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Roberto Fogari - One of the best experts on this subject based on the ideXlab platform.
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effect of ramipril hydrochlorothiazide and ramipril Canrenone combination on atrial fibrillation recurrence in hypertensive type 2 diabetic patients with and without cardiac autonomic neuropathy
Archives of Medical Science, 2017Co-Authors: Daniele Bosone, Alfredo Costa, Natascia Ghiotto, Matteo Cotta Ramusino, Annalisa Zoppi, Angela Dangelo, Roberto FogariAbstract:INTRODUCTION The aim of this study was to compare the effect of ramipril/Canrenone versus ramipril/hydrochlorothiazide (HCTZ) combination on atrial fibrillation (AF) recurrence in type 2 diabetic hypertensives with and without cardiac autonomic neuropathy (CAN). MATERIAL AND METHODS A total of 289 hypertensive type 2 diabetic patients, 95 with CAN, in sinus rhythm but with at least two episodes of AF in the previous 6 months were randomized to ramipril 5 mg plus Canrenone 50 mg (titrated to 10/100 mg) or to ramipril 5 mg plus HCTZ 12.5 mg (titrated to 10/25 mg) or to amlodipine 5 mg (titrated to 10 mg) for 1 year. Clinic blood pressure (BP) and a 24-h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. Serum procollagen type I carboxy-terminal peptide (PIP) and carboxy-terminal telopeptide of collagen type I (CITP) were evaluated before and after each treatment period. RESULTS Blood pressure was similarly and significantly reduced by all treatments. A total of 51% of patients with amlodipine had a recurrence of AF, as did 31% of patients with ramipril/HCTZ (p < 0.05 vs. amlodipine) and 13% of patients with ramipril/Canrenone (p < 0.01 vs. amlodipine and p < 0.05 vs. ramipril/HCTZ). A similar trend was found in diabetic patients with CAN. Both combinations reduced PIP and increased CITP, but the effects of ramipril/Canrenone were significantly more marked. CONCLUSIONS These findings suggest that in type 2 diabetic hypertensives, ramipril/Canrenone treatment was more effective than ramipril/HCTZ in reducing AF recurrence. This could be related to the greater improvement in cardiac fibrosis.
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Effect of ramipril/hydrochlorothiazide and ramipril/Canrenone combination on atrial fibrillation recurrence in hypertensive type 2 diabetic patients with and without cardiac autonomic neuropathy.
Archives of medical science : AMS, 2016Co-Authors: Daniele Bosone, Alfredo Costa, Natascia Ghiotto, Matteo Cotta Ramusino, Annalisa Zoppi, Angela D'angelo, Roberto FogariAbstract:INTRODUCTION The aim of this study was to compare the effect of ramipril/Canrenone versus ramipril/hydrochlorothiazide (HCTZ) combination on atrial fibrillation (AF) recurrence in type 2 diabetic hypertensives with and without cardiac autonomic neuropathy (CAN). MATERIAL AND METHODS A total of 289 hypertensive type 2 diabetic patients, 95 with CAN, in sinus rhythm but with at least two episodes of AF in the previous 6 months were randomized to ramipril 5 mg plus Canrenone 50 mg (titrated to 10/100 mg) or to ramipril 5 mg plus HCTZ 12.5 mg (titrated to 10/25 mg) or to amlodipine 5 mg (titrated to 10 mg) for 1 year. Clinic blood pressure (BP) and a 24-h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. Serum procollagen type I carboxy-terminal peptide (PIP) and carboxy-terminal telopeptide of collagen type I (CITP) were evaluated before and after each treatment period. RESULTS Blood pressure was similarly and significantly reduced by all treatments. A total of 51% of patients with amlodipine had a recurrence of AF, as did 31% of patients with ramipril/HCTZ (p < 0.05 vs. amlodipine) and 13% of patients with ramipril/Canrenone (p < 0.01 vs. amlodipine and p < 0.05 vs. ramipril/HCTZ). A similar trend was found in diabetic patients with CAN. Both combinations reduced PIP and increased CITP, but the effects of ramipril/Canrenone were significantly more marked. CONCLUSIONS These findings suggest that in type 2 diabetic hypertensives, ramipril/Canrenone treatment was more effective than ramipril/HCTZ in reducing AF recurrence. This could be related to the greater improvement in cardiac fibrosis.
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abstract 9533 effect of combined ramipril Canrenone on atrial fibrillation recurrence in hypertensive patients with a history of paroxysmal atrial fibrillation
Circulation, 2014Co-Authors: Roberto Fogari, Annalisa Zoppi, Giuseppe Derosa, Amedeo Mugellini, Maurizio Destro, P LazzariAbstract:Introduction: Angiotensin II and Aldosterone are key factors responsible for structural and electrical atrial remodelling in patients with atrial fibrillation (AF). Hypothesis: Aim of this study was to evaluate the effect of ramipril/hydrochlorothiazide (HCTZ) combination (R/H) vs ramipril/Canrenone (R/C) combination on symptomatic AF episode recurrence documented on the electrocardiogram (ECG) in hypertensive patients in sinus rhythm but with at least 2 episodes of AF in the previous 6 months. Canrenone is a derivative active metabolite of spiranolattone with lower antiandrogen activity. Methods: a cohort of 195 consecutive hypertensive out-patients (aged 67 years, 103 men) were randomized to R/H or R/C for 1 year. Clinic blood pressure (BP) and 24-h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. P wave dispersion (PWD) and procollagen type I carboxy-terminal peptide (PIP) were evaluated before and after 12 month of treatment. Results: SBP and DBP were similarly and significantly reduced by both treatments (p Conclusions: These findings suggest that in these patients R/C combination is more effective than R/H combination in reducing AF recurrence as well as in improving PWD and cardiac fibrosis despite a similar BP reduction. This data outline the importance of aldosterone receptor blockade in prevention of AF recurrence.
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comparative effect of Canrenone or hydrochlorothiazide addition to valsartan amlodipine combination on urinary albumin excretion in well controlled type 2 diabetic hypertensive patients with microalbuminuria
Expert Opinion on Pharmacotherapy, 2014Co-Authors: Roberto Fogari, Annalisa Zoppi, Giuseppe Derosa, Angela Dangelo, P Lazzari, Amedeo MugelliniAbstract:Objective: To compare the effect of adding Canrenone or hydrochlorothiazide (HCTZ) to valsartan/amlodipine combination on urinary albumin excretion (UAE) in microalbuminuric type 2 diabetic hypertensives. Research design and methods: After a 2-week placebo period and after 4 weeks of valsartan 160 mg plus amlodipine 5 mg combination, 120 patients whose blood pressure (BP) was not controlled (> 130/80 mmHg) were randomized to Canrenone 25 mg or HCTZ 12.5 mg in addition to the previous therapy for 24 weeks. After the first 6 weeks of triple therapy, Canrenone or HCTZ doses were doubled in the patients whose BP was yet uncontrolled. At the end of each period (placebo, dual combination and triple combination therapy), clinic and ambulatory BP measurements were recorded and 24 h UAE was evaluated. Results: Both triple combinations produced greater clinical and ambulatory BP reduction than dual therapy, with no difference between the two groups. UAE was reduced by both regimens, but the decrease associated with...
Giuseppe Derosa - One of the best experts on this subject based on the ideXlab platform.
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Canrenone on cardiovascular mortality in congestive heart failure Canrenone effects on cardiovascular mortality in patients with congestive heart failure the coffee it study
Pharmacological Research, 2019Co-Authors: Giuseppe Derosa, Pamela Maffioli, Laura Scelsi, Alessandro Bestetti, Massimo Vanasia, Arrigo F G Cicero, Luca Spinardi, Crescenzio Bentivenga, Daniela Degli Esposti, Massimiliano CaprioAbstract:Abstract Aim To evaluate Canrenone effects compared to other therapies on cardiovascular mortality in patients with chronic heart failure (CHF) and preserved systolic function after 10 years of evaluation. Methods We enrolled 532 patients with CHF and preserved systolic function. Patients were followed with a mean follow-up of 10 years: 166 patients were in therapy with Canrenone, while 336 patients were in conventional therapy. We re-evaluated these data after 10 years, together with the rate of death and survival. Results Systolic and diastolic blood pressure were lower with Canrenone compared to the group not treated with Canrenone, both in supine and orthostatism. In the group treated with Canrenone we recorded a lower value of fasting plasma glucose and glycated hemoglobin. Uric acid was lower in the group treated with Canrenone, no differences were observed regarding creatinine, sodium, potassium, brain natriuretic peptide (BNP), pro-BNP or plasma renin activity (PRA), while aldosterone levels were reduced in Canrenone group compared to control. After 10 years, left ventricular mass was lower in Canrenone group. We recorded a more pronounced progression of NYHA class in controls compared to patients treated with Canrenone, with also a higher number of deaths. A higher number of deaths was recorded in control group in the 68–83 years range compared to Canrenone. A higher incidence of death was reported among patients without hypercholesterolemia in control group; this was not significant in patients treated with Canrenone. A longer survival was observed in patients treated with Canrenone. Conclusion Administered to patients with CHF and preserved systolic fraction, reduced mortality and extended the life.
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a randomized double blind clinical trial of Canrenone vs hydrochlorothiazide in addition to angiotensin ii receptor blockers in hypertensive type 2 diabetic patients
Drug Design Development and Therapy, 2018Co-Authors: Giuseppe Derosa, G Gaudio, Gianfranco Pasini, Angela Dangelo, Pamela MaffioliAbstract:Aim The aim of this study was to evaluate the effects of Canrenone compared to hydrochlorothiazide (HCTZ) added to angiotensin II receptor blockers (ARBs) on glycemia, lipid profile, potassium, aldosterone and renal function in patients with hypertension and type 2 diabetes mellitus. Patients and methods The study enrolled 182 Caucasian patients with hypertension and type 2 diabetes mellitus. Patients were already taking ARBs and were randomized to Canrenone, 50 mg once a day, or HCTZ, 12.5 mg once a day for 1 month. After the first month, patients not reaching an adequate blood pressure (BP) were up-titrated to Canrenone 100 mg or HCTZ 25 mg once a day for 12 months. The following parameters were considered at 6 and 12 months: BP, body weight, body mass index (BMI), fasting plasma glucose (FPG), post-prandial glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin (HOMA-IR), lipid profile, potassium, plasma aldosterone, urine albumin excretion rate and estimated glomerular filtration rate (eGFR). Results We observed a similar decrease in BP with both treatments. Canrenone led to a significant decrease in FPG, PPG and HOMA index compared to baseline, while there was a significant increase in the same parameters with HCTZ. HCTZ also worsened glycated hemoglobin (HbA1c), while Canrenone did not change it. No variations in lipid profile were recorded with Canrenone, while there was a worsening of total cholesterol (TC) and triglycerides (Tg) with HCTZ. Potassium levels were decreased and uric acid levels were increased by HCTZ, but not by Canrenone that had a neutral effect on these parameters. We recorded a slight decrease in eGFR with HCTZ and an improvement with Canrenone; creatinine and eGFR were improved by Canrenone compared to HCTZ. Plasma aldosterone levels were decreased by Canrenone and increased by HCTZ. Conclusion Canrenone and HCTZ have a similar effect on BP; however, Canrenone seems to improve metabolic parameters, while HCTZ worsens them.
