How many patients with heart failure are suitable for combination ACE inhibitor and candesartan therapy?

Wynn, G. J., Rammohan, H. S., Stephens, B., Hawkins, N. M., McMurray, J. J.V. and Rodrigues, E. (2008) How many patients with heart failure are suitable for combination ACE inhibitor and candesartan therapy? Journal of Cardiac Failure, 14(6), S114. (doi: 10.1016/j.cardfail.2008.06.397)

Abstract

Background: Adding candesartan to ACE inhibitor therapy significantly reduced cardiovascular deaths and heart failure (HF) hospitalisations in the CHARM-Added trial. Many clinicians have not adopted this approach due to concerns that real-life patients differ from trials and are at greater risk of adverse events, particularly hyperkalaemia.<p></p> Methods: All referrals to the HF service of a large urban hospital in 2007 were included. Information was collected retrospectively from electronic patient records. We examined how many patients fulfilled CHARM-Added inclusion criteria and had predictors of hyperkalaemia, identified by analysis of that biochemical abnormality in the trial. <p></p> Results: Of 409 referrals, 194 fulfilled CHARM-Added enrolment criteria. With the exception of age, their characteristics and treatments were comparable to participants in CHARM-Added (Table). Predictors of hyperkalaemia were common (72% overall). Raised potassium (13%) and creatinine (7%) were similar to CHARM but advanced age (45%) and spironolactone use (30%) were notably more frequent.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McMurray, Professor John
• Authors: Wynn, G. J., Rammohan, H. S., Stephens, B., Hawkins, N. M., McMurray, J. J.V., and Rodrigues, E.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of Cardiac Failure
• Publisher: Elsevier
• ISSN: 1071-9164
• ISSN (Online): 1532-8414