[Utility of perindopril in mild-moderate heart failure in daily clinical practice. METRICA trial].
OBJECTIVE
Angiotensin II converting enzyme inhibitors have an unquestionable utility in heart failure, although these drugs are underused and rarely used at the recommended doses in the clinical practice. The objective of this investigation was to study the simplicity of perindopril use in the treatment of heart failure and to confirm its clinical and radiological efficacy.


METHODS
Perindopril was orally administered at 2-4 mg/day doses to 180 patients with heart failure and functional class I-III who were not being treated with angiotensin II converting enzyme inhibitors. The percentage of patients who reached the target dose (4 mg/day) was studied as well as clinical (functional class of the NYHA) and radiological efficacy of this treatment in these patients.


RESULTS
The target dose (4 mg/day) in heart failure was reached in 87.5% patients, with a rate of adverse effects of 18.9%. Eighty-nine percent of patients in the functional class III and 38.3% of patients in class II had clinical improvement. The cardio-thoracic index decreased from 0.57 to 0.54 (p < 0.05). A minimal irrelevant change was observed in the analytical levels of creatinine and potassium. Only three patients (1.7%) abandoned the trial early in its course.


CONCLUSIONS
An efficient dose for heart failure is simply and safely obtained with perindopril, with a significant improvement in the NYHA functional class and in the radiological cardio-thoracic index.
Barrios Alonso
V
V
Instituto de Cardiología, Hospital Ramón y Cajal, Ctra. Colmenar, km. 9.100, 28034 Madrid, Spain. vbarrios@hrc.insalud.es
Peña Pérez
G
G
Campuzano Ruiz
R
R
Lombera Romero
F
F
Peralta
Y
Y
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D020913:Perindopril / Q000627:therapeutic use*; D012720:Severity of Illness Index
D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril