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Comparison of angiotensin-converting enzyme inhibitor alone and in combination with irbesartan for the treatment of heart failure.

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.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Kum LC,Yip GW,Lee PW,Lam YY,Wu EB,Chan AK,Fung JW,Chan JY,Zhang Q,Kong SL,Yu CM

doi

10.1016/j.ijcard.2007.02.016

subject

Has Abstract

pub_date

2008-03-28 00:00:00

pages

16-21

issue

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(07)00487-1

journal_volume

125

pub_type

临床试验,杂志文章,随机对照试验

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Comparison of angiotensin-converting enzyme inhibitor alone and in combination with irbesartan for the treatment of heart failure.