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[PMID]:29241885
[Au] Autor:Ramos IC; Versteegh MM; de Boer RA; Koenders JMA; Linssen GCM; Meeder JG; Rutten-van Mölken MPMH
[Ad] Endereço:Institute for Medical Technology Assessment, Erasmus University Rotterdam, the Netherlands. Electronic address: corroramos@imta.eur.nl.
[Ti] Título:Cost Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines.
[So] Source:Value Health;20(10):1260-1269, 2017 12.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure with reduced left ventricular ejection fraction in the Netherlands; and to explore the effect of performing the cost-effectiveness analyses according to the new pharmacoeconomic Dutch guidelines (updated during the submission process of LCZ696), which require a value-of-information analysis and the inclusion of indirect medical costs of life-years gained. METHODS: We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. RESULTS: The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. CONCLUSIONS: LCZ696 is cost effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios.
[Mh] Termos MeSH primário: Aminobutiratos/uso terapêutico
Antagonistas de Receptores de Angiotensina/uso terapêutico
Farmacoeconomia
Insuficiência Cardíaca/tratamento farmacológico
Modelos Econômicos
Tetrazóis/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Aminobutiratos/economia
Antagonistas de Receptores de Angiotensina/economia
Inibidores da Enzima Conversora de Angiotensina/economia
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Doença Crônica
Análise Custo-Benefício
Enalapril/economia
Enalapril/uso terapêutico
Feminino
Guias como Assunto
Insuficiência Cardíaca/economia
Seres Humanos
Masculino
Meia-Idade
Neprilisina/antagonistas & inibidores
Países Baixos
Anos de Vida Ajustados por Qualidade de Vida
Ensaios Clínicos Controlados Aleatórios como Assunto
Volume Sistólico/efeitos dos fármacos
Tetrazóis/economia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (Angiotensin Receptor Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors); 0 (LCZ 696); 0 (Tetrazoles); 69PN84IO1A (Enalapril); EC 3.4.24.11 (Neprilysin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:29018174
[Au] Autor:Kristensen SL; Jhund PS; Mogensen UM; Rørth R; Abraham WT; Desai A; Dickstein K; Rouleau JL; Zile MR; Swedberg K; Packer M; Solomon SD; Køber L; McMurray JJV; PARADIGM-HF and ATMOSPHERE Committees and Investigators
[Ad] Endereço:From the BHF Cardiovascular Research Centre, University of Glasgow, United Kingdom (S.L.K., P.S.J., U.M.M., R.R., J.J.V.M.); Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Denmark (S.L.K., U.M.M., R.R., L.K.); The Division of Cardiovascular Medicine, Davis Heart and Lung R
[Ti] Título:Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide Levels in Heart Failure Patients With and Without Atrial Fibrillation.
[So] Source:Circ Heart Fail;10(10), 2017 Oct.
[Is] ISSN:1941-3297
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with heart failure (HF) and atrial fibrillation (AF) have higher circulating levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide) than HF patients without AF. There is uncertainty about the prognostic importance of a given concentration of NT-proBNP in HF patients with and without AF. We investigated this question in a large cohort of patients with HF and reduced ejection fraction. METHODS AND RESULTS: We studied 14 737 patients with HF and reduced ejection fraction and a measurement of NT-proBNP at time of screening, enrolled in either the PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) or the ATMOSPHERE trial (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure), of whom 3575 (24%) had AF on their baseline ECG. Median (Q1, Q3) levels of NT-proBNP were 1817 pg/mL (1095-3266 pg/mL) in those with AF and 1271 pg/mL (703-2569 pg/mL) in those without ( <0.0001). Patients with AF were older (67 versus 62 years), had worse New York Heart Association class (III/IV; 36% versus 24%), and experienced fewer previous HF hospitalizations (52% versus 61%) or myocardial infarction (30% versus 46%); all <0.001. We categorized patients with and without AF into 5 NT-proBNP bands: <400, 400 to 999 (reference), 1000 to 1999, 2000 to 2999, and ≥3000 pg/mL. For the primary composite outcome of cardiovascular death or HF hospitalization, event rates differed for patients with and without AF in the lowest band (<400 pg/mL; 8.2 versus 5.0 per 100 patient-years), but not for the higher bands (400-999 pg/mL, 7.4 versus 7.7 per 100 patient-years; 1000-1999 pg/mL, 9.8 versus 11.4 per 100 patient-year; 2000-2999 pg/mL, 13.5 versus 13.4 per 100 patient-years; ≥3000 pg/mL, 22.7 versus 23.0 per 100 patient-years). These findings were consistent whether NT-proBNP was examined as a categorical or continuous variable and before and after adjustment for other prognostic variables. We found similar results for the components of the composite outcome and all-cause mortality. CONCLUSIONS: HF and reduced ejection fraction patients with AF had higher NT-proBNP than those without AF. However, above a concentration of 400 pg/mL (representing most patients in each group), NT-proBNP had similar predictive value for adverse cardiovascular outcomes, irrespective of AF status. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier NCT00853658 (ATMOSPHERE) and NCT01035255 (PARADIGM-HF).
[Mh] Termos MeSH primário: Fibrilação Atrial/sangue
Doenças Cardiovasculares/mortalidade
Insuficiência Cardíaca/sangue
Hospitalização/estatística & dados numéricos
Peptídeo Natriurético Encefálico/sangue
Fragmentos de Peptídeos/sangue
[Mh] Termos MeSH secundário: Idoso
Amidas/uso terapêutico
Aminobutiratos/uso terapêutico
Antagonistas de Receptores de Angiotensina/uso terapêutico
Anti-Hipertensivos/uso terapêutico
Fibrilação Atrial/complicações
Estudos de Casos e Controles
Estudos de Coortes
Enalapril/uso terapêutico
Feminino
Fumaratos/uso terapêutico
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/tratamento farmacológico
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Volume Sistólico
Tetrazóis/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Aminobutyrates); 0 (Angiotensin Receptor Antagonists); 0 (Antihypertensive Agents); 0 (Fumarates); 0 (LCZ 696); 0 (Peptide Fragments); 0 (Tetrazoles); 0 (pro-brain natriuretic peptide (1-76)); 114471-18-0 (Natriuretic Peptide, Brain); 502FWN4Q32 (aliskiren); 69PN84IO1A (Enalapril)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE


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[PMID]:28784687
[Au] Autor:Lewis EF; Claggett BL; McMurray JJV; Packer M; Lefkowitz MP; Rouleau JL; Liu J; Shi VC; Zile MR; Desai AS; Solomon SD; Swedberg K
[Ad] Endereço:From the Brigham and Women's Hospital, Boston, MA (E.F.L., B.L.C., J.L., A.S.D., S.D.S.); BHF Cardiovascular Research Centre, University of Glasgow, United Kingdom (J.J.V.M.); Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX (M.P.); Novartis, East Hanover, NJ (M.P.L.
[Ti] Título:Health-Related Quality of Life Outcomes in PARADIGM-HF.
[So] Source:Circ Heart Fail;10(8), 2017 Aug.
[Is] ISSN:1941-3297
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients with heart failure and reduced ejection fraction have impaired health-related quality of life (HRQL) with variable responses to therapies that target mortality and heart failure hospitalizations. In PARADIGM-HF trial (Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] With ACEI [Angiotensin-Converting-Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure), sacubitril/valsartan reduced morbidity and mortality compared with enalapril. Another major treatment goal is to improve HRQL. Given improvements in mortality with sacubitril/valsartan, this analysis provides comprehensive assessment of impact of therapy on HRQL in survivors only. METHODS AND RESULTS: Patients (after run-in phase) completed disease-specific HRQL using Kansas City Cardiomyopathy Questionnaire (KCCQ) at randomization, 4 month, 8 month, and annual visits. Changes in KCCQ scores were calculated using repeated measures analysis of covariance model that adjusted for treatment and baseline values (principal efficacy prespecified at 8 months). Among the 8399 patients enrolled in PARADIGM-HF, 7623 (91%) completed KCCQ scores at randomization with complete data at 8 months for 6881 patients (90% of baseline). At 8 months, sacubitril/valsartan group noted improvements in both KCCQ clinical summary score (+0.64 versus -0.29; =0.008) and KCCQ overall summary score (+1.13 versus -0.14; <0.001) in comparison to enalapril group and significantly less proportion of patients with deterioration (≥5 points decrease) of both KCCQ scores (27% versus 31%; =0.01). Adjusted change scores demonstrated consistent improvements in sacubitril/valsartan compared with enalapril through 36 months. CONCLUSIONS: Change scores in KCCQ clinical summary scores and KCCQ overall summary scores were better in patients treated with sacubitril/valsartan compared with those treated with enalapril, with consistency in most domains, and persist during follow-up beyond 8 months. These findings demonstrate that sacubitril/valsartan leads to better HRQL in surviving patients with heart failure. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255.
[Mh] Termos MeSH primário: Aminobutiratos/uso terapêutico
Enalapril/uso terapêutico
Nível de Saúde
Insuficiência Cardíaca/psicologia
Qualidade de Vida
Tetrazóis/uso terapêutico
Valsartana/uso terapêutico
[Mh] Termos MeSH secundário: Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico
Antagonistas de Receptores de Angiotensina/uso terapêutico
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Feminino
Seguimentos
Insuficiência Cardíaca/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (Angiotensin II Type 1 Receptor Blockers); 0 (Angiotensin Receptor Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors); 0 (LCZ 696); 0 (Tetrazoles); 69PN84IO1A (Enalapril); 80M03YXJ7I (Valsartan)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE


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[PMID]:28720684
[Au] Autor:Nishizono R; Kikuchi M; Wang SQ; Chowdhury M; Nair V; Hartman J; Fukuda A; Wickman L; Hodgin JB; Bitzer M; Naik A; Wiggins J; Kretzler M; Wiggins RC
[Ad] Endereço:Departments of Internal Medicine.
[Ti] Título:FSGS as an Adaptive Response to Growth-Induced Podocyte Stress.
[So] Source:J Am Soc Nephrol;28(10):2931-2945, 2017 Oct.
[Is] ISSN:1533-3450
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Glomerular sclerotic lesions develop when the glomerular filtration surface area exceeds the availability of podocyte foot process coverage, but the mechanisms involved are incompletely characterized. We evaluated potential mechanisms using a transgenic (podocin promoter-AA-4E-BP1) rat in which podocyte capacity for hypertrophy in response to growth factor/nutrient signaling is impaired. FSGS lesions resembling human FSGS developed spontaneously by 7 months of age, and could be induced earlier by accelerating kidney hypertrophy by nephrectomy. Early segmental glomerular lesions occurred in the absence of a detectable reduction in average podocyte number per glomerulus and resulted from the loss of podocytes in individual glomerular capillary loops. Parietal epithelial cell division, accumulation on Bowman's capsule, and tuft invasion occurred at these sites. Three different interventions that prevented kidney growth and glomerular enlargement (calorie intake reduction, inhibition of mammalian target of rapamycin complex, and inhibition of angiotensin-converting enzyme) protected against FSGS lesion development, even when initiated late in the process. Ki67 nuclear staining and unbiased transcriptomic analysis identified increased glomerular (but not podocyte) cell cycling as necessary for FSGS lesion development. The rat FSGS-associated transcriptomic signature correlated with human glomerular transcriptomes associated with disease progression, compatible with similar processes occurring in man. We conclude that FSGS lesion development resulted from glomerular growth that exceeded the capacity of podocytes to adapt and adequately cover some parts of the filtration surface. Modest modulation of the growth side of this equation significantly ameliorated FSGS progression, suggesting that glomerular growth is an underappreciated therapeutic target for preservation of renal function.
