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Effect of candesartan on cause-specific mortality in heart failure patients: the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program.
Circulation 2004; 110(15):2180-3Circ

Abstract

BACKGROUND

Patients with heart failure are at increased risk of sudden death and death attributed to progressive pump failure. We assessed the effect of candesartan on cause-specific mortality in patients enrolled in the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program.

METHODS AND RESULTS

The CHARM program consisted of 3 component trials that enrolled patients with symptomatic heart failure: CHARM-Alternative (n=2028; LVEF<=40% [corrected] and ACE intolerant), CHARM-Added (n=2548; LVEF<=40%, [corrected] already on ACE inhibitors), and CHARM-Preserved (n=3023; LVEF >40%). Patients were randomized to candesartan, titrated to 32 mg QD, or placebo and were followed up for a median of 37.7 months. All deaths were reviewed by a blinded adjudication committee and categorized according to prespecified definitions on the basis of a narrative and source documentation. The number and rate of deaths by cause were calculated for each of the component trials and the overall program. Of all the patients, 8.5% died suddenly, and 6.2% died of progressive heart failure. Candesartan reduced both sudden death (HR 0.85 [0.73 to 0.99], P=0.036) and death from worsening heart failure (HR 0.78 [0.65 to 0.94], P=0.008). These reductions were most apparent in the patients with LVEF<=40% [corrected].

CONCLUSIONS

Candesartan reduced sudden death and death from worsening heart failure in patients with symptomatic heart failure, although this reduction was most apparent in patients with systolic dysfunction.

Authors+Show Affiliations

Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, Mass 02445, USA. ssolomon@rics.bwh.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

15466644

Citation

Solomon, Scott D., et al. "Effect of Candesartan On Cause-specific Mortality in Heart Failure Patients: the Candesartan in Heart Failure Assessment of Reduction in Mortality and Morbidity (CHARM) Program." Circulation, vol. 110, no. 15, 2004, pp. 2180-3.
Solomon SD, Wang D, Finn P, et al. Effect of candesartan on cause-specific mortality in heart failure patients: the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program. Circulation. 2004;110(15):2180-3.
Solomon, S. D., Wang, D., Finn, P., Skali, H., Zornoff, L., McMurray, J. J., ... Pfeffer, M. A. (2004). Effect of candesartan on cause-specific mortality in heart failure patients: the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program. Circulation, 110(15), pp. 2180-3.
Solomon SD, et al. Effect of Candesartan On Cause-specific Mortality in Heart Failure Patients: the Candesartan in Heart Failure Assessment of Reduction in Mortality and Morbidity (CHARM) Program. Circulation. 2004 Oct 12;110(15):2180-3. PubMed PMID: 15466644.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of candesartan on cause-specific mortality in heart failure patients: the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program. AU - Solomon,Scott D, AU - Wang,Duolao, AU - Finn,Peter, AU - Skali,Hicham, AU - Zornoff,Leonardo, AU - McMurray,John J V, AU - Swedberg,Karl, AU - Yusuf,Salim, AU - Granger,Christopher B, AU - Michelson,Eric L, AU - Pocock,Stuart, AU - Pfeffer,Marc A, Y1 - 2004/10/04/ PY - 2004/10/7/pubmed PY - 2005/6/25/medline PY - 2004/10/7/entrez SP - 2180 EP - 3 JF - Circulation JO - Circulation VL - 110 IS - 15 N2 - BACKGROUND: Patients with heart failure are at increased risk of sudden death and death attributed to progressive pump failure. We assessed the effect of candesartan on cause-specific mortality in patients enrolled in the Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM) program. METHODS AND RESULTS: The CHARM program consisted of 3 component trials that enrolled patients with symptomatic heart failure: CHARM-Alternative (n=2028; LVEF<=40% [corrected] and ACE intolerant), CHARM-Added (n=2548; LVEF<=40%, [corrected] already on ACE inhibitors), and CHARM-Preserved (n=3023; LVEF >40%). Patients were randomized to candesartan, titrated to 32 mg QD, or placebo and were followed up for a median of 37.7 months. All deaths were reviewed by a blinded adjudication committee and categorized according to prespecified definitions on the basis of a narrative and source documentation. The number and rate of deaths by cause were calculated for each of the component trials and the overall program. Of all the patients, 8.5% died suddenly, and 6.2% died of progressive heart failure. Candesartan reduced both sudden death (HR 0.85 [0.73 to 0.99], P=0.036) and death from worsening heart failure (HR 0.78 [0.65 to 0.94], P=0.008). These reductions were most apparent in the patients with LVEF<=40% [corrected]. CONCLUSIONS: Candesartan reduced sudden death and death from worsening heart failure in patients with symptomatic heart failure, although this reduction was most apparent in patients with systolic dysfunction. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15466644/Effect_of_candesartan_on_cause_specific_mortality_in_heart_failure_patients:_the_Candesartan_in_Heart_failure_Assessment_of_Reduction_in_Mortality_and_morbidity__CHARM__program_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000144474.65922.AA?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -