Trials Flashcards
What is the Save trial Intervention In who Outcomes
Treat MI with ACE inhibitor. Mostly asymptomatic Reduced mi.
What is stitch hypothesis 1 Who Intervention Outcomr
Omt vs Cabg in Ef <35. No stastical difference but in pt without angina. Lots of crossover. No survival difference with viability.
Survival differences in heart mate 2 trial
60% in hm2 vs 24% with xve at 2 yrs
Cumulative effect of ace inhibitors? + beta blockers + aldo blockers
28% 34% 15%
Solvd trial When Who Outcomes
1991 Ef < 35. Two trials one with sx/one no sx Enalapril 10 bid Lowered all cause mortality and death/HF hospitalizations
Save trial Who What happened
Post mi Ef <40, no overt HF Placebo vs captopril Reduced cv death 21%
What are the 4 bb trials RRR, inlusion
Us carvedilol 65 rrr, mild/mod HF Ef <3 cibis 35 mod/severe merit 35 mild/mod hf improve Ef by 30% Copernicus 35 severe Capricorn post mi
Comet trial
Carvedilol va metop Much less dm
Who should get beta blockers when to start When to titrate dose?
Symptomatic and asymptomatic Ef <40 Initiate once euvolemic/Discontinue inotropes prior to sc Change dose every 2 week
Elite 2 trial outcomes
Losartan had no benefit over captopril
Val heft Intervention Outcomes
Valsartan added to ace. Reduced HF hospitalizations.
Charm alt/added
Charm alt had benefit Added did not
Optimaal Intervention Outcome
Losartan vs captopril post mi. No difference
Valiant Intervention Outcome
Post mi Valsartan v captopril No differences
Who should get arb
Class 1: ace intolerant, those on Arbs already, Don’t use post mi, don’t use if on spirinolactone.
Consensus trial Intervention Outcome
Enalapril in stage d. Nnt 7
Optime CHF
No benefit of milrinone .5 But seemed to work better in non ischemic
Corona-Gissi HF
No benefit of statins
Rales Population Outcome Weaknesses
Class iv. Nnt 9 Weakness low use bb
Emphasis Population Intervention Nnt/rrr
Class ii/3 Ef<30 spirinolactone Nnt 19 rrr 15%
Ephasus Population Nnt
MI, Ef<35, sx of HF Nnt 44
How often should you measure k in pt on aldostorone
At week one and four and every 3 mos Don’t give k unless less than 4
Enrollment in emphasis Primary outcome Findings rrr nnt
Nyha 2, ef<30 or 35 with wide qrs Cv death or hf hospitalization, Rrr 30, nnt 19
Aheft What is endpoint?
Composite death, HF, qol 4 % arr Recommended for aa, with moderate to severe symptoms reasonable in ace intolerant


