Chang, S. M. et al. (2010) Efficacy and safety of angiotensin receptor blockade are not modified by aspirin in patients with chronic heart failure: a cohort study from the Candesartan in Heart failure - Assessment of Reduction in Mortality and morbidity (CHARM) programme. European Journal of Heart Failure, 12(7), pp. 738-745. (doi: 10.1093/eurjhf/hfq065)
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Abstract
It is unknown whether there is an interaction between aspirin and angiotensin receptor blockers on outcomes in patients with heart failure (HF). The efficacy and safety of candesartan vs. placebo was assessed in 7599 patients with symptomatic HF and reduced or preserved left ventricular ejection fraction enrolled in the CHARM programme according to baseline aspirin use. Patients were randomized to candesartan or matching placebo and were followed for a median of 38 months. Aspirin was used in 4246 (55.9%) of patients at baseline. When compared with placebo, candesartan use was associated with lower event rates for cardiovascular (CV) death or HF hospitalization (primary outcome) in both the aspirin group (28 vs. 31.9%, HR 0.81, 95% CI 0.72-0.90) and non-aspirin group (33 vs. 38%, HR 0.81, 95% CI 0.72-0.91). Baseline aspirin use did not modify the effectiveness of candesartan in reducing the risk of CV death or HF hospitalization in CHARM overall (P = 0.64) or in the CHARM individual trials. In addition, there was no significant interaction between aspirin therapy and candesartan in terms of discontinuation of study drug due to adverse reactions (P = 0.72). There appears to be no significant modification of the benefit of candesartan on CV mortality and morbidity outcomes or safety by concomitant use of aspirin in patients with chronic HF
| Item Type: | Articles |
|---|---|
| Keywords: | Angiotensin Angiotensin receptor blocker ANTIPLATELET THERAPY ASPIRIN BRADYKININ CANDESARTAN Chronic Chronic heart failure Cohort Cohort study CONVERTING-ENZYME-INHIBITORS DEATH DYSFUNCTION EFFICACY EJECTION FRACTION ENALAPRIL ENGLAND FAILURE HEART Heart failure HEART-FAILURE LOSARTAN MORBIDITY MORTALITY MYOCARDIAL-INFARCTION outcome OUTCOMES PATIENT patients RANDOMIZED-TRIAL RATES RECEPTOR REDUCTION RISK SAFETY SUBGROUP ANALYSIS SYSTEM SYSTEMS THERAPIES THERAPY TRIAL trials Valsartan ventricular ejection fraction VENTRICULAR SYSTOLIC FUNCTION |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McMurray, Professor John |
| Authors: | Chang, S. M., Granger, C. B., Johansson, P. A., Kosolcharoen, P., McMurray, J. J. V., Michelson, E. L., Murray, D. R., Olofsson, B., Pfeffer, M. A., Solomon, S. D., Swedberg, K., Yusuf, S., and Dunlap, M. E. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences |
| Journal Name: | European Journal of Heart Failure |
| ISSN: | 1388-9842 |
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