title: Aspirin alters arterial function in patients with chronic heart failure treated with ACE inhibitors: a dose-mediated deleterious effect.
abstract: BACKGROUND
  By inhibiting prostaglandin synthesis, aspirin can interfere with both arterial functional and angiotensin-converting enzyme inhibitor (ACEI) properties and be deleterious in chronic heart failure (CHF).
  
  
  OBJECTIVE
  Our aim was to prospectively evaluate the effect of aspirin on arterial functional properties in CHF patients treated with ACEIs.
  
  
  RESULTS
  Over three consecutive treatment periods of 7 days, 18 patients received placebo, followed by aspirin 100 mg/day, and then aspirin 325 mg/day. Single blind prospective assessment of reflected wave and time reflection by radial applanation tonometry; pulse wave velocity; blood pressure; thromboxane B2 (TxB2) and prostaglandins in plasma and urine was performed. Aspirin 325 mg/day induced a significant increase in augmentation index of reflected wave (P<0.0001 and P=0.0013 vs. placebo and aspirin 100 mg, respectively) and a significant decrease in reflected wave traveling times (P=0.0007 vs. placebo). Aspirin 100 mg/day produced a similar, though non-significant, trend in these parameters compared with placebo. Both aspirin treatments produced a statistically significant decrease in serum TxB2 (P<0.0001) but did not have an effect on the metabolite of prostaglandin I2 (P=0.136).
  
  
  CONCLUSIONS
  This study demonstrates the existence of a dose-mediated deleterious effect of aspirin upon arterial functional properties in CHF patients treated with ACEI.
authors.affiliation: Internal Medicine, Hospital Lariboisière, Paris, France. christophe.meune@cch.ap-hop-paris.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Meune
authors.forename: Isabelle
authors.initials: I
authors.lastname: Mahé
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Mourad
authors.forename: Alain
authors.initials: A
authors.lastname: Cohen-Solal
authors.forename: Bernard
authors.initials: B
authors.lastname: Levy
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Kevorkian
authors.forename: Guillaume
authors.initials: G
authors.lastname: Jondeau
authors.forename: Aïda
authors.initials: A
authors.lastname: Habib
authors.forename: Marilyne
authors.initials: M
authors.lastname: Lebret
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Knellwolf
authors.forename: Guy
authors.initials: G
authors.lastname: Simoneau
authors.forename: Charles
authors.initials: C
authors.lastname: Caulin
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bergmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D001158:Arteries / Q000187:drug effects* / Q000503:physiopathology*; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D002908:Chronic Disease; D018849:Controlled Clinical Trials as Topic; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D003971:Diastole / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004656:Enalapril / Q000008:administration & dosage / Q000009:adverse effects; D023381:Endpoint Determination; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D017706:Lisinopril / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D017257:Ramipril / Q000008:administration & dosage / Q000009:adverse effects; D012083:Renin / Q000097:blood / Q000187:drug effects; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013599:Systole / Q000187:drug effects; D013929:Thromboxane B2 / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D016861:Cyclooxygenase Inhibitors; D000450:Aldosterone; D013929:Thromboxane B2; D004656:Enalapril; D017706:Lisinopril; D012083:Renin; D017257:Ramipril; D001241:Aspirin