title: [Utility of perindopril in mild-moderate heart failure in daily clinical practice. METRICA trial].
abstract: 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.
authors.affiliation: Instituto de Cardiología, Hospital Ramón y Cajal, Ctra. Colmenar, km. 9.100, 28034 Madrid, Spain. vbarrios@hrc.insalud.es
authors.forename: V
authors.initials: V
authors.lastname: Barrios Alonso
authors.forename: G
authors.initials: G
authors.lastname: Peña Pérez
authors.forename: R
authors.initials: R
authors.lastname: Campuzano Ruiz
authors.forename: F
authors.initials: F
authors.lastname: Lombera Romero
authors.forename: Y
authors.initials: Y
authors.lastname: Peralta
mesh_terms: 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
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D020913:Perindopril