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Baseline characteristics of patients recruited in the AREA IN-CHF study (Antiremodelling Effect of Aldosterone Receptors Blockade with Canrenone in Mild Chronic Heart Failure).
J Cardiovasc Med (Hagerstown). 2007 Sep; 8(9):683-91.JC

Abstract

OBJECTIVE

Excess aldosterone activity contributes to the pathogenesis and progression of heart failure (HF). Aldosterone antagonists improve clinical outcome in patients with severe HF or left ventricular (LV) dysfunction after myocardial infarction, but knowledge of their impact in mild chronic HF is sparse. AREA IN-CHF was planned to investigate the effects of canrenone on progression of LV remodelling in mild HF.

METHODS

AREA IN-CHF is a multicentre, randomised, double-blind, parallel group comparison of canrenone (up to 50 mg/day) versus placebo in mild stable HF. The primary endpoint is change in echocardiographic LV end-diastolic volume over 12 months. Patients had New York Heart Association class II HF, LV ejection fraction < or =45%, stable standard therapy, creatinine < or =2.5 mg/dl, potassium < or =5.0 mmol/l. Follow-up examinations were scheduled monthly for the first 3 months and every 3 months thereafter. Aldosterone was measured at baseline, brain natriuretic peptide and procollagen type III amino-terminal peptide (PIIINP) at baseline and at 6 months. Echocardiography was performed at baseline, at 6 and 12 months.

RESULTS

Among 467 patients, median age 64 years (interquartile range (IQR) 56-70 years), 84% were men, 52% had ischaemic HF, 96% were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, 79% beta-blockers. Brain natriuretic peptide, aldosterone and PIIINP were 88 pg/ml (IQR 35-185 pg/ml), 118 pg/ml (IQR 75-177 pg/ml), and 5.38 microg/l (IQR 3.98-7.14 microg/l), respectively. LV end-diastolic volume was 79 ml/m (IQR 64-105 ml/m) and LV ejection fraction was 40% (IQR 33-45%).

CONCLUSIONS

The role of aldosterone blockade in patients with mild HF remains to be established. AREA IN-CHF is addressing this issue in a large population on optimal medical therapy.

Authors+Show Affiliations

Department of Cardiology, San Giovanni Addolorata Hospital, Rome, Italy. centro_studi@anmco.itNo 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17700397

Citation

Boccanelli, Alessandro, et al. "Baseline Characteristics of Patients Recruited in the AREA IN-CHF Study (Antiremodelling Effect of Aldosterone Receptors Blockade With Canrenone in Mild Chronic Heart Failure)." Journal of Cardiovascular Medicine (Hagerstown, Md.), vol. 8, no. 9, 2007, pp. 683-91.
Boccanelli A, Cacciatore G, Mureddu GF, et al. Baseline characteristics of patients recruited in the AREA IN-CHF study (Antiremodelling Effect of Aldosterone Receptors Blockade with Canrenone in Mild Chronic Heart Failure). J Cardiovasc Med (Hagerstown). 2007;8(9):683-91.
Boccanelli, A., Cacciatore, G., Mureddu, G. F., de Simone, G., Clemenza, F., De Maria, R., Di Lenarda, A., Gavazzi, A., Latini, R., Masson, S., Porcu, M., Vanasia, M., Gonzini, L., & Maggioni, A. P. (2007). Baseline characteristics of patients recruited in the AREA IN-CHF study (Antiremodelling Effect of Aldosterone Receptors Blockade with Canrenone in Mild Chronic Heart Failure). Journal of Cardiovascular Medicine (Hagerstown, Md.), 8(9), 683-91.
Boccanelli A, et al. Baseline Characteristics of Patients Recruited in the AREA IN-CHF Study (Antiremodelling Effect of Aldosterone Receptors Blockade With Canrenone in Mild Chronic Heart Failure). J Cardiovasc Med (Hagerstown). 2007;8(9):683-91. PubMed PMID: 17700397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Baseline characteristics of patients recruited in the AREA IN-CHF study (Antiremodelling Effect of Aldosterone Receptors Blockade with Canrenone in Mild Chronic Heart Failure). AU - Boccanelli,Alessandro, AU - Cacciatore,Giuseppe, AU - Mureddu,Gian Francesco, AU - de Simone,Giovanni, AU - Clemenza,Francesco, AU - De Maria,Renata, AU - Di Lenarda,Andrea, AU - Gavazzi,Antonello, AU - Latini,Roberto, AU - Masson,Serge, AU - Porcu,Maurizio, AU - Vanasia,Massimo, AU - Gonzini,Lucio, AU - Maggioni,Aldo Pietro, PY - 2007/8/19/pubmed PY - 2007/10/27/medline PY - 2007/8/19/entrez SP - 683 EP - 91 JF - Journal of cardiovascular medicine (Hagerstown, Md.) JO - J Cardiovasc Med (Hagerstown) VL - 8 IS - 9 N2 - OBJECTIVE: Excess aldosterone activity contributes to the pathogenesis and progression of heart failure (HF). Aldosterone antagonists improve clinical outcome in patients with severe HF or left ventricular (LV) dysfunction after myocardial infarction, but knowledge of their impact in mild chronic HF is sparse. AREA IN-CHF was planned to investigate the effects of canrenone on progression of LV remodelling in mild HF. METHODS: AREA IN-CHF is a multicentre, randomised, double-blind, parallel group comparison of canrenone (up to 50 mg/day) versus placebo in mild stable HF. The primary endpoint is change in echocardiographic LV end-diastolic volume over 12 months. Patients had New York Heart Association class II HF, LV ejection fraction < or =45%, stable standard therapy, creatinine < or =2.5 mg/dl, potassium < or =5.0 mmol/l. Follow-up examinations were scheduled monthly for the first 3 months and every 3 months thereafter. Aldosterone was measured at baseline, brain natriuretic peptide and procollagen type III amino-terminal peptide (PIIINP) at baseline and at 6 months. Echocardiography was performed at baseline, at 6 and 12 months. RESULTS: Among 467 patients, median age 64 years (interquartile range (IQR) 56-70 years), 84% were men, 52% had ischaemic HF, 96% were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, 79% beta-blockers. Brain natriuretic peptide, aldosterone and PIIINP were 88 pg/ml (IQR 35-185 pg/ml), 118 pg/ml (IQR 75-177 pg/ml), and 5.38 microg/l (IQR 3.98-7.14 microg/l), respectively. LV end-diastolic volume was 79 ml/m (IQR 64-105 ml/m) and LV ejection fraction was 40% (IQR 33-45%). CONCLUSIONS: The role of aldosterone blockade in patients with mild HF remains to be established. AREA IN-CHF is addressing this issue in a large population on optimal medical therapy. SN - 1558-2027 UR - https://www.unboundmedicine.com/medline/citation/17700397/Baseline_characteristics_of_patients_recruited_in_the_AREA_IN_CHF_study__Antiremodelling_Effect_of_Aldosterone_Receptors_Blockade_with_Canrenone_in_Mild_Chronic_Heart_Failure__ L2 - http://dx.doi.org/10.2459/JCM.0b013e3281053a9a DB - PRIME DP - Unbound Medicine ER -