Improving outcomes in chronic heart failure.
The publication of trials of angiotensin receptor blockers (ARBs) in recent years has led to the need to update the European Society of Cardiology guidelines for the management of chronic heart failure. Of primary importance among these studies were the three trials of the CHARM program comparing candesartan and placebo in patients with chronic heart failure. In CHARM-Alternative, candesartan significantly reduced the risk of cardiovascular death or hospitalization for heart failure in patients who could not tolerate angiotensin-converting enzyme (ACE) inhibitors. This risk was also significantly lowered by candesartan in CHARM-Added, which included patients who were already on ACE inhibitor therapy. At borderline significance, the risk of cardiovascular death or hospitalization for heart failure was reduced by candesartan in CHARM-Preserved, which included patients who presented with preserved systolic function and left ventricular ejection fraction. Candesartan also significantly reduced the risk of new-onset diabetes and of atrial fibrillation in the CHARM-Overall study.
Komajda
Michel
M
Institut de Cardiologie, Hopital Pitie-Salpetriere, Universite Pierre et Marie Curie, Paris, France.
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D002317:Cardiovascular Agents; D013777:Tetrazoles; C081643:candesartan