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efficacy and safety of two dosages of Canrenone as add on therapy in hypertensive patients taking ace inhibitors or angiotensin ii receptor blockers and hydrochlorothiazide at maximum dosage in a randomized clinical trial the escape it trial
Cardiovascular Therapeutics, 2017Co-Authors: Giuseppe Derosa, Pamela Maffioli, Maria Davino, Carla Sala, Amedeo Mugellini, V Vulpis, Salvatore Felis, Luigina Guasti, Riccardo Sarzani, Alessandro BestettiAbstract:SummaryAim To evaluate the effects of Canrenone as add-on therapy in patients already treated with angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARBs) and hydrochlorothiazide at the maximum dosage (25 mg/d). Method In this randomized, open-label, controlled trial, we enrolled 175 Caucasian patients with essential hypertension not well controlled by concomitant ACE-I or ARBs and hydrochlorothiazide. At baseline, 87 patients (57 males and 30 females) were randomized to add Canrenone 50 mg, and 88 (56 males and 32 females) patients to Canrenone 100 mg, once a day, for 3 months. At baseline and after 3 months, we evaluated blood pressure (BP), pulse pressure (PP), heart rate (HR), fasting plasma glucose (FPG), homeostasis model assessment insulin (HOMA Index), lipid profile, electrolytes, uric acid, estimated glomerular filtration rate (eGFR), plasma urea, aldosterone, B-type natriuretic peptide (BNP), and galectin-3. Results Blood pressure decreased with both dosages of Canrenone, with a better effect with Canrenone 100 mg (−20.26 vs −23.68 mm Hg for SBP, and −10.58 vs −12.38 mm Hg for DBP), without a clinically relevant increase in potassium levels. We did not observe any differences regarding FPG or HOMA Index, nor of lipid profile, with the exception of triglycerides, which increased compared to baseline with Canrenone 50 mg (+0.25 vs +0.34 mEq/L). Creatinine slightly increased with Canrenone 100 mg (+0.02 vs +0.05 mg/dL), although no variations of eGFR were observed in neither groups. There was an increase in aldosterone levels with Canrenone 50 mg. No changes in BNP or galectin-3 were recorded. Conclusion Both Canrenone dosages gave a decrease in blood pressure, with a better effect with the higher dose, with only a slight increase in potassium and creatinine levels, which were not clinically relevant. Clinical Trials Registration Eudract number: 2010-023606-13; ClinicalTrials.gov NCT02687178.
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the effects of Canrenone on inflammatory markers in patients with metabolic syndrome
Annals of Medicine, 2015Co-Authors: Giuseppe Derosa, Angela Dangelo, Lucio Bianchi, Davide Romano, Pamela MaffioliAbstract:AbstractAim. To evaluate the effects of Canrenone compared to placebo on blood pressure control, some non-conventional biomarkers in cardiovascular stratification, and on metalloproteinases in patients affected by metabolic syndrome.Methods. A total of 156 Caucasian patients were treated with placebo or Canrenone, 50 mg once a day, for 3 months and then 50 mg twice a day, till the end of the study.We evaluated: systolic (SBP) and diastolic blood pressure (DBP), body weight, body mass index (BMI), fasting plasma glucose (FPG), lipid profile, plasma aldosterone, creatinine, potassium, brain natriuretic peptide (BNP), metalloproteinases 2 and 9 (MMP-2 and -9), lipoprotein (a) (Lp(a)), and serum myeloperoxidase (MPO).Results. We observed a significant decrease of SBP and DBP in the Canrenone group compared to baseline. Canrenone gave a significant decrease of MMP-2 and -9, Lp(a), and MPO compared to baseline, not observed with placebo. Plasma aldosterone, but not BNP, decreased with Canrenone, both compared t...
