Trials

Front 1

CHARM

Back 1

*Heart Failure*

ARBs reduced death in HF; may add to ACEi benefit (N.B. Val-HF); no benefit in preserved LV dysfunction

Front 2

SOLVD

Back 2

*Heart Failure*

ACEi in asymptomatic LV dysfunction reduced incidence and hospitalization for HF

Front 3

RALES

Back 3

*Heart Failure*

Spironolactone reduced mortality and symptoms in NYHA 3+

Front 4

CIBIS-II

Back 4

*Heart Failure*

Bisoprolol improved mortality in NYHA 3-4

Front 5

COMET

Back 5

*Heart Failure*

Carvedilol superior to metoprolol reducing mortality in NYHA 2+ & EF <35%

Front 6

ACCOMPLISH

Back 6

*HTN*

CCBs are superior to diuretics when added to ACEi in high risk patients

Front 7

ALLHAT

Back 7

*HTN*

Similar control with CCB/Thiazide/ACEi; Thiazide may be superior. Doxazosin less suitable. Monotherapy often not sufficient.

Front 8

LIFE

Back 8

*HTN*

Losartan reduced mortality above atenolol for same BP reduction

Front 9

PROVE-IT

Back 9

*HLD*

Significantly reduced CVD events following MI with high-dose atorva vs. prava

Front 10

IMPROVE-IT

Back 10

*HLD*

Ezetimibe, added to simvastatin in post-ACS patients with high LDL, reduced (ARR 2%) composite of CV death, MI and non-fatal stroke - powered by reduction in MI and ischaemic stroke. When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes

Front 11

AIM-HIGH

Back 11

*HLD*

Niacin added to statin +- ezetimibe improved HDL/TAG but did not improve outcomes

Front 12

4S

Back 12

*HLD*

Simva reduces death, MI, revasc in angina/MI patients

Front 13

ENHANCE

Back 13

*HLD*

Ezetimibe added to simvastatin reduced LDL but not plaque size

Front 14

JUPITER

Back 14

*HLD*

Rosuvastatin reduces mortality in low LDL but raised CRP patients

Front 15

CARDS

Back 15

*HLD*

Atorvastatin reduced CV events even in low LDL DM patients; stopped early due to benefit

Front 16

HPS2-THRIVE

Back 16

*HLD*

No significant benefit of ER niacin/laropiprant on the primary outcome of major vascular events when added to effective statin-based LDL-lowering therapy

Front 17

FIELD

Back 17

*HLD*

T2DM+fenofibrate for 5 years had significant reductions in total CVD events, particularly nonfatal MI and coronary revasc. However, the primary endpoint of the FIELD trial, major coronary events, was not significantly reduced by fenofibrate compared w/placebo.

Front 18

ARISTOTLE

Back 18

*ACC*

In pts with a.fib, apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality.

Front 19

WARCEF

Back 19

*ACC*

No benefit from warfarin in prior stroke & LVEF <35%; reduced ischemic stroke offset by hemorrhage (benefit of warfarin in reducing the rate of stroke was offset by a significant increase in the rate of major bleeding)

Front 20

SPAF

Back 20

*ACC*

ASA and warfarin are both effective in reducing stroke and systemic embolism in patients with a.fib

Front 21

SPAF-II

Back 21

*ACC*

ASA sufficient in young & healthy. Warfarin may be necessary for higher risk patients.

Front 22

SPAF-III

Back 22

*ACC*

INR monitoring necessary for warfarin

Front 23

ELITE-II

Back 23

*HEART FAILURE*

Losartanwas not superior to captopril in improving survival in elderly heart-failurepatients, but was significantly better tolerated. ACE i's should be theinitial treatment for HF, although ARBs may be useful to block the renin angiotensin aldosterone systemwhen ACEi's are not tolerated.

Front 24

EMPHASIS

Back 24

*Heart Failure*

Eplerenone reduced mortality and symptoms in NYHA 2+

Front 25

MERIT

Back 25

*HEART FAILURE*

Metoprolol CR/XL once daily in addition tooptimum standard therapy improved survival. The drug waswell tolerated.

Front 26

Val-HeFT

Back 26

*Heart Failure*

Valsartan improved symptoms & mortality in NYHA2+; no benefit added to ACEi

Front 27

UKPDS

Back 27

*DM*

Reducing glucose exposure (HbA1c 7 % versus 7.9 % over median 10 yrs), with sulphonylurea or insulin therapy, reduced the risk of “any diabetes-related endpoint” by 12% and microvascular disease by 25%, with a 16% trend to a reduced risk of MI

Front 28

DCCT

Back 28

*T1DM*

Intensive BG control reduces the risk of nephropathy, neuropathy, and retinopathy

Front 29

ACCORD

Back 29

*DM*

T2DM and a high risk of CVD: intensive blood glucose control has been linked with a slightly higher risk of death compared with less-intensive tx

Front 30

ADVANCE

Back 30

Intensive BG control protects against serious complications; Intensive glucose control strategy safely controlled BG to a mean HbA1c level of 6.5%, significantly reduced overall risk of serious diabetes complications, with a 21% reduction in kidney disease and 30% reduction in the development of macro-albuminuria, a well established marker of increased CV risk.

Front 31

VADT

Back 31

*DM*

Intensive glucose control in patients with poorly controlled T2DM had no significant effect on the rates of major CV events, death, or microvascular complications, with the exception of progression of albuminuria