[Mh] Termos MeSH primário: Glomerulosclerose Segmentar e Focal/etiologia
Glomérulos Renais/crescimento & desenvolvimento
[Mh] Termos MeSH secundário: Adaptação Fisiológica
Animais
Peso Corporal
Ciclo Celular
Enalapril
Glomerulosclerose Segmentar e Focal/patologia
Seres Humanos
Glomérulos Renais/patologia
Masculino
Tamanho do Órgão
Podócitos/fisiologia
Distribuição Aleatória
Ratos Endogâmicos F344
Estresse Fisiológico
Transcriptoma
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
69PN84IO1A (Enalapril)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE
[do] DOI:10.1681/ASN.2017020174


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[PMID]:28607125
[Au] Autor:Li Y; Liang M; Wang G; Wang B; He M; Tang G; Yin D; Xu X; Huo Y; Cui Y; Hou FF; Qin X
[Ad] Endereço:From the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China (Y.L., M.L., G.W., B.W., X.X., F.F.H., X.Q.); National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangzhou
[Ti] Título:Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients: A Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial).
[So] Source:Hypertension;70(2):300-306, 2017 Aug.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We aimed to test the hypothesis that treatment with enalapril and folic acid is more effective in preventing new-onset proteinuria than enalapril alone among hypertensive patients. This is a post hoc analysis of the renal substudy of the CSPPT (China Stroke Primary Prevention Trial). A total of 13 071 eligible participants without proteinuria were randomized to receive a double-blind daily treatment of a single tablet containing 10-mg enalapril and 0.8-mg folic acid (n=6511) or 10-mg enalapril alone (n=6560). The primary outcome was new-onset proteinuria, defined as a urine dipstick reading of ≥1+ at the exit visit. Secondary outcomes included a composite of the primary outcome and all-cause death and the annual rate of estimated glomerular filtration rate decline. After a median 4.4 years of treatment, the primary event occurred in 213 (3.9%) and 188 (3.5%) participants, respectively, in the enalapril and the enalapril-folic acid group (odds ratio, 0.90; 95% confidence interval, 0.74-1.11). However, among participants with diabetes mellitus at baseline, folic acid therapy resulted in a significant reduction in the risk for the primary event (3.7% in the enalapril-folic acid group versus 7.4% in the enalapril group; odds ratio, 0.48; 95% confidence interval, 0.29-0.81) and the composite event (odds ratio, 0.62; 95% confidence interval, 0.42-0.92) and a 55% slower annual rate of estimated glomerular filtration rate decline (0.5% versus 1.1% per year; =0.002). Among those without diabetes mellitus at baseline, there were no between-group differences in all the outcomes. In conclusion, enalapril-folic acid therapy, compared with enalapril alone, significantly reduced the development of proteinuria in diabetic patients with hypertension. CLINICAL TRIAL REGISTRATION: URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00794885.
[Mh] Termos MeSH primário: Enalapril
Ácido Fólico
Hipertensão
Proteinúria
[Mh] Termos MeSH secundário: Idoso
Anti-Hipertensivos/administração & dosagem
Anti-Hipertensivos/efeitos adversos
China
Método Duplo-Cego
Interações Medicamentosas
Monitoramento de Medicamentos/métodos
Quimioterapia Combinada/métodos
Enalapril/administração & dosagem
Enalapril/efeitos adversos
Feminino
Ácido Fólico/administração & dosagem
Ácido Fólico/efeitos adversos
Seres Humanos
Hipertensão/complicações
Hipertensão/diagnóstico
Hipertensão/tratamento farmacológico
Hipertensão/fisiopatologia
Testes de Função Renal
Masculino
Meia-Idade
Mortalidade
Proteinúria/diagnóstico
Proteinúria/etiologia
Proteinúria/fisiopatologia
Proteinúria/prevenção & controle
Resultado do Tratamento
Urinálise/métodos
Complexo Vitamínico B/administração & dosagem
Complexo Vitamínico B/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antihypertensive Agents); 12001-76-2 (Vitamin B Complex); 69PN84IO1A (Enalapril); 935E97BOY8 (Folic Acid)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.117.09404


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[PMID]:28605330
[Au] Autor:Yusoff NSN; Mustapha Z; Sharif SET; Govindasamy C; Sirajudeen KNS
[Ad] Endereço:Department of Chemical Pathology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
[Ti] Título:Effect of Antihypertensive Drug Treatment on Oxidative Stress Markers in Heart of Spontaneously Hypertensive Rat Models.
[So] Source:J Environ Pathol Toxicol Oncol;36(1):43-53, 2017.
[Is] ISSN:2162-6537
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Oxidative stress has been suggested to play a role in hypertension- and hypertension-induced organ damage. The effect of antihypertensive drug treatments on oxidative stress markers has not been well assessed. Therefore, in this study we investigated the effect of enalapril on oxidative stress markers in hearts of hypertensive rat models such as spontaneously hypertensive rats (SHR) and SHRs administered N-nitro-L-arginine methyl ester (SHR+L-NAME rats). Male rats were divided into four groups: SHRs, SHR+enalapril (SHR-E) rats, SHR+L-NAME rats, SHR+enalapril+L-NAME (SHRE+L-NAME) rats. Rats (SHREs) were administered enalapril (30 mg kg-1 day-1) in drinking water from week 4 to week 28 and L-NAME (25 mg kg-1 day-1) from week 16 to week 28 in drinking water. At the end of 28 weeks, animals were sacrificed, and their hearts were collected for the assessment of oxidative stress markers and histological examination. Enalapril treatment significantly enhanced the total antioxidant status (TAS) (P < 0.001), reduced the oxidized glutathione ratio (GSH : GSSG) (P < 0.001), and reduced to thibarbituric acid reactive substances (TBARS) (P < 0.001) and protein carbonyl content (PCO) (P < 0.001), which thus reduced the oxidative stress in the heart. The fibrosis areas in SHRs and SHR+L-NAME rats were also markedly reduced. These findings suggest that enalapril might play a protective role in hypertension- and hypertension-induced organ damage.
[Mh] Termos MeSH primário: Enalapril/farmacologia
Coração/efeitos dos fármacos
NG-Nitroarginina Metil Éster/farmacologia
Estresse Oxidativo/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Anti-Hipertensivos/farmacologia
Coração/anatomia & histologia
Masculino
Ratos
Ratos Endogâmicos SHR
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); 69PN84IO1A (Enalapril); V55S2QJN2X (NG-Nitroarginine Methyl Ester)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1615/JEnvironPatholToxicolOncol.2017014521


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[PMID]:28577874
[Au] Autor:Heidari F; Vasudevan R; Mohd Ali SZ; Ismail P; Arkani M
[Ad] Endereço:Department of Biomedical Science, Genetic Research Group, Faculty of Medicine and Health Sciences, University Putra Malaysia, UPM Serdang Selangor, Malaysia. Electronic address: farzad720@gmail.com.
[Ti] Título:RAS Genetic Variants in Interaction with ACE Inhibitors Drugs Influences Essential Hypertension Control.
[So] Source:Arch Med Res;48(1):88-95, 2017 Jan.
[Is] ISSN:1873-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUNDS AND AIMS: Essential Hypertension (EH) is a common disorder associated with increased cardiovascular morbidity and mortality in Malaysia. To investigate how genetic polymorphisms of the renin-angiotensin-aldosterone system (RAS) influence EH control with angiotensin-converting enzyme inhibitor drugs (ACEI). METHODS: A case-control, cross-sectional population-based nested study (n = 142) included hypertensive subjects treated with ACEI drugs, either lisinopril or enalapril (20 mg, once daily) as monotherapy for 24 weeks. In total seven possible polymorphisms of RAS genes were genotyped. The association between those polymorphisms and the changes in blood pressure were observed in the 24 week treatment. RESULTS: Statistically significant associations of I, G, T, M and G alleles of ACE (I/D, G2350A), AGT (M235T, T175M and G-6A) respectively were observed in essential hypertensive subjects. The decrease in systolic blood pressure and diastolic blood pressure after 24 weeks of treatment of the patients carrying II, GG, and TT genotypes were greater than the groups carrying DD, AA, MM, MM and GG of I/D, G2350A, M235T, T174M and G-6A genotypes respectively. In contrast, No significant difference was observed between renin gene polymorphisms (Bg/I and MboI) and hypertensives. CONCLUSIONS: Although this study shows a possible association of polymorphisms of RAS genes with the risk of non-control of HT in ACEI-treated patients and indicates the importance of all this system's components in regulating HT, it needs to be replicated in other data sources.
[Mh] Termos MeSH primário: Inibidores da Enzima Conversora de Angiotensina/uso terapêutico
Enalapril/uso terapêutico
Hipertensão/tratamento farmacológico
Lisinopril/uso terapêutico
Sistema Renina-Angiotensina/genética
[Mh] Termos MeSH secundário: Adulto
Alelos
Pressão Sanguínea/efeitos dos fármacos
Estudos de Casos e Controles
Estudos Transversais
Hipertensão Essencial
Feminino
Genótipo
Seres Humanos
Hipertensão/genética
Hipertensão/fisiopatologia
Masculino
Meia-Idade
Polimorfismo de Nucleotídeo Único
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Angiotensin-Converting Enzyme Inhibitors); 69PN84IO1A (Enalapril); E7199S1YWR (Lisinopril)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE


  8 / 5922 MEDLINE  
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[PMID]:28577679
[Au] Autor:Mogensen UM; Køber L; Kristensen SL; Jhund PS; Gong J; Lefkowitz MP; Rizkala AR; Rouleau JL; Shi VC; Swedberg K; Zile MR; Solomon SD; Packer M; McMurray JJV; PARADIGM-HF Investigators and Committees
[Ad] Endereço:BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK; Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
[Ti] Título:The effects of sacubitril/valsartan on coronary outcomes in PARADIGM-HF.
[So] Source:Am Heart J;188:35-41, 2017 Jun.
[Is] ISSN:1097-6744
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Angiotensin converting enzyme inhibitors (ACE-I), are beneficial both in heart failure with reduced ejection fraction (HF-REF) and after myocardial infarction (MI). We examined the effects of the angiotensin-receptor neprilysin inhibitor sacubitril/valsartan, compared with the ACE-I enalapril, on coronary outcomes in PARADIGM-HF. METHODS AND RESULTS: We examined the effect of sacubitril/valsartan compared with enalapril on the following outcomes: i) the primary composite endpoint of cardiovascular (CV) death or HF hospitalization, ii) a pre-defined broader composite including, in addition, MI, stroke, and resuscitated sudden death, and iii) a post hoc coronary composite of CV-death, non-fatal MI, angina hospitalization or coronary revascularization. At baseline, of 8399 patients, 3634 (43.3%) had a prior MI and 4796 (57.1%) had a history of any coronary artery disease. Among all patients, compared with enalapril, sacubitril/valsartan reduced the risk of the primary outcome (HR 0.80 [0.73-0.87], P<.001), the broader composite (HR 0.83 [0.76-0.90], P<.001) and the coronary composite (HR 0.83 [0.75-0.92], P<.001). Although each of the components of the coronary composite occurred less frequently in the sacubitril/valsartan group, compared with the enalapril group, only CV death was reduced significantly. CONCLUSIONS: Compared with enalapril, sacubitril/valsartan reduced the risk of both the primary endpoint and a coronary composite outcome in PARADIGM-HF. Additional studies on the effect of sacubitril/valsartan on atherothrombotic outcomes in high-risk patients are merited.
[Mh] Termos MeSH primário: Aminobutiratos/administração & dosagem
Doença da Artéria Coronariana/terapia
Enalapril/administração & dosagem
Insuficiência Cardíaca/tratamento farmacológico
Volume Sistólico/efeitos dos fármacos
Tetrazóis/administração & dosagem
[Mh] Termos MeSH secundário: Antagonistas de Receptores de Angiotensina/administração & dosagem
Inibidores da Enzima Conversora de Angiotensina/administração & dosagem
Causas de Morte/tendências
Angiografia Coronária
Doença da Artéria Coronariana/complicações
Doença da Artéria Coronariana/diagnóstico
Relação Dose-Resposta a Droga
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Saúde Global
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/mortalidade
Hospitalização/tendências
Seres Humanos
Masculino
Meia-Idade
Revascularização Miocárdica
Estudos Prospectivos
Taxa de Sobrevida/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (Angiotensin Receptor Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors); 0 (LCZ 696); 0 (Tetrazoles); 69PN84IO1A (Enalapril)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE


  9 / 5922 MEDLINE  
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[PMID]:28542215
[Au] Autor:Ismail B; deKemp RA; Croteau E; Hadizad T; Burns KD; Beanlands RS; DaSilva JN
[Ad] Endereço:Cardiac PET Centre, Department of Medicine (Division of Cardiology), University of Ottawa Heart Institute, Ottawa, ON, Canada.
[Ti] Título:Treatment with enalapril and not diltiazem ameliorated progression of chronic kidney disease in rats, and normalized renal AT1 receptor expression as measured with PET imaging.
[So] Source:PLoS One;12(5):e0177451, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:ACE inhibitors are considered first line of treatment in patients with many forms of chronic kidney disease (CKD). Other antihypertensives such as calcium channel blockers achieve similar therapeutic effectiveness in attenuating hypertension-related renal damage progression. Our objective was to explore the value of positron emission tomography (PET) imaging of renal AT1 receptor (AT1R) to guide therapy in the 5/6 subtotal-nephrectomy (Nx) rat model of CKD. Ten weeks after Nx, Sprague-Dawley rats were administered 10mg/kg/d enalapril (NxE), 30mg/kg/d diltiazem (NxD) or left untreated (Nx) for an additional 8-10 weeks. Kidney AT1R expression was assessed using in vivo [18F]fluoropyridine-losartan PET and in vitro autoradiography. Compared to shams, Nx rats exhibited higher systolic blood pressure that was reduced by both enalapril and diltiazem. At 18-20 weeks, plasma creatinine and albuminuria were significantly increased in Nx, reduced to sham levels in NxE, but enhanced in NxD rats. Enalapril treatment decreased kidney angiotensin II whereas diltiazem induced significant elevations in plasma and kidney levels. Reduced PET renal AT1R levels in Nx were normalized by enalapril but not diltiazem, and results were supported by autoradiography. Reduction of renal blood flow in Nx was restored by enalapril, while no difference was observed in myocardial blood flow amongst groups. Enhanced left ventricle mass in Nx was not reversed by enalapril but was augmented with diltiazem. Stroke volume was diminished in untreated Nx compared to shams and restored with both therapies. [18F]Fluoropyridine-Losartan PET allowed in vivo quantification of kidney AT1R changes associated with progression of CKD and with various pharmacotherapies.
