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(Circulation. 1999;100:e126.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Meeting Highlights

Highlights of the 21st Congress of the European Society of Cardiology

James J. Ferguson, MD

From St Luke’s Episcopal Hospital, Texas Heart Institute, Baylor College of Medicine, The University of Texas Health Science Center at Houston.

	Introduction

 
The following studies were presented at the 21st Congress of the European Society of Cardiology, August 28–September 1, 1999, in Barcelona, Spain.

	Vascular Disease

 
HOPE (Heart Outcomes Prevention Evaluation)
Presenters: Salim Yusuf, McMaster University, Hamilton, Ontario, Canada; Gilles Dagenais, University of Montreal, Montreal, Canada; Peter Sleight, University of Oxford, Oxford, UK; on behalf of the HOPE Investigators.

The study: A large-scale multicenter (267 hospitals in 19 countries), randomized, placebo-controlled trial of ACE-inhibitor therapy and vitamin E supplementation in patients at high risk for vascular events. Inclusion criteria included age >55 years and evidence of vascular disease (coronary heart disease, stroke, and peripheral vascular disease, or diabetes and 1 other cardiovascular risk factor). Patients with heart failure, a low ejection fraction, current ACE-inhibitor or vitamin E therapy, or acute events within the previous 4 weeks were excluded. A total of 9541 qualifying patients were randomized in a 2x2 factorial design to ramipril (up to 10 mg/d) or placebo and vitamin E (400 IU/d) or placebo and were followed up for 4 to 6 years. The primary end point of the study was the composite of cardiovascular death, myocardial infarction (MI), and stroke. Secondary end points included revascularization and the development of congestive heart failure (CHF), unstable angina, or complications of diabetes. The study was terminated at 4.5 years because of convincing benefit in the ramipril group.

The results: Vitamin E therapy was not associated with any significant clinical benefit. Composite primary outcome events occurred in 16% of the vitamin E group and 15.4% of the placebo . . . [Full Text of this Article]