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Effects of candesartan on left ventricular function, aldosterone and BNP in chronic heart failure
Cardiovascular Drugs and Therapy, 02/06/2012
Clinical Article
Aleksova A et al. – In CandHeart, the addition of candesartan to standard medical treatment did not reduce circulating BNP more than standard therapy (primary endpoint), but it significantly improved LV function and produced a marked decrease in aldosterone levels at study end.
Methods- A total of 514 patients with stable symptomatic NYHA II–IV HF and any left ventricular ejection fraction (LVEF)were randomized to candesartan (target dose 32 mg once daily) as add–on therapy or standard medical therapy alone.
- Standardized echocardiographic exams were performed locally under central quality control, whereas biomarkers were assayed in a core laboratory.
- The majority of patients (73.3%) were NYHA II and on ACE inhibitors (91.8%) and beta–blockers (85.4%).
- Mean age was 66±11 years.
- Mean LVEF was 36.2±9.7% and 24.9% of patients had LVEF ≥ 40%.
- LVEF increased significantly more in the candesartan group (p=0.09 at 12 weeks and p=0.01 at 48 weeks) and left ventricular end–diastolic diameter decreased in candesartan group (p=0.05 at 12 weeks).
- Candesartan significantly reduced aldosterone at 48 weeks (p=0.009).
- BNP was reduced similarly over time in both study groups (p=0.35 and p=0.98 at 12 and 48 weeks, respectively).
- There were 6.6% of discontinuations of candesartan for adverse events.