PowerPoint プレゼンテーション - 埼玉医科大学総合医療 ….ppt

Combined analyses of the results of TRANSCEND and PRoFESS trials comparing telmisartan with placebo Results The median duration of follow-up was 56 (IQR 51–64) months. All randomised patients were included in the efficacy analyses. Mean blood pressure was lower in the telmisartan group than in the placebo group throughout the study (weighted mean difference between groups 4?0/2?2 [SD 19?6/12?0] mm Hg). 465 (15?7%) patients experienced the primary outcome in the telmisartan group compared with 504 (17?0%) in the placebo group (hazard ratio 0?92, 95% CI 0?81–1?05, p=0?216). One of the secondary outcomes—a composite of cardiovascular death, myocardial infarction, or stroke—occurred in 384 (13?0%) patients on telmisartan compared with 440 (14?8%) on placebo (0?87, 0?76–1?00, p=0?048 unadjusted; p=0?068 after adjustment for multiplicity of comparisons and overlap with primary outcome). 894 (30?3%) patients receiving telmisartan were hospitalised for a cardiovascular reason, compared with 980 (33?0%) on placebo (relative risk 0?92, 95% CI 0?85–0?99; p=0?025). Fewer patients permanently discontinued study medication in the telmisartan group than in the placebo group (639 [21?6%] vs 705 [23?8%]; p=0?055); the most common reason for permanent discontinuation was hypotensive symptoms (29 [0?98%] in the telmisartan group vs 16 [0?54%] in the placebo group). Conclusion Telmisartan was well tolerated in patients unable to tolerate ACE inhibitors. Although the drug had no significant effect on the primary outcome of this study, which included hospitalisations for heart failure, it modestly reduced the risk of the composite outcome of cardiovascular death, myocardial infarction, or stroke. Comparative effect of renin-active agents vs placebo in prevention of cardiovascular events Dr. de Ferranti is director of the Preventive Cardiology Clinic at Children’s Hospital Boston and an assistant professor of pediatrics at Harvard Medical School, in Boston. Dr. Ludwig is director of th