EDITORIAL

Unexpected news from the scientific sessions of the American College of Cardiology During the last scientific sessions of the American College of Cardiology in March 2002, the results oftwo major clinical trials were presented. For many people the outcomes of both trials were surprising. The first tial investigated the effects ofthe combined neutral endopeptidase (NEP)/angiotensin-converting enzyme (ACE) inhibitor omapatrilat in patients with heart failure. Neutral endopeptidases regulate the breakdown of natriuretic peptides. Natriuretic peptides are upregulated in patients with heart failure and are thought to contraregulate some ofthe deleterious effects of the activated renin-angiotensin system. So, the NEP/ACE inhibitor omapatrilaat not only inhibits ACE, but upregulates natriuretic peptides as well. The IMPRESS study demonstrated additional effects of omapatrilaat compared with lisinopril in patients with heart failure. However, this pilot study was not powered and designed to demonstrate effects on clinical outcome. Therefore, the OVERTURE study was performed to investigate the difference between omapatrilaat (40 mg) and enalapril (20 mg) on mortality and hospitalisation for heart failure (primary endpoint) in 5770 patients with systolic heart failure (left ventricular ejection fraction

Unexpected news from the scientific sessions of the American College of Cardiology.

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