Effects of aspirin and clopidogrel on plasma brain natriuretic peptide in patients with heart failure receiving ACE inhibitors.

Abstract

BACKGROUND:

By inhibiting prostaglandins, aspirin may be deleterious in heart failure (HF) and/or may counteract angiotensin-converting enzyme (ACE) inhibitor efficacy. Conversely, clopidogrel has no effect on prostaglandin metabolism.

AIM:

To investigate the effect of aspirin and clopidogrel on brain natriuretic peptide (BNP) levels in HF patients treated with ACE inhibitors.

METHODS:

36 patients with stable HF (65+/-13 years, 24 males/12 females, NYHA class II to IV, ejection fraction <40%, 13 with coronary disease, all treated with ACE inhibitors) were enrolled in this prospective, double-blind study and randomised to aspirin 325 mg/day or clopidogrel 75 mg/day for 14 days. BNP was determined at day 0 and day 14.

RESULTS:

19 patients were randomised to aspirin and 17 to clopidogrel. Baseline characteristics were similar in both groups. BNP levels increased in the aspirin group from day 0 to day 14 (107+/-103 to 144+/-149 pg/ml, p=0.04) whereas clopidogrel had no effect (104+/-107 and 97+/-99 pg/ml respectively, p=0.61).

CONCLUSION:

This study demonstrates an adverse effect of aspirin 325 mg/day on BNP plasma levels in HF patients treated with ACE inhibitors. In contrast clopidogrel 75 mg/day had no effect.

• Authors: Christophe Meune, Karim Wahbi, Yvonne Fulla, Alain Cohen-Solal, Denis Duboc, Isabelle Mahé, Guy Simoneau, Jean-François Bergmann, Simon Weber, Stéphane Mouly
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 9 Issue 2 Pg. 197-201 (Feb 2007) ISSN: 1388-9842 [Print] England
• PMID: 16914369 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Angiotensins
• Prostaglandins
• Natriuretic Peptide, Brain
• Clopidogrel
• Ticlopidine
• Aspirin

Topics

• Aged
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Angiotensins (drug effects)
• Aspirin (adverse effects, pharmacology)
• Clopidogrel
• Female
• Heart Failure (blood, drug therapy)
• Humans
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood, drug effects)
• Prostaglandins
• Ticlopidine (analogs & derivatives, pharmacology)