Table 1.
Study characteristics of included trials.
| Trial, author | Year | Trial type | Inclusion criteria | Primary outcomes | Intervention | Control | Follow-up (m) | Total | Intervention | Control | Male | Age | Htn | HF | Prior MI | ACEi | ARB | RAS |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AVOID, Parving11 | 2008 | RCT | Hypertension, diabetes, nephropathy | Reduction in ACR | Aliskiren + Losartan | Losartan | 6 | 599 | 301 | 298 | 427 (71%) | 61 | 599 (100%) | NR | 34 (6%) | 0 (0%) | 599 (100%) | 599 (100%) |
| ALTITUDE, Parving12 | 2012 | RCT | Diabetes, micro or macroalbuminuria, CVD | CV mortality, cardiac arrest, nonfatal MI/stroke, HFH, renal outcomes | Aliskiren + SMT | Placebo, SMT | 32.9 | 8552 | 4274 | 4278 | 5826 (68%) | 65 | NR | 872 (10%) | 1424 (17%) | 3787 (44%) | 4796 (56%) | 8552 (100%) |
| ASPIRE, Shah13 | 2012 | RCT | Post-acute MI with HF | CV mortality, HFH, MI, stroke, cardiac arrest | Aliskiren + SMT | Placebo, SMT | 8.3 | 214 | 112 | 102 | 175 (82%) | 62 | 146 (68%) | 12 (6%) | 214 (100%) | 189 (88%) | 24 (11%) | 213 (100%) |
| ASTRONAUT, Maggioni14 | 2013 | RCT | HF, LVEF <40%, raised biomarkers | CV mortality, HFH | Aliskiren + SMT | Placebo, SMT | 12 | 662 | 319 | 343 | 508 (77%) | 66 | 542 (82%) | 662 (100%) | NR | 414 (61%) | 152 (23%) | 566 (84%) |
| AQUARIUS, Puri15 | 2015 | RCT | Coronary artery stenosis, CV risk factors | Change in % atheroma volume | Aliskiren + SMT | Placebo, SMT | 24 | 115 | 55 | 60 | 90 (78%) | 61 | 103 (90%) | NR | 33 (29%) | 71 (62%) | 29 (25%) | 100 (87%) |
| ATMOSPHERE, McMurray16 | 2016 | RCT | Symptomatic HF, LVEF <35%, raised biomarkers | CV mortality, HFH | Aliskiren | Enalapril | 24.1 | 1317 | 665 | 652 | 1027 (78%) | 64 | 988 (75%) | 856 (65%) | 632 (48%) | 1317 (100%) | 0 (0%) | 1317 (100%) |
| 3A Registry, Kistner17 | 2016 | POS | Hypertension | NA | Aliskiren + ACEi/ARB | ACEi/ARB | 12 | 1936 | 1381 | 555 | 1137 (59%) | 67 | 1936 (100%) | 447 (23%) | NR | – | – | 1936 (100%) |
ALTITUDE: Aliskiren Trial in Type 2 Diabetes Using Cardiorenal Endpoints; ATMOSPHERE: Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure; ASPIRE: Aliskiren Study in Post-MI Patients to Reduce Remodelling; ASTRONAUT: Aliskiren Trial on Acute Heart Failure Outcomes; AQUARIUS: Aliskiren Quantitative Atherosclerosis Regression Intravascular Ultrasound Study; RCT: randomised controlled trial; POS: prospective observational study; CV: cardiovascular; HF: heart failure; LVEF: left ventricular ejection fraction; MI: myocardial infarction; ACEi: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor blocker; RAS: renin–angiotensin system blocker; ACR: albumin-to-creatinine ratio; HFH: hospitalisation for heart failure; MI: myocardial infarction; CVD: cardiovascular disease; SMT: standard medical therapy (includes ACEi and ARB); NR: not recorded; Htn: hypertension.