The ONgoing Telmisartan Alone and in

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Presentation transcript:

The ONgoing Telmisartan Alone and in ONTARGET The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial Salim Yusuf, Koon K. Teo, Janice Pogue, Leanne Dyal, and Ingrid Copland, Population Health Research Institute and Investigators Yusuf, et al. N ENGL J MED.358;15:1547-1559 1

Change in BP (mmHg) ONTARGET Ramipril Telmisartan Combination Systolic -6.0 -6.9 -8.4 Diastolic -4.6 -5.2 Yusuf, et al. N ENGL J MED.358;15:1547-1559 2

Time to Permanent Discontinuation ONTARGET Time to Permanent Discontinuation of Study Medication NO. at Risk Telmisartan 8542 7954 7384 6909 6478 Ramipril 8576 7796 7165 6681 6254 Years of Follow-up Cumulative Hazard Rates Yusuf, et al. N ENGL J MED.358;15:1547-1559

Reasons for Permanently Stopping Study Medications ONTARGET Reasons for Permanently Stopping Study Medications Ram N=8576 Tel N=8542 Tel vs. Ram RR P Hypotension 149 229 1.54 0.0001 Syncope 15 19 1.27 0.4850 Cough 360 93 0.26 <0.0001 Diarrhea 12 1.59 0.20 Angioedema 25 10 0.40 0.0115 Renal Impairment 60 68 1.14 0.46 Any Discontinuation 2099 1962 0.94 0.02 Yusuf, et al. N ENGL J MED.358;15:1547-1559

Time to Primary Outcome ONTARGET Time to Primary Outcome Telmisartan Cumulative Hazard Rates Ramipril Years of Follow-up NO. at Risk 8542 8176 7778 7420 7051 Telmisartan 8576 8214 7832 7473 7095 Ramipril Yusuf, et al. N ENGL J MED.358;15:1547-1559

Primary Outcome & HOPE Primary Outcome ONTARGET Primary Outcome & HOPE Primary Outcome Ram Tel Tel vs Ram N (%) RR (95% CI) P (non-inf) N 8576 8542 Primary Outcome CV Death, MI, Stroke, CHF Hosp 1412 (16.46%) 1423 (16.66%) 1.01 (0.94-1.09) 0.0038 (Adjusted for SBP) 1.02 (0.95-1.10) 0.0055 HOPE Primary Outcome CV Death, MI, Stroke 1210 (14.11%) 1190 (13.93%) 0.99 (0.91-1.07) 0.0009 0.0012 Yusuf, et al. N ENGL J MED.358;15:1547-1559 6

Time to Primary Outcome ONTARGET Time to Primary Outcome Ramipril Cumulative Hazard Rates Tel.&Ram. Years of Follow-up NO. at Risk 8576 8214 7832 7473 7095 Ramipril 8502 8134 7740 7377 7023 Tel.&Ram. Yusuf, et al. N ENGL J MED.358;15:1547-1559 7 7

Reasons for Permanently Stopping Study Medications ONTARGET Reasons for Permanently Stopping Study Medications Ram N=8576 Ram + Tel N=8502 Ram + Tel vs. Ram RR P Hypotension 149 406 2.75 <0.0001 Syncope 15 29 1.95 0.032 Cough 360 392 1.10 0.1885 Diarrhea 12 39 3.28 0.0001 Angioedema 25 18 0.73 0.30 Renal Impairment 60 94 1.58 0.0050 Any Discontinuation 2099 2495 1.20 Yusuf, et al. N ENGL J MED.358;15:1547-1559