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ACE Inhibitor Helps Heart Patients With Kidney Problems

Angiotensin-converting enzyme therapy helps stable heart patients with impaired renal function

MONDAY, June 26 (HealthDay News) -- The angiotensin-converting enzyme (ACE) inhibitor trandolapril may improve survival for some heart patients with kidney problems, according to a report published online June 26 in Circulation: Journal of the American Heart Association.

Scott D. Solomon, M.D., of Brigham and Women's Hospital in Boston, and colleagues studied renal function and the effect of ACE inhibitors in 8,290 chronic stable coronary artery disease patients randomly treated with 4 milligrams a day of trandolapril or a placebo. Some 16.3 percent of the patients (1,355) had impaired kidney function.

In the Prevention of Events with an ACE inhibitor (PEACE) trial, the researchers found a strong connection between the renal glomerular filtration rate (eGFR) and the "treatment group with respect to cardiovascular and all-cause mortality." Taking trandolapril was linked to reduced mortality in patients with impaired renal function, but not in patients whose kidneys functioned normally.

"Although trandolapril did not improve survival in the overall PEACE cohort, in which mean eGFR was relatively high, trandolapril reduced mortality in patients with reduced eGFR," the authors write. "These data suggest that reduced renal function may define a subset of patients most likely to benefit from ACE-inhibitor therapy for cardiovascular protection."

The study was supported by Knoll Pharmaceuticals and Abbott Laboratories, which also provided the study medications.

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