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abstract 9533 effect of combined ramipril Canrenone on atrial fibrillation recurrence in hypertensive patients with a history of paroxysmal atrial fibrillation
Circulation, 2014Co-Authors: Roberto Fogari, Annalisa Zoppi, Giuseppe Derosa, Amedeo Mugellini, Maurizio Destro, P LazzariAbstract:Introduction: Angiotensin II and Aldosterone are key factors responsible for structural and electrical atrial remodelling in patients with atrial fibrillation (AF). Hypothesis: Aim of this study was to evaluate the effect of ramipril/hydrochlorothiazide (HCTZ) combination (R/H) vs ramipril/Canrenone (R/C) combination on symptomatic AF episode recurrence documented on the electrocardiogram (ECG) in hypertensive patients in sinus rhythm but with at least 2 episodes of AF in the previous 6 months. Canrenone is a derivative active metabolite of spiranolattone with lower antiandrogen activity. Methods: a cohort of 195 consecutive hypertensive out-patients (aged 67 years, 103 men) were randomized to R/H or R/C for 1 year. Clinic blood pressure (BP) and 24-h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. P wave dispersion (PWD) and procollagen type I carboxy-terminal peptide (PIP) were evaluated before and after 12 month of treatment. Results: SBP and DBP were similarly and significantly reduced by both treatments (p Conclusions: These findings suggest that in these patients R/C combination is more effective than R/H combination in reducing AF recurrence as well as in improving PWD and cardiac fibrosis despite a similar BP reduction. This data outline the importance of aldosterone receptor blockade in prevention of AF recurrence.
Amitava Dasgupta - One of the best experts on this subject based on the ideXlab platform.
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clinically insignificant negative interferences of spironolactone potassium canrenoate and their common metabolite Canrenone in new dimension vista loci digoxin immunoassay
Journal of Clinical Laboratory Analysis, 2012Co-Authors: Amitava Dasgupta, Myrtle Johnson, Tamal K SenguptaAbstract:Spironolactone, a potassium-sparing diuretic metabolized to Canrenone is often used with digoxin to treat various conditions including congestive heart failure. Potassium canrenoate is a similar drug, which is also metabolized to Canrenone. Due to reported both positive and negative interference of spironolactone, potassium canrenoate, and their common metabolite Canrenone with digoxin immunoassays, we investigated potential interference of these compounds with the new homogenous sequential chemiluminescent assay for digoxin based on the luminescent oxygen channeling technology (LOCI digoxin) for application on the Dimension and Vista platform. When aliquots of a drug-free serum pool were supplemented with various amounts of spironolactone, potassium canrenoate, or Canrenone and apparent digoxin values were measured using Dimension Vista LOCI digoxin assay, we observed no detected value except when aliquots were supplemented with very high amounts of potassium canrenoate or Canrenone. However, we observed that apparent digoxin concentrations were very low. When aliquots of a serum digoxin pool (prepared by pooling specimens from patients receiving digoxin), were further supplemented with various amounts of spironolactone, potassium canrenoate, or Canrenone and serum digoxin concentrations were remeasured using the LOCIdigoxin assay, only statistically significant falsely lower digoxin values (negative interference) were observed in specimens containing very high amounts of Canrenone or potassium canrenoate. However, such small bias may not have any clinical significance. We conclude that new Dimension Vista LOCI digoxin assay is virtually free from interferences of spironolactone, potassium canrenoate, and their common metabolite Canrenone.
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abbott architect clinical chemistry and immunoassay systems digoxin assays are free of interferences from spironolactone potassium canrenoate and their common metabolite Canrenone
Therapeutic Drug Monitoring, 2011Co-Authors: Andrea Defrance, David A Armbruster, Diana Petty, Kelley C Cooper, Amitava DasguptaAbstract:Spironolactone, which is metabolized to Canrenone, is often used in combination with digoxin. Potassium canrenoate is a similar drug that is also metabolized to Canrenone. As a result of reported interference of spironolactone, potassium canrenoate, and their common metabolite Canrenone with digoxin immunoassays, we investigated potential interference of these compounds with two relatively new digoxin assays for application on ARCHITECT clinical chemistry platforms (cDig, particle-enhanced turbidimetric inhibition immunoassay) and ARCHITECT immunoassay platforms (iDig, chemiluminescent microparticle immunoassay), both from Abbott Diagnostics. When aliquots of drug-free serum pool were supplemented with various amounts of spironolactone, potassium canrenoate, and Canrenone, no apparent digoxin concentration was observed using cDig assay on ARCHITECT c4000, c8000, and c16000 or iDig assay on i1000SR and i2000SR analyzers. In addition, we observed no false increase in serum digoxin value when aliquots of a digoxin pool were further supplemented with various amounts of spironolactone, potassium canrenoate, or Canrenone. We conclude that both the cDig and iDig assays on the ARCHITECT analyzers are free from interferences by spironolactone, potassium canrenoate, and Canrenone.
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effect of spironolactone potassium canrenoate and their common metabolite Canrenone on dimension vista digoxin assay
Journal of Clinical Laboratory Analysis, 2010Co-Authors: Amitava Dasgupta, Myrtle JohnsonAbstract:Spironolactone, a potassium sparing diuretic metabolized to Canrenone, is often used with digoxin to treat various conditions including congestive heart failure. Potassium canrenoate is a similar drug that is also metabolized to Canrenone. Due to reported interference of spironolactone, potassium canrenoate, and their common metabolite Canrenone with digoxin immunoassays, we investigated potential interference of these compounds with Dimension Vista Digoxin immunoassay using Flex reagent cartridge. Aliquots of a drug-free serum pool were supplemented with various amounts of spironolactone, potassium canrenoate, or Canrenone and apparent digoxin values were measured using Dimension Vista digoxin assay, we observed none-detected value except when aliquots were supplemented with higher amounts of spironolactone or Canrenone. Similarly, when aliquots of a serum digoxin pool (prepared by pooling specimens from patients receiving digoxin) where further supplemented with various amounts of spironolactone, potassium canrenoate, or Canrenone, we observed moderately falsely elevated digoxin values only in specimens containing higher amounts of spironolactone or Canrenone. We conclude that spironolactone and Canrenone but not potassium canrenoate may cause modest interference with Dimension Vista digoxin assay but such interferences may not be clinically significant except with very high amounts of Canrenone. J. Clin. Lab. Anal. 24:413–417, 2010. © 2010 Wiley-Liss, Inc.
