Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) Trials
Although erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive of future events in individuals with cardiovascular disease. We evaluated whether ED is predictive of mortality and cardiovascular outcomes,...
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| Veröffentlicht in: | Circulation (New York, N.Y.) Jg. 121; H. 12; S. 1439 |
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| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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United States
30.03.2010
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| ISSN: | 1524-4539, 1524-4539 |
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| Abstract | Although erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive of future events in individuals with cardiovascular disease. We evaluated whether ED is predictive of mortality and cardiovascular outcomes, and because inhibition of the renin-angiotensin system in high-risk patients reduces cardiovascular events, we also tested the effects on ED of randomized treatments with telmisartan, ramipril, and the combination of the 2 drugs (ONTARGET), as well as with telmisartan or placebo in patients who were intolerant of angiotensin-converting enzyme inhibitors (TRANSCEND).
In a prespecified substudy, 1549 patients underwent double-blind randomization, with 400 participants assigned to receive ramipril, 395 telmisartan, and 381 the combination thereof (ONTARGET), as well as 171 participants assigned to receive telmisartan and 202 placebo (TRANSCEND). ED was evaluated at baseline, at 2-year follow-up, and at the penultimate visit before closeout. ED was predictive of all-cause death (hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.21 to 2.81, P=0.005) and the composite primary outcome (HR 1.42, 95% CI 1.04 to 1.94, P=0.029), which consisted of cardiovascular death (HR 1.93, 95% CI 1.13 to 3.29, P=0.016), myocardial infarction (HR 2.02, 95% CI 1.13 to 3.58, P=0.017), hospitalization for heart failure (HR 1.2, 95% CI 0.64 to 2.26, P=0.563), and stroke (HR 1.1, 95% CI 0.64 to 1.9, P=0.742). The study medications did not influence the course or development of ED.
ED is a potent predictor of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke, and heart failure in men with cardiovascular disease. Trial treatment did not significantly improve or worsen ED.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT 00153101. |
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| AbstractList | Although erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive of future events in individuals with cardiovascular disease. We evaluated whether ED is predictive of mortality and cardiovascular outcomes, and because inhibition of the renin-angiotensin system in high-risk patients reduces cardiovascular events, we also tested the effects on ED of randomized treatments with telmisartan, ramipril, and the combination of the 2 drugs (ONTARGET), as well as with telmisartan or placebo in patients who were intolerant of angiotensin-converting enzyme inhibitors (TRANSCEND).
In a prespecified substudy, 1549 patients underwent double-blind randomization, with 400 participants assigned to receive ramipril, 395 telmisartan, and 381 the combination thereof (ONTARGET), as well as 171 participants assigned to receive telmisartan and 202 placebo (TRANSCEND). ED was evaluated at baseline, at 2-year follow-up, and at the penultimate visit before closeout. ED was predictive of all-cause death (hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.21 to 2.81, P=0.005) and the composite primary outcome (HR 1.42, 95% CI 1.04 to 1.94, P=0.029), which consisted of cardiovascular death (HR 1.93, 95% CI 1.13 to 3.29, P=0.016), myocardial infarction (HR 2.02, 95% CI 1.13 to 3.58, P=0.017), hospitalization for heart failure (HR 1.2, 95% CI 0.64 to 2.26, P=0.563), and stroke (HR 1.1, 95% CI 0.64 to 1.9, P=0.742). The study medications did not influence the course or development of ED.
ED is a potent predictor of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke, and heart failure in men with cardiovascular disease. Trial treatment did not significantly improve or worsen ED.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT 00153101. Although erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive of future events in individuals with cardiovascular disease. We evaluated whether ED is predictive of mortality and cardiovascular outcomes, and because inhibition of the renin-angiotensin system in high-risk patients reduces cardiovascular events, we also tested the effects on ED of randomized treatments with telmisartan, ramipril, and the combination of the 2 drugs (ONTARGET), as well as with telmisartan or placebo in patients who were intolerant of angiotensin-converting enzyme inhibitors (TRANSCEND).BACKGROUNDAlthough erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive of future events in individuals with cardiovascular disease. We evaluated whether ED is predictive of mortality and cardiovascular outcomes, and because inhibition of the renin-angiotensin system in high-risk patients reduces cardiovascular events, we also tested the effects on ED of randomized treatments with telmisartan, ramipril, and the combination of the 2 drugs (ONTARGET), as well as with telmisartan or placebo in patients who were intolerant of angiotensin-converting enzyme inhibitors (TRANSCEND).In a prespecified substudy, 1549 patients underwent double-blind randomization, with 400 participants assigned to receive ramipril, 395 telmisartan, and 381 the combination thereof (ONTARGET), as well as 171 participants assigned to receive telmisartan and 202 placebo (TRANSCEND). ED was evaluated at baseline, at 2-year follow-up, and at the penultimate visit before closeout. ED was