The results of several large therapeutic cardiovascular trials were reported in 2002. The LIFE study concluded that
losartan is superior compared to
atenolol in terms of prevention of cardiovascular morbidity and mortality, the benefit being for CVA without changing the incidence of
myocardial infarction. The OPTIMAAL study stated the disappointing results of post-
infarct losartan. The IONA study represents a first demonstration with
nicorandil of benefit not only in angina crises but equally on cardiac morbidity and mortality. The HPS study confirms the benefit of a
statin in
secondary prevention but for the first time, no matter what the initial level of
LDL-cholesterol. Finally in the LIPS study, it is reported that
statins reduce major cardiovascular events after coronary angioplasty. The year 2002 was marked elsewhere by imagination after the publication of the RAVEL study on coated
stents delivering anti-proliferative drugs in order to avoid
coronary restenosis. Three drugs were the subject of work confirming their potential significance in cardiovascular pathology: a)
ezetimibe, representing a new class of
cholesterol lowering drugs with which the association with
statins seems especially synergic, b)
nesiritide recombinant
type B natriuretic peptide, whose significance was confirmed in acute cardiac insufficiency. c)
levosimendan (
calcium sensitisor) which moreover can be a significant treatment in cardiac decompensation as suggested by the LIDO study with a follow up of 180 days. By contrast, omapatrilate did not confirm its potential superiority over
ACE inhibitors in the treatment of cardiac insufficiency. Some encouraging data were reported in 2002 in the field of therapeutic angiogenesis as much at the myocardial level as in lower limb
arteritis. Finally, 2002 was marked by the publication of the WHI study which intensified suspicions regarding hormonal substitution treatment, confirming the advantage of not only secondary but perhaps primary cardiovascular prevention.