TRACE研究PPT课件.ppt

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1、TRACE:TRandolaprilCardiacEvaluationPurposeTodeterminewhetherlong-termtherapywiththeACEinhibitortrandolaprilreducesmorbidityandmortalityinpatientswhohaveleftventriculardysfunctionsoonafterMIReferenceKøberL,Torp-PedersenC,CarlsenJRetal.fortheTRACEStudyGrou

2、p.Aclinicaltrialoftheangiotensin-converting-enzymeinhibitortrandolaprilinpatientswithleftventriculardysfunctionaftermyocardialinfarction.NEnglJMed1995;333:1670–6.TRACE:TRandolaprilCardiacEvaluation-TRIALDESIGN-DesignMulticenter,randomized,double-blind,pl

3、acebo-controlledPatients1749patientswithleftventricularsystolicdysfunction(wall-motionindex<1.2,ejectionfraction<35%)<7daysafterMIFollowupandprimaryendpoint2.0–4.1yearsfollowup.Primaryendpointall-causemortalityTreatmentMatchedplacebooronce-dailytrandolap

4、ril1mgfor2days,increasedto2mgafter2days,increasedto4mgafter4weeks;reducedto1–2mgdailyifhighestdosenottoleratedTRACE:TRandolaprilCardiacEvaluation-RESULTS-Intrandolaprilgroup,significantreductionin:All-causemortalityanddeathfromcardiovascularcausesSuddend

5、eathProgressiontosevereheartfailureTrendtowardreductionofrecurrentMI(fatalornon-fatal)intrandolaprilgroupwasnotsignificantToleranceprofilefortrandolaprilsimilartothatofotherACEinhibitors;cough,hypotension,peripheralvasculardisordersandhyperkalemiasignifi

6、cantlyhigherintrandolaprilgroupTRACE:TRandolaprilCardiacEvaluation-RESULTScontinued-YearsafterrandomizationMortality(%)001234876873TrandolaprilPlaceboNo.atrisk67764761356231928020222010403050Cumulativeall-causemortalityRelativerisk0.78P=0.001Køberetal.NE

7、nglJMed1995;333:1670–6.PlaceboTrandolaprilTRACE:TRandolaprilCardiacEvaluation-RESULTScontinued-PCardiovascularoutcomesKøberetal.NEnglJMed1995;333:1670–6.Relativerisk(95%CI)Death,allcausesDeathfromcardiovascularcausesSuddendeathProgressiontosevereheartfai

8、lureRecurrentMI(fatalornon-fatal)Trandolapriln=876(%)34.725.812.014.311.3Placebon=873(%)42.333.015.219.612.90.78(0.67–0.91)0.75(0.63–0.89)0.76(0.59–0.98)0.71(0.56–0.89)0.86(0.66–1.13)0.0010.0010.030.0030.29TRACE:TRandolapr