| Abstract | OBJECTIVE: Angiotensin-converting enzyme inhibitor (ACEI) is beneficial in patients with congestive heart failure (CHF). Some, but not all, angiotensin receptor blocker (ARB) was demonstrated to be effective as "add-on" therapy. We investigated whether irbesartan is useful as an add-on therapy in CHF. DESIGN: Randomized control trial. SETTING: Single center. PATIENTS: 50 CHF patients on stable doses of ACEI. INTERVENTIONS: Add-on therapy with irbesartan (300 mg/day) or continuation of conventional therapy (control group) for 1 year. MAIN OUTCOME MEASURES: Serial clinical and echocardiographic assessment were performed as baseline, 3 months and 1 year after therapy. RESULTS: There was no difference in clinical characteristics between 2 groups. Patients in the add-on therapy group had significant increase in 6-Minute Hall-Walk distance (351+/-89 to 392+/-84 m, P<0.01), achieved higher METs exercise time on treadmill test (3.9+/-1.1 to 4.6+/-1.3 METs, P=0.01), reduction of NYHA Class (2.4+/-0.5 to 2.0+/-0.8, P<0.005) and improvement of QOL score (28+/-19 to 17+/-18, P<0.05). These parameters were not improved in the control group and a worsening of exercise capacity was observed (P<0.05). A reduction of left ventricular end-systolic diameter (4.94+/-0.85 vs 4.30+/-1.17 cm, P<0.05) was observed in the add-on group. At the end of 1 year, more patients have normal or abnormal relaxation pattern in the add-on group than the control group (82% vs 53% chi(2)=7.1, P=0.02). Blood pressure and renal function were unchanged in both groups. CONCLUSION: The addition of irbesartan to conventional ACEI therapy in CHF further improves symptoms, exercise capacity and quality of life without adverse effects on hemodynamics and renal function. |
| Authors | Leo Chi-Chiu Kum, Gabriel Wai-Kwok Yip, Pui-Wai Lee, Yat-Yin Lam, Eugene B Wu, Anna Kin-Yin Chan, Jeffrey Wing-Hong Fung, Joseph Yat-Sun Chan, Qing Zhang, Shun-Ling Kong, Cheuk-Man Yu
(Affiliation: Division of Cardiology, SH Ho Cardiovascular and Stroke Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.)
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| Journal | International journal of cardiology
(Int J Cardiol)
Vol. 125
Issue 1
Pg. 16-21
(Mar 28 2008)
ISSN: 1874-1754 Netherlands |
| PMID | 17433840
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
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| Chemical References |
- Angiotensin II Type 1 Receptor Blockers
- Angiotensin-Converting Enzyme Inhibitors
- Biphenyl Compounds
- Tetrazoles
- irbesartan
|
| Topics |
- Aged
- Angiotensin II Type 1 Receptor Blockers
(administration & dosage, therapeutic use)
- Angiotensin-Converting Enzyme Inhibitors
(administration & dosage, therapeutic use)
- Biphenyl Compounds
(administration & dosage, therapeutic use)
- Diastole
- Drug Therapy, Combination
- Exercise Tolerance
- Female
- Heart Failure
(drug therapy, physiopathology, ultrasonography)
- Humans
- Male
- Quality of Life
- Questionnaires
- Stroke Volume
(drug effects)
- Systole
- Tetrazoles
(administration & dosage, therapeutic use)
- Treatment Outcome
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