Use of aspirin in conjunction with angiotensin-converting enzyme inhibitors does not worsen long-term survival in heart failure.

Abstract:

BACKGROUND:A negative interaction has been shown to exist between aspirin and angiotensin-converting enzyme inhibitors (ACE-I) in subjects with heart failure. We explored the effect of combined ACE-I and aspirin therapy compared to ACE-I without aspirin on clinical outcomes in patients with heart failure. METHODS:430 consecutive subjects (70+/-14 years, 55% male, 41% with coronary artery disease) released from the hospital with a primary diagnosis of heart failure were classified into three groups based on the use of aspirin and ACE-I at discharge: ACE-I without aspirin (group I, n=134), ACE-I with aspirin (group II, n=138) and no ACE-I (group III, n=158). Follow-up (all-cause mortality and the composite end-point of mortality or emergent heart transplant) was available in 406 (94%) patients at a median duration of 28 months. Differences in outcomes between patient groups were compared using contingency tables, Kaplan-Meier survival, and Cox regression analyses. Similar analyses were conducted in four predefined subsets (patients with and without coronary artery disease, and those with left ventricular ejection fraction 45%). RESULTS:Death and the composite end-point occurred in 155 (38%) and 165 (41%) patients, respectively. In the total cohort as well as in the four subsets, the treatment group showed no association with clinical outcomes in univariate or multivariate analyses. CONCLUSIONS:In patients with a principal discharge diagnosis of heart failure, the use of aspirin, in combination with ACE-I, does not worsen long-term survival compared to the use of ACE-I without aspirin.

journal_name

Int J Cardiol

authors

Harjai KJ,Solis S,Prasad A,Loupe J

doi

10.1016/s0167-5273(02)00401-1

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

207-14

issue

2-3

eissn

0167-5273

issn

1874-1754

pii

S0167527302004011

journal_volume

88

pub_type

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