CDK 169/vol.36 no.3/Mei - Juni 2009
189
TINJAUAN PUSTAKA
plasebo meningkatkan IMT 0,033 mm (p=0,007). Kematian semua
sebab dan kejadian kardiovaskular yang mayor tidak berbeda
bermakna antara amlodipin dan plasebo, tetapi amlodipin me-
nyebabkan lebih sedikit angina tidak stabil (4,8%/tahun vs 6,9%
/tahun) dan revaskularisasi koroner (4,2%/tahun vs 7,0%/tahun;
p<0,001).
· CAMELOT
41
Uji klinik acak, tersamar ganda selama 24 bulan membanding-
kan amlodipin 10 mg dengan enalapril 20 mg dan plasebo pada
1.991 pasien dengan penyakit arteri koroner yang terbukti
secara angiografik koroner (>20% stenosis) dan TD diastolik
<100 mm Hg. Parameter efikasi primer adalah insidens kejadian
kardiovaskular untuk amlodipin vs plasebo.
Hasilnya: TD awal 129/78 mm Hg untuk semua pasien, turun 4,8/2,5
mmHg dengan amlodipin, 4,9/2,4 mm Hg dengan enalapril,
naik 0,7/0,6 mm Hg dengan plasebo (p<0,001 untuk kedua obat vs
plasebo). Kejadian kardiovaskular 23,1% pada kelompok plasebo,
16,6% pada kelompok amlodipin (rasio hazard = 0,69; 95% CI =
0,54-0,88; p=0,003) dan 20,2% pada kelompok enalapril (rasio
hazard = 0,85; 95% CI = 0,67-1,07; p=0,16).
· NORMALISE
41
Substudi dari CAMELOT pada 274 pasien yang diukur progresi
aterosklerosisnya dengan ultrasound intravaskular (IVUS).
Hasilnya: Progresi aterosklerosis pada kelompok amlodipin
cenderung menurun vs plasebo (p=0,12). Dibandingkan dengan
nilai awal, IVUS menunjukkan progresi di kelompok plasebo
(1,3%; p<0,001), kecenderungan progresi pada kelompok
enalapril (0,8%; p=0,08) dan tidak ada progresi di kelompok
amlodipin (0,5%; p=0,31). Untuk kelompok amlodipin, hubungan
antara penurunan TD dengan progresi adalah r=0,19 (p=0,07).
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