HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Is addition of angiotensin receptor blockade superior to increasing ACE inhibitor dose in patients with heart failure?

Abstract
We conducted a prospective, randomised, open-label, blinded end point (PROBE) study examining the relative efficacy of irbesartan 300 mg/day versus maximising dose of ACE inhibitor, additional to background conventional heart failure therapy. Patients with CHF, NYHA Class II-III and a left ventricular ejection fraction <40% were randomised to one of two treatment arms. All patients were receiving ≤ half target dose of ACE inhibitor as background therapy. 44 patients received an increase in their background ACE inhibitor while 45 patients were given irbesartan (target dose 300 mg/day) in addition to their background ACE inhibitor. The primary end-point was change in brain natriuretic peptide (BNP) from baseline to 6 months. Change in hs-CRP level, 6 min walk distance, and Minnesota living with heart failure quality of life questionnaire (MLWHF) from baseline to 6 months were also evaluated. Patients were well matched at baseline for all end-point parameters as well as for age, gender and baseline systolic ventricular function. There was general improvement in clinical status for all patients but no significant difference between increased ACE inhibitor vs added ARB for change in BNP, hs-CRP, NYHA, 6 min walk or MLWHF (all P>0.05). This PROBE study has demonstrated similar clinical responses with increased dose of ACE inhibitor compared to addition of ARB in patients with systolic CHF. These findings suggest that either approach to increasing renin-angiotensin blockade in patients taking low doses of background ACE inhibitor results in similar clinical outcomes.
AuthorsJ Brack, A Sindone, R Funston, H Schneider, M Skiba, K-C Ueng, H Krum
JournalInternational journal of cardiology (Int J Cardiol) Vol. 139 Issue 3 Pg. 309-12 (Mar 18 2010) ISSN: 1874-1754 [Electronic] Netherlands
PMID19027970 (Publication Type: Comparative Study, Letter, Multicenter Study, Randomized Controlled Trial)
CopyrightCopyright © 2008 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
Topics
  • Aged
  • Angiotensin II Type 1 Receptor Blockers (administration & dosage, therapeutic use)
  • Angiotensin-Converting Enzyme Inhibitors (administration & dosage, therapeutic use)
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Endpoint Determination
  • Female
  • Heart Failure (drug therapy, physiopathology)
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: