title: The effect of Crataegus oxycantha Special Extract WS 1442 on clinical progression in patients with mild to moderate symptoms of heart failure.
abstract: OBJECTIVE
  To examine whether hawthorn (Crataegus Special Extract WS 1442 {CSE}) inhibits progression in heart failure (HF) patients.
  
  
  METHODS
  We performed a retrospective analysis of data from the HERB CHF study in which patients with mild to moderate HF were randomised to either CSE 900 mg or placebo for 6 months. The primary outcome was time to progression of HF (HF death, hospitalisation, or sustained increase in diuretics) as assessed by log-rank tests and by Cox modelling.
  
  
  RESULTS
  Progression of HF occurred in 46.6% of the CSE and 43.3% of the placebo groups (OR 1.14, 95% CI=0.56, 2.35: p=0.86). Patients receiving CSE were 3.9 times (95% CI=1.1-13.7: p=0.035) more likely to experience HF progression at baseline. In adjusted analysis, the risk of having early HF progression in the CSE group increased to 6.4 (95% CI=1.5, 26.5: p=0.011). In patients with LVEF< or =35%, those taking CSE were at significantly greater risk (3.2, 95% CI=1.3, 8.3: p=0.02) than the placebo group.
  
  
  CONCLUSIONS
  CSE does not reduce heart failure progression in patients who have HF. CSE appears to increase the early risk of HF progression.
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI 48104, USA. szick@umich.edu <szick@umich.edu>
authors.forename: Suzanna M
authors.initials: SM
authors.lastname: Zick
authors.forename: Brenda
authors.initials: B
authors.lastname: Gillespie
authors.forename: Keith D
authors.initials: KD
authors.lastname: Aaronson
mesh_terms: D000328:Adult; D000368:Aged; D027825:Crataegus; D018450:Disease Progression; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume
chemical_list: D010936:Plant Extracts; C007145:crataegus extract