Author(s): Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, et al.
Background:Half of patients with chronic heart failure (CHF) have preserved left-ventricular ejection fraction (LVEF), but few treatments have specifically been assessed in such patients. In previous studies of patients with CHF and low LVEF or vascular disease and preserved LVEF, inhibition of the renin-angiotensin system is beneficial. We investigated the effect of addition of an angiotensin-receptor blocker to current treatments.
Methods:Between March, 1999, and July, 2000, we randomly assigned 3023 patients candesartan (n=1514, target dose 32 mg once daily) or matching placebo (n=1509). Patients had New York Heart Association functional class II-IV CHF and LVEF higher than 40%. The primary outcome was cardiovascular death or admission to hospital for CHF. Analysis was done by intention to treat.
Findings:Median follow-up was 36.6 months. 333 (22%) patients in the candesartan and 366 (24%) in the placebo group experienced the primary outcome (unadjusted hazard ratio 0.89 [95% CI 0.77-1.03], p=0.118; covariate adjusted 0.86 [0.74-1.0], p=0.051). Cardiovascular death did not differ between groups (170 vs 170), but fewer patients in the candesartan group than in the placebo group were admitted to hospital for CHF once (230 vs 279, p=0.017) or multiple times. Composite outcomes that included non-fatal myocardial infarction and non-fatal stroke showed similar results to the primary composite (388 vs 429; unadjusted 0.88 [0.77-1.01], p=0.078; covariate adjusted 0.86 [0.75-0.99], p=0.037).
Interpretation:Candesartan has a moderate impact in preventing admissions for CHF among patients who have heart failure and LVEF higher than 40%.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/13678871
Author(s): Evans GA
Author(s): Ruegg C, Tissot JD, Farmer P, Mariotti A
Author(s): Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, et al.
Author(s): Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, et al.
Author(s): Borlaug BA, Paulus WJ
Author(s): Zile MR, Baicu CF, Gaasch WH
Author(s): Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, et al.
Author(s): Borlaug BA, Lam CS, Roger VL, Rodeheffer RJ, Redfield MM
Author(s): Phan TT, Abozguia K, Nallur Shivu G, Mahadevan G, Ahmed I, et al.
Author(s): Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, et al.
Author(s): Borlaug BA, Olson TP, Lam CS, Flood KS, Lerman A, et al.
Author(s): Ahmed SH, Clark LL, Pennington WR, Webb CS, Bonnema DD, et al.
Author(s): Gonzalez A, Lopez B, Querejeta R, Zubillaga E, Echeverria T, et al.
Author(s): Tschope C, Bock CT, Kasner M, Noutsias M, Westermann D, et al.
Author(s): Niethammer M, Sieber M, von Haehling S, Anker SD, Munzel T, et al.
Author(s): Borlaug BA, Melenovsky V, Russell SD, Kessler K, Pacak K, et al.
Author(s): Phan TT, Shivu GN, Abozguia K, Davies C, Nassimizadeh M, et al.
Author(s): Phan TT, Shivu GN, Abozguia K, Davies C, Nassimizadeh M, et al.
Author(s): Lenzen MJ, Scholte op Reimer WJ, Boersma E, Vantrimpont PJ, Follath F, et al.
Author(s): McMurray JJ, Carson PE, Komajda M, McKelvie R, Zile MR, et al.
Author(s): Ahmed A, Rich MW, Fleg JL, Zile MR, Young JB, et al.
Author(s): Cleland JG, Tendera M, Adamus J, Freemantle N, Polonski L, et al.
Author(s): Junhong W, Jing Y, Jizheng M, Shushu Z, Xiangjian C, et al.
Author(s): Kittleson MM, Ye SQ, Irizarry RA, Minhas KM, Edness G, et al.
Author(s): Wellcome Trust Case Control Consortium
Author(s): Levy D, Larson MG, Benjamin EJ, Newton-Cheh C, Wang TJ, et al.
Author(s): Newton-Cheh C, Johnson T, Gateva V, Tobin MD, Bochud M, et al.
Author(s): Levy D, Ehret GB, Rice K, Verwoert GC, Launer LJ, et al.
Author(s): Lander ES, Linton LM, Birren B, Nusbaum C, Zody MC, et al.
Author(s): Frazer KA, Ballinger DG, Cox DR, Hinds DA, Stuve LL, et al.
Author(s): Berhane BT, Zong C, Liem DA, Huang A, Le S, et al.
Author(s): Rauchhaus M, Doehner W, Francis DP, Davos C, Kemp M, et al.
Author(s): Hinglais N, Heudes D, Nicoletti A, Mandet C, Laurent M, et al.
Author(s): Martos R, Baugh J, Ledwidge M, O'Loughlin C, Conlon C, et al.
Author(s): Witt H, Schubert C, Jaekel J, Fliegner D, Penkalla A, et al.
Author(s): Villari B, Campbell SE, Schneider J, Vassalli G, Chiariello M, et al.
Author(s): Villari B, Campbell SE, Schneider J, Vassalli G, Chiariello M, et al.
Author(s): Kruger M, Kotter S, Grutzner A, Lang P, Andresen C, et al.
Author(s): Borbely A, Falcao-Pires I, van Heerebeek L, Hamdani N, Edes I, et al.
Author(s): Hidalgo C, Hudson B, Bogomolovas J, Zhu Y, Anderson B, et al.
Author(s): riones AM, Arribas SM, Salaices M
Author(s): Kawaguchi M, Hay I, Fetics B, Kass DA
Author(s): Kawaguchi M, Hay I, Fetics B, Kass DA
Author(s): Hundley WG, Kitzman DW, Morgan TM, Hamilton CA, Darty SN, et al.
Author(s): Kelly RP, Tunin R, Kass DA
Author(s): Durier S, Fassot C, Laurent S, Boutouyrie P, Couetil JP, et al.
Author(s): Mantero A, Gentile F, Gualtierotti C, Azzollini M, Barbier P, et al.
Author(s): Lam CS, Roger VL, Rodeheffer RJ, Bursi F, Borlaug BA, et al.
Author(s): Stuyvers BD, Miura M, ter Keurs HE
Author(s): Kokubo M, Uemura A, Matsubara T, Murohara T
Author(s): Molkentin JD
Author(s): Gallego-Delgado J, Lazaro A, Osende JI, Esteban V, Barderas MG, et al.
Author(s): Wong WT, Wong SL, Tian XY, Huang Y
Author(s): Thomas SR, Witting PK, Drummond GR
Author(s): Landmesser U, Dikalov S, Price SR, McCann L, Fukai T, et al.
Author(s): Silberman GA, Fan TH, Liu H, Jiao Z, Xiao HD, et al.
Author(s): Regitz-Zagrosek V, Brokat S, Tschope C
Author(s): Laule M, Meisel C, Prauka I, Cascorbi I, Malzahn U, et al.
Author(s): Hart EC, Charkoudian N, Wallin GG, Curry TB, Eisenach JH, et al.
Author(s): Stein PK, Barzilay JI
Author(s): Bauer A, Malik M, Schmidt G, Barthel P, Bonnemeier H, et al.
Author(s): Beery AK, Zucker I
Author(s): Geller SE, Koch A, Pellettieri B, Carnes M
Author(s): Foulkes MA
Author(s): Shannon P, Markiel A, Ozier O, Baliga NS, Wang JT, et al.