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effect of spironolactone potassium canrenoate and their common metabolite Canrenone on serum digoxin measurement by digoxin iii a new digoxin immunoassay
Therapeutic Drug Monitoring, 2008Co-Authors: Amitava Dasgupta, Gertie Tso, Alice WellsAbstract:Abstract: Spironolactone and potassium canrenoate (aldosterone antagonist diuretics) are often used with digoxin in clinical practice. It has been well documented in the literature that spironolactone, potassium canrenoate, and their common metabolite Canrenone cross-react with several digoxin immunoassays at concentrations expected after therapeutic usage of these drugs and falsely elevate or lower serum digoxin concentrations. Recently, Abbott Laboratories marketed a new Digoxin III immunoassay for application on the AxSYM analyzer. We studied the potential interference of these compounds with this new digoxin assay. The Tina-quant assay was used as the reference method because spironolactone, potassium canrenoate, and Canrenone do not interfere with serum digoxin measurement using this assay. Aliquots of drug-free serum were supplemented with therapeutic and above therapeutic concentrations of spironolactone, Canrenone, and potassium canrenoate, and apparent digoxin concentrations were measured using the Digoxin III assay and Tina-quant assay. Significant apparent digoxin concentrations were observed when the Digoxin III digoxin assay was used, but no apparent digoxin levels was observed using the Tina-quant assay. When serum pools prepared from patients receiving digoxin were further supplemented with these compounds in concentrations expected in sera of patients receiving these medications, falsely elevated digoxin levels were observed using Digoxin III assay, but no statistically significant change was observed using the Tina-quant assay. We conclude that spironolactone, potassium canrenoate, and their common metabolite Canrenone interfere with the serum digoxin measurements using the new Digoxin III assay.
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a new enzyme linked chemiluminescent immunosorbent digoxin assay is virtually free from interference of spironolactone potassium canrenoate and their common metabolite Canrenone
Journal of Clinical Laboratory Analysis, 2006Co-Authors: Amitava Dasgupta, Edward Kang, Pradip DattaAbstract:Spironolactone and potassium canrenoate (aldosterone antagonist diuretics) are sometimes used in conjunction with digoxin for patient management. Spironolactone, potassium canrenoate, and their common metabolite Canrenone interfere with serum digoxin measurement using various immunoassays. Recently a new enzyme-linked chemiluminescent immunosorbent digoxin assay (ECLIA-Digoxin) became commercially available for application on the ADVIA IMS 800i modular system (Bayer HealthCare, Tarrytown, NY). We investigated the potential interference of spironolactone and related compounds in this assay by comparing the results with the fluorescence polarization immunoassay (FPIA), which is known to have significant cross-reactivity with these compounds as well as a turbidimetric assay for digoxin with no known cross-reactivity with spironolactone and related compounds. Aliquots of drug free serum were supplemented with therapeutic and above therapeutic concentrations of spironolactone, Canrenone, and potassium canrenoate, and apparent digoxin concentrations were measured. No apparent digoxin concentration was observed using the ECLIA-Digoxin or turbidimetric assay. When serum pools prepared from patients receiving digoxin were further supplemented with these compounds, we observed no significant change in digoxin concentrations in the presence of these compounds with the ECLIA-Digoxin. We conclude that this assay is virtually free from interferences from spironolactone, potassium canrenoate and their common metabolite Canrenone. J. Clin. Lab. Anal. 20:204–208, 2006. © 2006 Wiley-Liss, Inc.
Pamela Maffioli - One of the best experts on this subject based on the ideXlab platform.
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Canrenone on cardiovascular mortality in congestive heart failure Canrenone effects on cardiovascular mortality in patients with congestive heart failure the coffee it study
Pharmacological Research, 2019Co-Authors: Giuseppe Derosa, Pamela Maffioli, Laura Scelsi, Alessandro Bestetti, Massimo Vanasia, Arrigo F G Cicero, Luca Spinardi, Crescenzio Bentivenga, Daniela Degli Esposti, Massimiliano CaprioAbstract:Abstract Aim To evaluate Canrenone effects compared to other therapies on cardiovascular mortality in patients with chronic heart failure (CHF) and preserved systolic function after 10 years of evaluation. Methods We enrolled 532 patients with CHF and preserved systolic function. Patients were followed with a mean follow-up of 10 years: 166 patients were in therapy with Canrenone, while 336 patients were in conventional therapy. We re-evaluated these data after 10 years, together with the rate of death and survival. Results Systolic and diastolic blood pressure were lower with Canrenone compared to the group not treated with Canrenone, both in supine and orthostatism. In the group treated with Canrenone we recorded a lower value of fasting plasma glucose and glycated hemoglobin. Uric acid was lower in the group treated with Canrenone, no differences were observed regarding creatinine, sodium, potassium, brain natriuretic peptide (BNP), pro-BNP or plasma renin activity (PRA), while aldosterone levels were reduced in Canrenone group compared to control. After 10 years, left ventricular mass was lower in Canrenone group. We recorded a more pronounced progression of NYHA class in controls compared to patients treated with Canrenone, with also a higher number of deaths. A higher number of deaths was recorded in control group in the 68–83 years range compared to Canrenone. A higher incidence of death was reported among patients without hypercholesterolemia in control group; this was not significant in patients treated with Canrenone. A longer survival was observed in patients treated with Canrenone. Conclusion Administered to patients with CHF and preserved systolic fraction, reduced mortality and extended the life.
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a randomized double blind clinical trial of Canrenone vs hydrochlorothiazide in addition to angiotensin ii receptor blockers in hypertensive type 2 diabetic patients
Drug Design Development and Therapy, 2018Co-Authors: Giuseppe Derosa, G Gaudio, Gianfranco Pasini, Angela Dangelo, Pamela MaffioliAbstract:Aim The aim of this study was to evaluate the effects of Canrenone compared to hydrochlorothiazide (HCTZ) added to angiotensin II receptor blockers (ARBs) on glycemia, lipid profile, potassium, aldosterone and renal function in patients with hypertension and type 2 diabetes mellitus. Patients and methods The study enrolled 182 Caucasian patients with hypertension and type 2 diabetes mellitus. Patients were already taking ARBs and were randomized to Canrenone, 50 mg once a day, or HCTZ, 12.5 mg once a day for 1 month. After the first month, patients not reaching an adequate blood pressure (BP) were up-titrated to Canrenone 100 mg or HCTZ 25 mg once a day for 12 months. The following parameters were considered at 6 and 12 months: BP, body weight, body mass index (BMI), fasting plasma glucose (FPG), post-prandial glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin (HOMA-IR), lipid profile, potassium, plasma aldosterone, urine albumin excretion rate and estimated glomerular filtration rate (eGFR). Results We observed a similar decrease in BP with both treatments. Canrenone led to a significant decrease in FPG, PPG and HOMA index compared to baseline, while there was a significant increase in the same parameters with HCTZ. HCTZ also worsened glycated hemoglobin (HbA1c), while Canrenone did not change it. No variations in lipid profile were recorded with Canrenone, while there was a worsening of total cholesterol (TC) and triglycerides (Tg) with HCTZ. Potassium levels were decreased and uric acid levels were increased by HCTZ, but not by Canrenone that had a neutral effect on these parameters. We recorded a slight decrease in eGFR with HCTZ and an improvement with Canrenone; creatinine and eGFR were improved by Canrenone compared to HCTZ. Plasma aldosterone levels were decreased by Canrenone and increased by HCTZ. Conclusion Canrenone and HCTZ have a similar effect on BP; however, Canrenone seems to improve metabolic parameters, while HCTZ worsens them.
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efficacy and safety of two dosages of Canrenone as add on therapy in hypertensive patients taking ace inhibitors or angiotensin ii receptor blockers and hydrochlorothiazide at maximum dosage in a randomized clinical trial the escape it trial
Cardiovascular Therapeutics, 2017Co-Authors: Giuseppe Derosa, Pamela Maffioli, Maria Davino, Carla Sala, Amedeo Mugellini, V Vulpis, Salvatore Felis, Luigina Guasti, Riccardo Sarzani, Alessandro BestettiAbstract:SummaryAim To evaluate the effects of Canrenone as add-on therapy in patients already treated with angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARBs) and hydrochlorothiazide at the maximum dosage (25 mg/d). Method In this randomized, open-label, controlled trial, we enrolled 175 Caucasian patients with essential hypertension not well controlled by concomitant ACE-I or ARBs and hydrochlorothiazide. At baseline, 87 patients (57 males and 30 females) were randomized to add Canrenone 50 mg, and 88 (56 males and 32 females) patients to Canrenone 100 mg, once a day, for 3 months. At baseline and after 3 months, we evaluated blood pressure (BP), pulse pressure (PP), heart rate (HR), fasting plasma glucose (FPG), homeostasis model assessment insulin (HOMA Index), lipid profile, electrolytes, uric acid, estimated glomerular filtration rate (eGFR), plasma urea, aldosterone, B-type natriuretic peptide (BNP), and galectin-3. Results Blood pressure decreased with both dosages of Canrenone, with a better effect with Canrenone 100 mg (−20.26 vs −23.68 mm Hg for SBP, and −10.58 vs −12.38 mm Hg for DBP), without a clinically relevant increase in potassium levels. We did not observe any differences regarding FPG or HOMA Index, nor of lipid profile, with the exception of triglycerides, which increased compared to baseline with Canrenone 50 mg (+0.25 vs +0.34 mEq/L). Creatinine slightly increased with Canrenone 100 mg (+0.02 vs +0.05 mg/dL), although no variations of eGFR were observed in neither groups. There was an increase in aldosterone levels with Canrenone 50 mg. No changes in BNP or galectin-3 were recorded. Conclusion Both Canrenone dosages gave a decrease in blood pressure, with a better effect with the higher dose, with only a slight increase in potassium and creatinine levels, which were not clinically relevant. Clinical Trials Registration Eudract number: 2010-023606-13; ClinicalTrials.gov NCT02687178.
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the effects of Canrenone on inflammatory markers in patients with metabolic syndrome
Annals of Medicine, 2015Co-Authors: Giuseppe Derosa, Angela Dangelo, Lucio Bianchi, Davide Romano, Pamela MaffioliAbstract:AbstractAim. To evaluate the effects of Canrenone compared to placebo on blood pressure control, some non-conventional biomarkers in cardiovascular stratification, and on metalloproteinases in patients affected by metabolic syndrome.Methods. A total of 156 Caucasian patients were treated with placebo or Canrenone, 50 mg once a day, for 3 months and then 50 mg twice a day, till the end of the study.We evaluated: systolic (SBP) and diastolic blood pressure (DBP), body weight, body mass index (BMI), fasting plasma glucose (FPG), lipid profile, plasma aldosterone, creatinine, potassium, brain natriuretic peptide (BNP), metalloproteinases 2 and 9 (MMP-2 and -9), lipoprotein (a) (Lp(a)), and serum myeloperoxidase (MPO).Results. We observed a significant decrease of SBP and DBP in the Canrenone group compared to baseline. Canrenone gave a significant decrease of MMP-2 and -9, Lp(a), and MPO compared to baseline, not observed with placebo. Plasma aldosterone, but not BNP, decreased with Canrenone, both compared t...
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effects of Canrenone in patients with metabolic syndrome
Expert Opinion on Pharmacotherapy, 2013Co-Authors: Giuseppe Derosa, Angela Dangelo, Aldo Bonaventura, Lucio Bianchi, Davide Romano, Elena Fogari, Pamela MaffioliAbstract:Background: Metabolic syndrome is becoming a common disease due to a rise in obesity rates among adults. Objectives: The aim was to evaluate the effects of Canrenone compared to placebo on metabolic and inflammatory parameters in patients affected by metabolic syndrome.A total of 145 patients were treated with placebo or Canrenone, 50 mg/day, for 3 months and then 50 mg b.i.d. till the end of the study.Blood pressure, body weight, body mass index, fasting plasma glucose (FPG), fasting plasma insulin, HOMA-IR, lipid profile, plasma aldosterone, brain natriuretic peptide, high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-α (TNF-α) and M value were evaluated. Results: A decrease of blood pressure was observed in Canrenone group compared to baseline; moreover, systolic blood pressure value recorded after 6 months of Canrenone therapy was lower than the one recorded with placebo. Canrenone gave a significant decrease of FPI and HOMA index, and an increase of M value both compared to baseline ...
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a randomized double blind clinical trial of Canrenone vs hydrochlorothiazide in addition to angiotensin ii receptor blockers in hypertensive type 2 diabetic patients
Drug Design Development and Therapy, 2018Co-Authors: Giuseppe Derosa, G Gaudio, Gianfranco Pasini, Angela Dangelo, Pamela MaffioliAbstract:Aim The aim of this study was to evaluate the effects of Canrenone compared to hydrochlorothiazide (HCTZ) added to angiotensin II receptor blockers (ARBs) on glycemia, lipid profile, potassium, aldosterone and renal function in patients with hypertension and type 2 diabetes mellitus. Patients and methods The study enrolled 182 Caucasian patients with hypertension and type 2 diabetes mellitus. Patients were already taking ARBs and were randomized to Canrenone, 50 mg once a day, or HCTZ, 12.5 mg once a day for 1 month. After the first month, patients not reaching an adequate blood pressure (BP) were up-titrated to Canrenone 100 mg or HCTZ 25 mg once a day for 12 months. The following parameters were considered at 6 and 12 months: BP, body weight, body mass index (BMI), fasting plasma glucose (FPG), post-prandial glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin (HOMA-IR), lipid profile, potassium, plasma aldosterone, urine albumin excretion rate and estimated glomerular filtration rate (eGFR). Results We observed a similar decrease in BP with both treatments. Canrenone led to a significant decrease in FPG, PPG and HOMA index compared to baseline, while there was a significant increase in the same parameters with HCTZ. HCTZ also worsened glycated hemoglobin (HbA1c), while Canrenone did not change it. No variations in lipid profile were recorded with Canrenone, while there was a worsening of total cholesterol (TC) and triglycerides (Tg) with HCTZ. Potassium levels were decreased and uric acid levels were increased by HCTZ, but not by Canrenone that had a neutral effect on these parameters. We recorded a slight decrease in eGFR with HCTZ and an improvement with Canrenone; creatinine and eGFR were improved by Canrenone compared to HCTZ. Plasma aldosterone levels were decreased by Canrenone and increased by HCTZ. Conclusion Canrenone and HCTZ have a similar effect on BP; however, Canrenone seems to improve metabolic parameters, while HCTZ worsens them.
