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Patients with acute coronary syndromes and elevated levels of natriuretic peptides: the results of the AVANT GARDE-TIMI 43 Trial.

Author(s): Scirica BM, Morrow DA, Bode C, Ruzyllo W, Ruda M, Oude Ophuis AJ, Lopez-Sendon J, Swedberg K, Ogorek M, Rifai N, Lukashevich V, Maboudian M, Cannon CP, McCabe CH, Braunwald E.

Affiliation(s): TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. bscirica@partners.org

Publication date & source: 2010, Eur Heart J. , 31(16):1993-2005

AIMS: Elevated natriuretic peptides (NPs) are associated with an increased cardiovascular risk following acute coronary syndromes (ACSs). However, the therapeutic implications are still undefined. We hypothesized that early inhibition of renin-angiotensin-aldosterone system (RAAS) in patients with preserved left ventricular function but elevated NPs but following ACS would reduce haemodynamic stress as reflected by a greater reduction NP compared with placebo. METHODS AND RESULTS: AVANT GARDE-TIMI 43 trial, a multinational, double-blind trial, randomized 1101 patients stabilized after ACS without clinical evidence of heart failure or left ventricular function

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