Treatment with the angiotensin-converting enzyme inhibitor trandolapril (Roussel Uclaf's Odrik) caused a decrease in overall mortality of 22% in survivors of myocardial infarction with moderate-to-severe left ventricular dysfunction, according to Christian Torp-Pederson, Gentofte University Hospital, Copenhagen, Denmark, presenting primary results of the Trandolapril Cardiac Evaluation (TRACE) study at the joint XIIth World Congress of Cardiology and XVth European Congress of the European Society of Cardiology in Berlin, Germany, last week.
The double-blind study, conducted at 27 centers in Denmark, enrolled patients on the basis of echocardiographic evidence of left ventricular dysfunction, as determined by a wall motion index of <=1.2. A total of 1,749 patients were randomized to receive either trandolapril or placebo, in addition to conventional therapy, within three to seven days of MI. Trandolapril was initiated at 1mg daily for two days, and gradually increased to a maximum level of 4mg daily as tolerated. Follow-up continued for at least two years, with some patients being followed for as long as four years.
The conventional therapy regimen, which was administered as a concomitant therapy, was described as the best possible regime for the indication. The drugs used included beta blockers, diuretics and calcium channel blockers. Patients were not admitted to the trial if they received any other ACE inhibitors.
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