Left Ventricular Mass and Volume With Telmisartan , Ramipril , or Combination in Patients With Previous Atherosclerotic Events or With Diabetes Mellitus (from the ONgoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial [ONTARGET])

• Published in: The American journal of cardiology 2009-12, Vol.104 (11), p.1484-1489
• Main Authors: Cowan, Brett R., BE, MBChB, Young, Alistair A., PhD, Anderson, Craig, MBBS, PhD, Doughty, Robert N., MD, Krittayaphong, Rungroj, MD, Lonn, Eva, MD, MSc, Marwick, Thomas H., MBBS, PhD, Reid, Chris M., BA, DipEd, MSc, PhD, Sanderson, John E., MD, Schmieder, Roland E., MD, Teo, Koon, MB, PhD, Wadham, Angela K., BA, Worthley, Stephen G., MBBS, PhD, Yu, Cheuk-Man, MD, Yusuf, Salim, MD, Jennings, Garry L., MD
• Format: Article
• Language: English
• Subjects: ACE inhibitors; Aged; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Arteriosclerosis; Atherosclerosis (general aspects, experimental research); Atherosclerosis - complications; Benzimidazoles - therapeutic use; Benzoates - therapeutic use; Biological and medical sciences; Blood and lymphatic vessels; Cardiology; Cardiology. Vascular system; Cardiovascular; Diabetes; Diabetes Complications - diagnosis; Diabetes Complications - drug therapy; Diabetes. Impaired glucose tolerance; Drug Therapy, Combination; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Hypertension - drug therapy; Hypertrophy, Left Ventricular - diagnosis; Hypertrophy, Left Ventricular - drug therapy; Magnetic Resonance Imaging; Male; Medical sciences; NMR; Nuclear magnetic resonance; Ramipril - therapeutic use; Survival Analysis; Treatment Outcome; Ventricular Dysfunction, Left - drug therapy
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.07.018

The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) showed that the angiotensin receptor blocker telmisartan 80 mg was not inferior to the angiotensin-converting enzyme inhibitor ramipril 10 mg, and the combination no more effective than ramipril alone, in decreasing morbidity and mortality in patients with cardiovascular disease or high-risk diabetes. Although therapy targeting angiotensin II is known to decrease left ventricular (LV) mass and volume, the relative influence of angiotensin-converting enzyme inhibitor inhibitors and angiotensin receptor blocker, and their combination, on the heart remains unclear in this population. Magnetic resonance imaging was performed in 287 patients enrolled in ONTARGET, across 8 centers in 6 countries, at randomization and after 2-year treatment (90, 100, and 97 patients in the ramipril, telmisartan, and combination therapy groups, respectively). Baseline patient characteristics showed higher frequencies of coronary artery disease, Asian ethnicity, and use of statins and β blockers than the main ONTARGET trial. LV mass decreased in all groups (p