Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: The HOPE randomized trial
Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: The HOPE randomized trial
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DOI：
10.7326/0003-4819-134-8-200104170-00007
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发表时间：
2001-04-17
影响因子：
39.2
通讯作者：
Yusuf, S
中科院分区：
文献类型：
--
作者：
Mann, JFE;Gerstein, HC;Yusuf, S
背景：与早期肾功能不全相关的心血管风险尚不清楚。临床医生通常不愿意在肾功能不全患者中使用血管紧张素转换酶抑制剂。目的：确定轻度肾功能不全是否会增加心血管风险，雷米普利是否会降低这种风险。设计：事后分析。环境：心脏结果和预防评估（HOPE）研究，一项涉及267个研究中心的随机、双盲、多国试验。患者：轻度肾功能不全患者980例（血清肌酐浓度大于等于124 μ mol/L[大于等于1.4 mg/dL]），肾功能正常患者8307例（血清肌酐浓度< 124 μ mol/L[差值为0.2）。结论：在先前存在血管疾病或糖尿病并伴有心血管危险因素的患者中，轻度肾功能不全显著增加随后心血管事件的风险。雷米普利在不增加不良反应的情况下降低了心血管风险。
Background: The cardiovascular risk associated with early renal insufficiency is unknown. Clinicians are often reluctant to use angiotensin-converting enzyme inhibitors in patients with renal insufficiency.Objective: To determine whether mild renal insufficiency increases cardiovascular risk and whether ramipril decreases that risk.Design: Post hoc analysis.Setting: The Heart Outcomes and Prevention Evaluation (HOPE) study, a randomized, double-blind, multinational trial involving 267 study centers.Patients: 980 patients with mild renal insufficiency (serum creatinine concentration greater than or equal to 124 mu mol/L [greater than or equal to 1.4 mg/dL]) and 8307 patients with normal renal function (serum creatinine concentration < 124 mu mol/L [ 0.2 for the difference).Conclusions: In patients who had preexisting vascular disease or diabetes combined with an additional cardiovascular risk factor, mild renal insufficiency significantly increased the risk for subsequent cardiovascular events. Ramipril reduced cardiovascular risk without increasing adverse effects.