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effect of ramipril hydrochlorothiazide and ramipril Canrenone combination on atrial fibrillation recurrence in hypertensive type 2 diabetic patients with and without cardiac autonomic neuropathy
Archives of Medical Science, 2017Co-Authors: Daniele Bosone, Alfredo Costa, Natascia Ghiotto, Matteo Cotta Ramusino, Annalisa Zoppi, Angela Dangelo, Roberto FogariAbstract:INTRODUCTION The aim of this study was to compare the effect of ramipril/Canrenone versus ramipril/hydrochlorothiazide (HCTZ) combination on atrial fibrillation (AF) recurrence in type 2 diabetic hypertensives with and without cardiac autonomic neuropathy (CAN). MATERIAL AND METHODS A total of 289 hypertensive type 2 diabetic patients, 95 with CAN, in sinus rhythm but with at least two episodes of AF in the previous 6 months were randomized to ramipril 5 mg plus Canrenone 50 mg (titrated to 10/100 mg) or to ramipril 5 mg plus HCTZ 12.5 mg (titrated to 10/25 mg) or to amlodipine 5 mg (titrated to 10 mg) for 1 year. Clinic blood pressure (BP) and a 24-h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. Serum procollagen type I carboxy-terminal peptide (PIP) and carboxy-terminal telopeptide of collagen type I (CITP) were evaluated before and after each treatment period. RESULTS Blood pressure was similarly and significantly reduced by all treatments. A total of 51% of patients with amlodipine had a recurrence of AF, as did 31% of patients with ramipril/HCTZ (p < 0.05 vs. amlodipine) and 13% of patients with ramipril/Canrenone (p < 0.01 vs. amlodipine and p < 0.05 vs. ramipril/HCTZ). A similar trend was found in diabetic patients with CAN. Both combinations reduced PIP and increased CITP, but the effects of ramipril/Canrenone were significantly more marked. CONCLUSIONS These findings suggest that in type 2 diabetic hypertensives, ramipril/Canrenone treatment was more effective than ramipril/HCTZ in reducing AF recurrence. This could be related to the greater improvement in cardiac fibrosis.
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the effects of Canrenone on inflammatory markers in patients with metabolic syndrome
Annals of Medicine, 2015Co-Authors: Giuseppe Derosa, Angela Dangelo, Lucio Bianchi, Davide Romano, Pamela MaffioliAbstract:AbstractAim. To evaluate the effects of Canrenone compared to placebo on blood pressure control, some non-conventional biomarkers in cardiovascular stratification, and on metalloproteinases in patients affected by metabolic syndrome.Methods. A total of 156 Caucasian patients were treated with placebo or Canrenone, 50 mg once a day, for 3 months and then 50 mg twice a day, till the end of the study.We evaluated: systolic (SBP) and diastolic blood pressure (DBP), body weight, body mass index (BMI), fasting plasma glucose (FPG), lipid profile, plasma aldosterone, creatinine, potassium, brain natriuretic peptide (BNP), metalloproteinases 2 and 9 (MMP-2 and -9), lipoprotein (a) (Lp(a)), and serum myeloperoxidase (MPO).Results. We observed a significant decrease of SBP and DBP in the Canrenone group compared to baseline. Canrenone gave a significant decrease of MMP-2 and -9, Lp(a), and MPO compared to baseline, not observed with placebo. Plasma aldosterone, but not BNP, decreased with Canrenone, both compared t...
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comparative effect of Canrenone or hydrochlorothiazide addition to valsartan amlodipine combination on urinary albumin excretion in well controlled type 2 diabetic hypertensive patients with microalbuminuria
Expert Opinion on Pharmacotherapy, 2014Co-Authors: Roberto Fogari, Annalisa Zoppi, Giuseppe Derosa, Angela Dangelo, P Lazzari, Amedeo MugelliniAbstract:Objective: To compare the effect of adding Canrenone or hydrochlorothiazide (HCTZ) to valsartan/amlodipine combination on urinary albumin excretion (UAE) in microalbuminuric type 2 diabetic hypertensives. Research design and methods: After a 2-week placebo period and after 4 weeks of valsartan 160 mg plus amlodipine 5 mg combination, 120 patients whose blood pressure (BP) was not controlled (> 130/80 mmHg) were randomized to Canrenone 25 mg or HCTZ 12.5 mg in addition to the previous therapy for 24 weeks. After the first 6 weeks of triple therapy, Canrenone or HCTZ doses were doubled in the patients whose BP was yet uncontrolled. At the end of each period (placebo, dual combination and triple combination therapy), clinic and ambulatory BP measurements were recorded and 24 h UAE was evaluated. Results: Both triple combinations produced greater clinical and ambulatory BP reduction than dual therapy, with no difference between the two groups. UAE was reduced by both regimens, but the decrease associated with...
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effects of Canrenone in patients with metabolic syndrome
Expert Opinion on Pharmacotherapy, 2013Co-Authors: Giuseppe Derosa, Angela Dangelo, Aldo Bonaventura, Lucio Bianchi, Davide Romano, Elena Fogari, Pamela MaffioliAbstract:Background: Metabolic syndrome is becoming a common disease due to a rise in obesity rates among adults. Objectives: The aim was to evaluate the effects of Canrenone compared to placebo on metabolic and inflammatory parameters in patients affected by metabolic syndrome.A total of 145 patients were treated with placebo or Canrenone, 50 mg/day, for 3 months and then 50 mg b.i.d. till the end of the study.Blood pressure, body weight, body mass index, fasting plasma glucose (FPG), fasting plasma insulin, HOMA-IR, lipid profile, plasma aldosterone, brain natriuretic peptide, high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-α (TNF-α) and M value were evaluated. Results: A decrease of blood pressure was observed in Canrenone group compared to baseline; moreover, systolic blood pressure value recorded after 6 months of Canrenone therapy was lower than the one recorded with placebo. Canrenone gave a significant decrease of FPI and HOMA index, and an increase of M value both compared to baseline ...