Heart Failure: Is There a Role for Angiotensin II Receptor Blockers?
Bibliographic record
Abstract
ABSTRACT Angiotensin-converting enzyme (ACE) inhibitors are currently considered the mainstay of treatment for heart failure because of their effects in decreasing morbidity and mortality. However, up to 10% of patients with heart failure may be intolerant of ACE inhibitor therapy because of intractable cough caused by these agents. The use of angiotensin II receptor blockers (ARBs) is now emerging for the management of heart failure in such patients. A literature review was undertaken to assess the clinical evidence available on the use of ARBs in the treatment of heart failure. Comparisons of these agents with ACE inhibitors in heart failure are growing but still limited. In particular, the effect of ARBs on morbidity and mortality is not clear. A recent meta-analysis of 17 clinical trials did not reveal any superiority of ARBs over ACE inhibitors in reducing either mortality or admission to hospital among patients with heart failure. On the basis of preliminary evidence, ARBs may be used in patients with heart failure who are intolerant of ACE inhibitors because of cough. Further research is required to more clearly define the role of these agents in the management of heart failure. RESUME Les inhibiteurs de l’enzyme de conversion de l’angiotensine (ECA) sont consideres actuellement comme la pierre angulaire du traitement de l’insuffisance cardiaque, parce qu’ils reduisent la morbidite et la mortalite. Cependant, jusqu’a 10 % des patients souffrant d’insuffisance cardiaque peuvent presenter une intolerance aux inhibiteurs de l’ECA, se manifestant par une toux rebelle. On a donc de plus en plus recours chez ces patients aux antagonistes des recepteurs de l’angiotensine II (ARA). Une revue de la litterature a ete effectuee pour evaluer les donnees cliniques sur l’utilisation des ARA dans le traitement de l’insuffisance cardiaque. On trouve un nombre croissant, quoique limite, de donnees comparant ces agents aux inhibiteurs de l’ECA dans le traitement de l’insuffisance cardiaque. Plus precisement, les effets des ARA sur la morbidite et la mortalite ne sont pas clairs. D’ailleurs, une meta-analyse recente de 17 essais cliniques n’a pu demontrer que les ARA exercaient un effet superieur aux inhibiteurs de l’ECA sur la reduction de la mortalite ou des hospitalisations chez les patients atteints d’insuffisance cardiaque. Ces donnees preliminaires permettent de conclure que les ARA peuvent etre utilises chez les patients souffrant d’insuffisance cardiaque et qui presentent une intolerance aux inhibiteurs de l’ECA se manifestant par une toux. D’autres recherches sont necessaires pour definir plus clairement le role de ces agents dans le traitement de l’insuffisance cardiaque.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".