[Mh] Termos MeSH primário: Progressão da Doença
Enalapril/farmacologia
Regulação da Expressão Gênica/efeitos dos fármacos
Rim/efeitos dos fármacos
Tomografia por Emissão de Pósitrons
Receptor Tipo 1 de Angiotensina/metabolismo
Insuficiência Renal Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Angiotensina II/sangue
Animais
Pressão Sanguínea/efeitos dos fármacos
Peso Corporal/efeitos dos fármacos
Diltiazem/farmacologia
Diltiazem/uso terapêutico
Enalapril/uso terapêutico
Coração/efeitos dos fármacos
Coração/fisiopatologia
Rim/metabolismo
Rim/patologia
Rim/fisiopatologia
Masculino
Tamanho do Órgão/efeitos dos fármacos
Ratos
Ratos Sprague-Dawley
Fluxo Sanguíneo Regional/efeitos dos fármacos
Insuficiência Renal Crônica/diagnóstico por imagem
Insuficiência Renal Crônica/metabolismo
Insuficiência Renal Crônica/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptor, Angiotensin, Type 1); 11128-99-7 (Angiotensin II); 69PN84IO1A (Enalapril); EE92BBP03H (Diltiazem)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177451


  10 / 5922 MEDLINE  
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[PMID]:28377431
[Au] Autor:Wong PC; Guo J; Zhang A
[Ad] Endereço:Department of Cardiology, First Affiliated Hospital of Jinan University, Guangzhou, China.
[Ti] Título:The renal and cardiovascular effects of natriuretic peptides.
[So] Source:Adv Physiol Educ;41(2):179-185, 2017 Jun 01.
[Is] ISSN:1522-1229
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The landmark report by de Bold et al. in 1981 signified the heart as one of the endocrine organs involved in fluid and salt balance (de Bold AJ, Borenstein HB, Veress AT, Sonnenberg H. 28: 89-94, 1981). Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are secreted from cardiomyocytes in response to cardiac stretch as in the case of heart failure, whereas C-type natriuretic peptide (CNP) is secreted from endothelial and renal cells in response to cytokines and endothelium-dependent agonists, such as acetylcholine. Binding ANP or BNP to natriuretic peptide receptor A induces cyclic guanylyl monophosphate as second messenger in the target cells to mediate the following: natriuresis; water diuresis; increasing glomerular filtration rate; decreasing systemic sympathetic activities; plasma volume; cardiac output and blood pressure; and curbing mitoses of heart fibroblasts and hypertrophy of cardiovascular muscle cells. ANP, BNP, and CNP are cleared from the bloodstream by natriuretic peptide receptor C and degraded by an ectoenzyme called neprilysin (NEP). The plasma levels of BNP are typically >100 pg/ml in patients with congestive heart failure. Sacubitril/valsartan is an angiotensin receptor NEP inhibitor that prevents the clinical progression of surviving patients with heart failure more effectively than enalapril, an angiotensin-converting enzyme inhibitor. A thorough understanding of the renal and cardiovascular effects of natriuretic peptides is of major importance for first-year medical students to gain insight into the significance of plasma levels of BNP in patients with heart failure.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/sangue
Peptídeos Natriuréticos/sangue
Peptídeos Natriuréticos/metabolismo
[Mh] Termos MeSH secundário: Aminobutiratos/uso terapêutico
Fator Natriurético Atrial/sangue
Fator Natriurético Atrial/metabolismo
Progressão da Doença
Enalapril/uso terapêutico
Insuficiência Cardíaca/tratamento farmacológico
Seres Humanos
Rim/fisiopatologia
Peptídeo Natriurético Encefálico/sangue
Peptídeo Natriurético Encefálico/metabolismo
Peptídeo Natriurético Tipo C/sangue
Peptídeo Natriurético Tipo C/metabolismo
Tetrazóis/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aminobutyrates); 0 (LCZ 696); 0 (Natriuretic Peptides); 0 (Tetrazoles); 114471-18-0 (Natriuretic Peptide, Brain); 127869-51-6 (Natriuretic Peptide, C-Type); 69PN84IO1A (Enalapril); 85637-73-6 (Atrial Natriuretic Factor)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.1152/advan.00177.2016



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