predictive of all-cause death (hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.21 to 2.81, P=0.005) and the composite primary outcome (HR 1.42, 95% CI 1.04 to 1.94, P=0.029), which consisted of cardiovascular death (HR 1.93, 95% CI 1.13 to 3.29, P=0.016), myocardial infarction (HR 2.02, 95% CI 1.13 to 3.58, P=0.017), hospitalization for heart failure (HR 1.2, 95% CI 0.64 to 2.26, P=0.563), and stroke (HR 1.1, 95% CI 0.64 to 1.9, P=0.742). The study medications did not influence the course or development of ED.METHODS AND RESULTSIn a prespecified substudy, 1549 patients underwent double-blind randomization, with 400 participants assigned to receive ramipril, 395 telmisartan, and 381 the combination thereof (ONTARGET), as well as 171 participants assigned to receive telmisartan and 202 placebo (TRANSCEND). ED was evaluated at baseline, at 2-year follow-up, and at the penultimate visit before closeout. ED was predictive of all-cause death (hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.21 to 2.81, P=0.005) and the composite primary outcome (HR 1.42, 95% CI 1.04 to 1.94, P=0.029), which consisted of cardiovascular death (HR 1.93, 95% CI 1.13 to 3.29, P=0.016), myocardial infarction (HR 2.02, 95% CI 1.13 to 3.58, P=0.017), hospitalization for heart failure (HR 1.2, 95% CI 0.64 to 2.26, P=0.563), and stroke (HR 1.1, 95% CI 0.64 to 1.9, P=0.742). The study medications did not influence the course or development of ED.ED is a potent predictor of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke, and heart failure in men with cardiovascular disease. Trial treatment did not significantly improve or worsen ED.CONCLUSIONSED is a potent predictor of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke, and heart failure in men with cardiovascular disease. Trial treatment did not significantly improve or worsen ED.URL: http://www.clinicaltrials.gov. Unique identifier: NCT 00153101.CLINICAL TRIAL REGISTRATIONURL: http://www.clinicaltrials.gov. Unique identifier: NCT 00153101. |
| Author | Baumhäkel, Magnus Jennings, Garry L R Gao, Peggy Jansky, Petr Dagenais, Gilles R Teo, Koon Liu, Lisheng Mann, Johannes F Probstfield, Jeffrey Yusuf, Salim Böhm, Michael Sleight, Peter Diaz, Rafael |
| Author_xml | – sequence: 1 givenname: Michael surname: Böhm fullname: Böhm, Michael email: boehm@uks.eu organization: Department of Cardiology, University of the Saarland, Saarbrücken, Germany. boehm@uks.eu – sequence: 2 givenname: Magnus surname: Baumhäkel fullname: Baumhäkel, Magnus – sequence: 3 givenname: Koon surname: Teo fullname: Teo, Koon – sequence: 4 givenname: Peter surname: Sleight fullname: Sleight, Peter – sequence: 5 givenname: Jeffrey surname: Probstfield fullname: Probstfield, Jeffrey – sequence: 6 givenname: Peggy surname: Gao fullname: Gao, Peggy – sequence: 7 givenname: Johannes F surname: Mann fullname: Mann, Johannes F – sequence: 8 givenname: Rafael surname: Diaz fullname: Diaz, Rafael – sequence: 9 givenname: Gilles R surname: Dagenais fullname: Dagenais, Gilles R – sequence: 10 givenname: Garry L R surname: Jennings fullname: Jennings, Garry L R – sequence: 11 givenname: Lisheng surname: Liu fullname: Liu, Lisheng – sequence: 12 givenname: Petr surname: Jansky fullname: Jansky, Petr – sequence: 13 givenname: Salim surname: Yusuf fullname: Yusuf, Salim |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20231536$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Fu, S Tobe, S Nauck, M Pomposiello, J C Jordan, J Killinger, C R Pilon, D Dagenais, G Amuchastegui, M Commerford, P Hahn, K Dvorak, J Serra, C M Whitsitt, P Smetana, K Jansky, P Ludewig, S Kuschnir, E Nebelsieck, H Yan, X Sabbah, E Mann, J F E Humphreys, J Douketis, J Gyenes, G Ma, S Rybak, K Liu, L Marzetti, E M Cuneo, C A Scholze, J Wu, Z Brado, B Wang, S Vico, M L Kerr Saraiva, J F Jennings, G Verheugt, F W A Zhang, S Andres, R Caccavo, A Weihs, W Holaj, R Scherwinski, I Lu, F Castellanos, C R Nawaz, S Zhang, C Orlandini, A Lu, Z Teo, K Hiscock, J G Dietz, U Meunier, M Zhu, J Keltai, M Nast, H P Böhm, Michael Majul, C Piegas, L S Esteves, J P Holle, G Schmieder, R St Maurice, F Steurer, G Fagard, F Haak, T Hasbani, E Pan, C Hohenecker, J Muenzel, T Li, L Lonn, E Bono, J O Booth, W Cartasegna, L R Elshot, S Pederzoliova, E Schwaab, B Kolloch, R E Cardona, E Sun, G Diaz, R Szaky, T Sanchez, R A Eber, B Sun, M Klein, C Rossi, P R Polasek, P Proulx, G Dedek, V Lochnan, H Goulet, S Ribeiro, A B Kerr Saraiva, L N Hominal, M A |
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| DOI | 10.1161/CIRCULATIONAHA.109.864199 |
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| Discipline | Medicine Anatomy & Physiology |
| EISSN | 1524-4539 |
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| PublicationTitle | Circulation (New York, N.Y.) |
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| PublicationYear | 2010 |
| References | 20425903 - Nat Rev Cardiol. 2010 May;7(5):241 20458777 - Nat Rev Urol. 2010 May;7(5):238 |
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| Snippet | Although erectile dysfunction (ED) is associated with cardiovascular risk factors and atherosclerosis, it is not known whether the presence of ED is predictive... |
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| SubjectTerms | Angiotensin II Type 1 Receptor Blockers Angiotensin-Converting Enzyme Inhibitors Benzimidazoles - administration & dosage Benzoates - administration & dosage Cardiovascular Diseases - diagnosis Cardiovascular Diseases - drug therapy Double-Blind Method Drug Therapy, Combination Erectile Dysfunction - epidemiology Erectile Dysfunction - etiology Humans Male Mortality Predictive Value of Tests Ramipril - administration & dosage Treatment Outcome |
| Title | Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) Trials |
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