Left Ventricular Mass and Volume With Telmisartan, Ramipril, or Combination in Patients With Previous Atherosclerotic Events or With Diabetes Mellitus (from the ONgoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial [ONTARGET])
MetadataShow full item record
The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) showed that the angiotensin receptor blocker telmisartan 80 mg was not inferior to the angiotensin-converting enzyme inhibitor ramipril 10 mg, and the combination no more effective than ramipril alone, in decreasing morbidity and mortality in patients with cardiovascular disease or high-risk diabetes. Although therapy targeting angiotensin II is known to decrease left ventricular (LV) mass and volume, the relative influence of angiotensin-converting enzyme inhibitor inhibitors and angiotensin receptor blocker, and their combination, on the heart remains unclear in this population. Magnetic resonance imaging was performed in 287 patients enrolled in ONTARGET, across 8 centers in 6 countries, at randomization and after 2-year treatment (90, 100, and 97 patients in the ramipril, telmisartan, and combination therapy groups, respectively). Baseline patient characteristics showed higher frequencies of coronary artery disease, Asian ethnicity, and use of statins and ß blockers than the main ONTARGET trial. LV mass decreased in all groups (p <0.0001 for each), but there were no significant differences in change in LV mass or volume among groups, except that LV mass index decreased more on combination versus telmisartan (p = 0.04). Key determinants of LV mass decrease were a history of hypertension (p = 0.03), baseline mass (p <0.0001), and decrease in systolic blood pressure (p <0.0001). The best magnetic resonance imaging predictor of composite events was end-systolic volume (p <0.0001). In conclusion, telmisartan and ramipril had similar effects on LV mass and volume, and combination therapy was not more effective, in high-risk patients with cardiovascular disease. These results are consistent with the major outcome findings of the main ONTARGET study. © 2009 Elsevier Inc. All rights reserved.
Showing items related by title, author, creator and subject.
Clifford, Rhonda (2004)People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention ...
The impact of lifestyle factors on the clinical outcomes of in vitro fertilisation-embryo transfer (IVF) treatmentJoesbury, Karen Ann (2003)Objectives: To determine the effect of female and male cigarette smoking, caffeine and alcohol consumption, stress and indicators of dietary status on the clinical outcomes of NF treatment. Design: Prospective cohort ...
The cardiac MRI substudy to ongoing telmisartan alone and in combination with ramipril global endpoint trial/telmisartan randomized assessment study in ACE-intolerant subjects with cardiovascular disease: Analysis protocol and baseline characteristicsCowan, B.; Young, A.; Anderson, C.; Doughty, R.; Krittayaphong, R.; Lonn, E.; Marwick, T.; Reid, Christopher; Sanderson, J.; Schmieder, R.; Teo, K.; Wadham, A.; Worthley, S.; Yu, C.; Yusuf, S.; Jennings, G. (2009)Background: The ONTARGET and TRANSCEND clinical trials were designed to investigate the cardioprotective effects of telmisartan 80 mg and ramipril 10 mg, alone and in combination, in patients at high risk of cardiovascular ...