Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and/or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Patients With Stable Ischemic Heart Disease and Preserved Left Ventricular Systolic Function
Summary of Evaluated Trials That Investigated the Addition of an ACEI or an ARB to Standard Therapy for Stable Ischemic Heart Disease With Preserved Left Ventricular Systolic Function
This table is a brief overview summary of the randomized, placebo-controlled trials that met the inclusion criteria for the comparative effectiveness review (CER). The patients enrolled in these trials had stable ischemic heart disease and preserved left ventricular systolic function and were randomized to receive standard medical therapy alone or standard medical therapy combined with an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB). The enrollment criteria for all of the trials excluded patients who had had a recent myocardial infarction or who had had a revascularization procedure within 3 to 6 months of trial enrollment, depending on the trial.
Of the 9 trials that were evaluated, 7 had investigated ACEIs and two had investigated ARBs. The median follow-up for the trials was 3.5 years (range, 0.5–4.8).
For further details on the trials that were evaluated, please refer to the original CER on which this slide is based (available at: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=335).
- Agency for Healthcare Research and Quality. Methods Reference Guide for Effectiveness and Comparative Effectiveness Reviews, Version 1.0 [Draft posted Oct. 2007]. Rockville, MD.
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- Yusuf S, Sleight P, Pogue J, et al, for the Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000;342:145-53.
- MacMahon S, Sharpe N, Gamble G, et al, for the PART-2 Collaborative Research Group. Randomized, placebo-controlled trial of the angiotensin-converting enzyme inhibitor, ramipril, in patients with coronary or other occlusive arterial disease: Prevention of Atherosclerosis with Ramipril. J Am Coll Cardiol 2000;36:438-43.
- Yusuf S, Teo K, Anderson C, et al, for the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease (TRANSCEND) Investigators. Effects of angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomized controlled trial. Lancet 2008; 372:1174-83.
- Coleman CI, Baker WL, Kluger J, et al. Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II-Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease. Comparative Effectiveness Review No. 18. (Prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center under Contract No. 290-2007-10067-I.) Rockville, MD: Agency for Healthcare Research and Quality; October 2009.
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