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1、IschemiaManagementwithAccuprilPostBypassGraftviaInhibitionofAngiotensinConvertingEnzymeIMAGINEPresentedatTheEuropeanSocietyofCardiologyHotLineSession,September2005PresentedbyDr.WHvanGilstQuinapril(upto40mg/day)n=1280Endpoints:Primary–compositeofcardio
2、vasculardeathorresuscitatedcardiacarrest,nonfatalMI,coronaryrevascularization,hospitalizationforunstableangina,documentedanginanotrequiringhospitalization,stroke,orheartfailurerequiringhospitalizationIMAGINEESC2005Placebon=12732553patientswithin7daysp
3、ost-CABG,stablepost-operatively,inhospitalatthetimeofrandomization,LVejectionfraction>40%IMAGINE:PrimaryendpointTheprimarycompositeendpointofcardiovasculardeathorresuscitatedcardiacarrest,nonfatalMI,coronaryrevascularization,hospitalizationforunstable
4、angina,documentedanginanotrequiringhospitalization,stroke,orheartfailurerequiringhospitalizationwasnotsignificantlydifferentinthequinaprilgroupcomparedtoplacebo(Hazardratio:1.15,95%Cl0.92-1.42,p=0.224)Theendpointwasnumericallybutnotsignificantlyhigher
5、inthequinaprilgroupESC2005IMAGINE:ComponentsofPrimaryEndpointESC2005IMAGINE:SummaryAmongpatientsundergoingcoronaryarterybypasssurgery,initiationoftheACE-inhibitorquinaprilearlypostsurgerywasnotassociatedwithadifferenceintheprimarycompositeendpointcomp
6、aredwithplaceboatamedianthreeyearfollow-up,withdatasuggestingapossibleincreasedriskduringthefirstthreemonthsfollowingsurgery.DatafromlargetrialssuchasEUROPAandHOPEsupporttheuseofACE-inhibitortherapyinstablecoronaryarterydiseasepatients.Patientsinthepr
7、esentstudy,whilepost-bypasssurgery,wererelativelylow-risk(meanejectionfraction60%)andhadtobestablepost-operativelytobeenrolled.Despitethesecharacteristics,earlyinitiationofquinaprilwithin7daysofsurgerywasassociatedwithnolatebenefit.ESC2005
