev. cardiovasculaires 0.88 [0.71; 1.08] |
| Trial | Treatments | Patients | Method |
|---|
| CAMELOT (enalapril), 2004 | Enalapril 20mg daily (n=673) vs. Placebo (n=655) | patients with angiographically documented CAD (>20% stenosis by coronary angiography) and diastolic blood pressure <100 mm Hg | double blind Parallel groups Sample size: 673/655 Primary endpoint: cardiovascular events FU duration: 24 months |
|
| patients at high risk for cardiovascular events | perindopril | not classified | versus placebo or control No demonstrated result for efficacy perindopril inferior to placebo in terms of Toux in EUROPA, 2003 perindopril inferior to placebo in terms of hypotension in EUROPA, 2003 perindopril inferior to placebo in terms of Arrêt pour effet secondaire in EUROPA, 2003 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| EUROPA, 2003 | perindopril vs placebo | Crit principaux 0.81 [0.72; 0.91] EUROPA endpoint 0.81 [0.72; 0.91] Ev. coronariens 0.77 [0.66; 0.88] Infarctus non mortel 0.78 [0.67; 0.90] Ev. cardiovasculaires 0.81 [0.72; 0.91] | Toux 5.06 [3.47; 7.38] hypotension 3.53 [2.06; 6.04] Arrêt pour effet secondaire 1.10 [1.03; 1.17] | Insuffisance rénale 1.25 [0.65; 2.41] Mortalité totale 0.89 [0.78; 1.02] Décès cardiovasculaires 0.86 [0.72; 1.03] revascularisation 0.96 [0.86; 1.07] AVC mortels et non mortels 0.96 [0.73; 1.26] |
| Trial | Treatments | Patients | Method |
|---|
| EUROPA, 2003 | perindopril 8 mg once daily (n=6110) vs. placebo (n=6108) | low-risk patients with stable coronary heart disease and no apparent heart failure | double blind Parallel groups Sample size: 6110/6108 Primary endpoint: cardiovascular death, myocardial infarction, or cardiac arrest FU duration: 4.2y |
|
| patients at high risk for cardiovascular events | quinapril | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| QUIET, 2001 | quinapril vs placebo | | | Crit principaux 1.02 [0.91; 1.15] Mortalité totale 0.99 [0.59; 1.68] Décès coronariens 0.92 [0.42; 2.00] Ev. coronariens 0.88 [0.61; 1.29] Décès cardiovasculaires 0.92 [0.44; 1.95] revascularisation 1.11 [0.86; 1.42] Infarctus non mortel 0.89 [0.58; 1.39] Ev. cardiovasculaires 0.88 [0.61; 1.29] |
| Trial | Treatments | Patients | Method |
|---|
| QUIET, 2001 | Quinapril 20mg one daily (n=878) vs. Placebo (n=872) | patients with angiographic evidence of coronary artery disease without systolic leftventricular dysfunction | double blind Parallel groups Sample size: 878/872 Primary endpoint: FU duration: 27 months |
|
| patients at high risk for cardiovascular events | ramipril | not classified | versus placebo or control No demonstrated result for efficacy ramipril inferior to placebo in terms of Toux in HOPE, 2000 ramipril inferior to placebo in terms of Angiodème in HOPE, 2000 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| HOPE, 2000 | ramipril vs placebo | Crit principaux 0.79 [0.72; 0.87] nouveau diabète 0.66 [0.52; 0.84] Mortalité totale 0.85 [0.76; 0.95] Décès cardiovasculaires 0.75 [0.65; 0.87] revascularisation 0.87 [0.80; 0.95] Infarctus non mortel 0.81 [0.72; 0.91] AVC mortels et non mortels 0.69 [0.57; 0.84] Ev. cardiovasculaires 0.79 [0.72; 0.87] HOPE endpoint 0.79 [0.72; 0.87] | Toux 4.01 [3.17; 5.06] Angiodème 2.43 [1.01; 5.86] | hypotension 1.26 [0.92; 1.72] Arrêt pour effet secondaire 1.06 [0.99; 1.13] |
| Trial | Treatments | Patients | Method |
|---|
| HOPE, 2000 | ramipril 10 mg once per day orally (n=4645) vs. placebo (n=4652) | high-risk patients (55 years of age or older) with evidence of vascular disease or diabetes plus one other cardiovascular risk factor and who were not known to have a low ejection fraction or heart failure | double blind Parallel groups Sample size: 4645/4652 Primary endpoint: FU duration: 5 y |
|
| patients at high risk for cardiovascular events | ramipril | not classified | versus No demonstrated result for efficacy telmisartan + ramipril inferior to ramipril in terms of Insuffisance rénale in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to ramipril in terms of hypotension in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to ramipril in terms of Arrêt pour effet secondaire in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to telmisartan in terms of Insuffisance rénale in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of Toux in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of hypotension in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of Arrêt pour effet secondaire in ONTARGET (association vs telmisartan), 2008 | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET (association vs ramipril), 2008 | telmisartan + ramipril vs ramipril | | Insuffisance rénale 1.58 [1.14; 2.18] hypotension 2.75 [2.28; 3.31] Arrêt pour effet secondaire 1.20 [1.14; 1.26] | Crit principaux 0.99 [0.93; 1.06] nouveau diabète 0.89 [0.77; 1.03] Mortalité totale 1.06 [0.98; 1.15] Ev. coronariens 1.07 [0.94; 1.22] Décès cardiovasculaires 1.04 [0.93; 1.16] revascularisation 1.04 [0.96; 1.11] AVC mortels et non mortels 0.93 [0.81; 1.07] Toux 1.10 [0.96; 1.26] Ev. cardiovasculaires 1.00 [0.93; 1.08] Angiodème 0.73 [0.40; 1.33] | | ONTARGET (association vs telmisartan), 2008 | telmisartan + ramipril vs telmisartan | nouveau diabète 0.81 [0.70; 0.94] | Insuffisance rénale 1.39 [1.02; 1.89] Toux 4.23 [3.38; 5.30] hypotension 1.78 [1.52; 2.09] Arrêt pour effet secondaire 1.28 [1.21; 1.34] | Crit principaux 0.98 [0.91; 1.05] Mortalité totale 1.08 [1.00; 1.17] Ev. coronariens 1.00 [0.88; 1.14] Décès cardiovasculaires 1.04 [0.93; 1.16] revascularisation 1.01 [0.95; 1.09] AVC mortels et non mortels 1.02 [0.88; 1.17] Ev. cardiovasculaires 1.01 [0.94; 1.09] Angiodème 1.81 [0.84; 3.92] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET (association vs ramipril), 2008 | telmisartan 80mg + ramipril 10mg daily (n=8502) vs. ramipril 10 mg daily
(n=8576)
| patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage
| double blind Parallel groups Sample size: 8502/8576 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y
| | ONTARGET (association vs telmisartan), 2008 | telmisartan 80mg + ramipril 10mg daily
(n=8502) vs. telmisartan 80 mg daily (n=8542)
| patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage
| double blind Parallel groups Sample size: 8502/8542 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y
|
|
| patients at high risk for cardiovascular events | telmisartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| TRANSCEND, 2008 | telmisartan vs placebo | Ev. cardiovasculaires 0.88 [0.77; 1.00] HOPE endpoint 0.88 [0.77; 1.00] | | cancer occurence 1.16 [0.97; 1.39] cancer occurence (as prespecified endpoint) 1.16 [0.97; 1.39] Crit principaux 0.93 [0.83; 1.04] Insuffisance rénale 1.86 [0.95; 3.64] Mortalité totale 1.05 [0.91; 1.20] Ev. coronariens 0.79 [0.63; 1.01] Décès cardiovasculaires 1.02 [0.86; 1.22] revascularisation 0.90 [0.79; 1.03] AVC mortels et non mortels 0.83 [0.65; 1.06] Toux 0.84 [0.42; 1.66] hypotension 1.82 [0.99; 3.35] Arrêt pour effet secondaire 0.91 [0.83; 1.00] Angiodème 0.67 [0.11; 4.01] |
| Trial | Treatments | Patients | Method |
|---|
| TRANSCEND, 2008 | telmisartan 80 mg/day (n=2954) vs. placebo (n=2972) | high-risk patients intolerant to
angiotensin-converting enzyme inhibitors | double blind Parallel groups Sample size: 2954/2972 Primary endpoint: CV death, MI, stroke, hospitalization for HF FU duration: median 56 months (IQR 51-64) |
|
| patients at high risk for cardiovascular events | telmisartan | not classified | versus No demonstrated result for efficacy telmisartan inferior to ramipril in terms of hypotension in ONTARGET (telmisartan alone), 2008 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET (telmisartan alone), 2008 | telmisartan vs ramipril | Toux 0.26 [0.21; 0.33] Arrêt pour effet secondaire 0.94 [0.89; 0.99] Angiodème 0.40 [0.19; 0.84] | hypotension 1.54 [1.26; 1.89] | Crit principaux 1.01 [0.95; 1.08] nouveau diabète 1.09 [0.95; 1.26] Insuffisance rénale 1.14 [0.81; 1.61] Mortalité totale 0.98 [0.90; 1.06] Ev. coronariens 1.07 [0.94; 1.22] Décès cardiovasculaires 1.00 [0.89; 1.11] revascularisation 1.02 [0.95; 1.10] AVC mortels et non mortels 0.91 [0.80; 1.05] Ev. cardiovasculaires 0.99 [0.92; 1.06] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET (telmisartan alone), 2008 | telmisartan 80mg daily (n=8542) vs. ramipril 10 mg daily (n=8576) | patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage | double blind Parallel groups Sample size: 8542/8576 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y |
|
| patients at high risk for cardiovascular events | trandolapril | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| PEACE, 2004 | trandolapril vs placebo | nouveau diabète 0.83 [0.73; 0.96] | | Crit principaux 0.97 [0.90; 1.05] EUROPA endpoint 0.97 [0.84; 1.11] PEACE endpoint 0.99 [0.92; 1.06] Mortalité totale 0.89 [0.77; 1.03] Ev. coronariens 0.97 [0.90; 1.05] Décès cardiovasculaires 0.95 [0.76; 1.19] revascularisation 0.92 [0.78; 1.07] Infarctus non mortel 1.00 [0.84; 1.20] AVC mortels et non mortels 0.77 [0.56; 1.04] Ev. cardiovasculaires 0.97 [0.84; 1.12] HOPE endpoint 0.94 [0.82; 1.07] |
| Trial | Treatments | Patients | Method |
|---|
| PEACE, 2004 | Trandolapril at a target dose of 4 mg per day (n=4158) vs. Placebo (n=4132) In February 2002, given the increasing evidence
of the benefit of ACE inhibitors or angiotensinreceptor
blockers in patients with diabetes mellitus
and renal disease,
the investigators were adviced to substitute open-label ACE inhibitors for the masked study treatment in
patients with diabetes and either overt proteinuria
or hypertension and microalbuminuria. | patients with stable coronary artery disease and
normal or slightly reduced left ventricular function | Double blind Parallel groups Sample size: 4158/4132 Primary endpoint: death from cardiovascular causes, nonfatal myocardial infarction, or coronary revascularization FU duration: median 4.8 y |
|
