Effects of Acute Angiotensin II Type 1 Receptor Antagonism and Angiotensin Converting Enzyme Inhibition on Plasma Fibrinolytic Parameters in Patients With Heart Failure
Key result
Acute administration of losartan 50 mg, but not enalapril 10 mg, significantly improved plasma fibrinolytic parameters in heart failure patients (P<0.02 for difference between treatments).
Why the study?
Does acute administration of losartan compared to enalapril improve plasma fibrinolytic parameters in patients with moderately severe chronic heart failure?
Population
20 patients with moderately severe chronic heart failure
Comparison
Losartan 50 mg acute administration vs Enalapril 10 mg acute administration
Design
RCT, randomized, crossover design, single-blind
Follow-up
6 hours
Authors
Discussion
Loading...
Member takes
Implication
Losartan may confer acute fibrinolytic benefits over enalapril in heart failure; extends evidence for differential ARB versus ACEI effects on thrombosis pathways.
Study Design
Type
RCT (n=20)
Blinding
Single-blind
Randomization
crossover
Structured PICO
Does acute administration of losartan compared to enalapril improve plasma fibrinolytic parameters in patients with moderately severe chronic heart failure?
P
Population
20 patients with moderately severe chronic heart failure evaluated 6 hours post-dose.
I
Intervention
Losartan 50 mg acute administration
C
Comparator
Enalapril 10 mg acute administration (crossover design)
O
Outcome
Plasma tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) antigen and activity measured at baseline and 6 hours after the dosesurrogate
Main Result
p-value: p=<0.02
Acute AT1 receptor antagonism with losartan significantly improves plasma fibrinolytic parameters to a greater extent than ACE inhibition with enalapril in patients with heart failure.
Cite This Study
Goodfield et al. (1999) conducted an RCT in moderately severe chronic heart failure (n=20). Losartan vs. Enalapril 10 mg was evaluated on Plasma tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) antigen and activity (p=<0.02). Acute administration of losartan 50 mg, but not enalapril 10 mg, significantly improved plasma fibrinolytic parameters in heart failure patients (P<0.02 for difference between treatments).