title: Rationale, design and baseline characteristics of a study to evaluate effects of candesartan on cardiovascular events after drug-eluting stent implantation in patients with ischemic heart disease.
abstract: OBJECTIVE
  Few multicenter studies have assessed the effects of angiotensin receptor blockers on cardiovascular events after drug-eluting stent implantation in patients with ischemic heart disease.
  
  
  METHODS
  An open-label multicenter randomized prospective study is in progress to evaluate the effects of candesartan on cardiovascular events in patients with ischemic heart disease after implantation of sirolimus- and/or paclitaxel-eluting stents.
  
  
  RESULTS
  A total of 1,145 patients were enrolled at 39 institutes in the Candesartan for prevention of Cardiovascular events after CYPHER or TAXUS Coronary stenting (4C trial). Patients were randomized into a group treated with candesartan (n=602) and a group treated with standard medical therapy without candesartan (n=543). The primary endpoint of the 4C trial is a composite of all-cause death, successful resuscitation after cardiopulmonary arrest and cardiovascular events including non-fatal myocardial infarction, unstable angina requiring emergent hospitalization, congestive heart failure requiring emergent hospitalization and cerebrovascular attacks. All patients will be followed-up for 36 months.
  
  
  CONCLUSIONS
  The 4C trial will be the first multicenter study to elucidate the effects of candesartan after drug-eluting stent implantation and may provide new information to optimize medical therapy after percutaneous coronary interventions.
authors: Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Japan. tom@kumamoto-u.ac.jp
authors: Tomohiro
authors: T
authors: Sakamoto
authors: Hisao
authors: H
authors: Ogawa
authors: Koichi
authors: K
authors: Nakao
authors: Shunichi
authors: S
authors: Koide
authors: Nobuyasu
authors: N
authors: Yamamoto
authors: Hideki
authors: H
authors: Shimomura
authors: Toshiyuki
authors: T
authors: Matsumura
authors: Shuichi
authors: S
authors: Oshima
authors: Koichi
authors: K
authors: Kikuta
authors: Hideki
authors: H
authors: Oka
authors: Kazuo
authors: K
authors: Kimura
authors: Kunihiko
authors: K
authors: Matsui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D055808:Drug Discovery; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000628:therapy*; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage; D013777:Tetrazoles / Q000627:therapeutic use*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; D017239:Paclitaxel; C081643:candesartan; D020123:Sirolimus