6/30/23, 2:19 AM TRANSCEND Pathway Feedback Search Clinical Topics Home Studies TRANSCEND TRANSCEND Disease Disease Disease Acute ischemic stroke Coronary artery disease Diabetes m Trial question What is the role of telmisartan in patients intolerant to ACEIs with CVD or diabetes? Study design Multi-center Double blinded RCT Population Characteristics of study participants 43.0% female N = 5926 57.0% male 5926 patients (2547 female, 3379 male) Inclusion criteria: patients intolerant to ACEIs with CVD or diabetes with end-organ damage Key exclusion criteria: symptomatic congestive HF; uncontrolled hypertension on treatment; renal artery stenosis; hepatic dysfunction; proteinuria Interventions N=2954 telmisartan (at a dose of 80 mg/day) N=2972 placebo (matching placebo) Primary outcome Composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failure 17 17 0 % https://web.pathway.md/studies/recR3LSw0iZHk9lhL 1/2 6/30/23, 2:19 AM 17.0 % TRANSCEND Pathway 15.7 12.8 % 8.5 % 4.3 % No significant difference 0.0 % Telmisartan Placebo No significant difference in composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for HF (15.7% vs. 17%; HR 0.92, 95% CI 0.81 to 1.05) Secondary outcomes Significant decrease in composite of cardiovascular death, myocardial infarction, or stroke (13% vs. 14.8%; HR 0.87, 95% CI 0.76 to 1) Significant decrease in hospitalization for cardiovascular cause (30.3% vs. 33%; RR 0.92, 95% CI 0.85 to 0.99) No significant difference in revascularization procedures (11.8% vs. 13.1%; HR 0.9, 95% CI 0.77 to 1.03) Safety outcomes Significant difference in discontinuation of study drug due to hypotensive symptoms (0.98% vs. 0.54%). Conclusion In patients intolerant to ACEIs with CVD or diabetes with end-organ damage, telmisartan was not superior to placebo with respect to the composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for HF. Reference Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) Investigators, S Yusuf, K Teo et al. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet. 2008 Sep 27;372(9644):1174-83. Open reference URL https://web.pathway.md/studies/recR3LSw0iZHk9lhL 2/2