Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis - a randomized study
Candesartan, an angiotensin II type-1 receptor blocker, reduces cardiovascular events in patients on chronic haemodialysis - a randomized study
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DOI：
10.1093/ndt/gfl293
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发表时间：
2006-09-01
影响因子：
6.1
通讯作者：
Dohi, Yasuaki
中科院分区：
文献类型：
--
作者：
Takahashi, Akihiko;Takase, Hiroyuki;Dohi, Yasuaki
背景心血管事件是慢性血液透析患者预后的主要决定因素。本研究旨在探讨坎地沙坦（一种血管紧张素II 1型受体阻滞剂）是否能降低这些患者的心血管事件发生率。共入组了80例病情稳定且无心脏疾病临床证据的长期血液透析患者（男性/女性，47/33;平均年龄+/- SEM，61 +/- 1岁）。患者随机分为坎地沙坦组（n = 43）和对照组（n = 37），坎地沙坦4-8 mg/d，随访19.4 ± 1.2个月，终点为心血管事件，如致死性/非致死性心肌梗死、不稳定型心绞痛、充血性心力衰竭、严重心律失常和猝死。两组在基线时表现出相似的临床特征。在随访期间，坎地沙坦组7例患者和对照组17例患者发生心血管事件。Kaplan-Meier分析显示对照组心血管事件发生率和死亡率均显著高于坎地沙坦组（分别为45.9vs16.3%和18.9vs0.0%）（P < 0.01）。坎地沙坦治疗可显著降低长期维持性血液透析患者的心血管事件和死亡率，因此可改善这些患者的预后。
Background. Cardiovascular events are the major determinants of the prognosis of patients on chronic haemodialysis. The present study was designed to investigate whether candesartan, an angiotensin II type-1 receptor blocker, reduces the incidence of cardiovascular events in these patients.Methods. A total of 80 chronic haemodialysis patients (male/female, 47/33; mean age +/- SEM, 61 +/- 1 years) in stable condition and with no clinical evidence of cardiac disorders were enrolled. Patients were randomly assigned candesartan 4-8 mg/day (candesartan group; n = 43) or nothing (control group; n = 37), and followed for 19.4 +/- 1.2 months with as endpoint cardiovascular events such as fatal/nonfatal myocardial infarction, unstable angina pectoris, congestive heart failure, severe arrhythmia and sudden death.Results. Both groups exhibited similar clinical characteristics at baseline. During follow-up, cardiovascular events occurred in seven patients in the candesartan group and 17 in the control group. Kaplan-Meier analysis revealed that cardiovascular events and mortality rates were significantly (P < 0.01) higher in the control group than in the candesartan group (45.9 vs 16.3% and 18.9 vs 0.0%, respectively).Conclusions. Candesartan therapy significantly reduces cardiovascular events and mortality in patients on chronic maintenance haemodialysis and therefore improves the prognosis of these patients.