CHARMPreserved研究课件.pptVIP

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CHARMPreserved研究课件.ppt

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CHARM-Preserved:Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved Purpose To determine whether the angiotensin II receptor blocker candesartan is beneficial in patients with chronic heart failure (CHF) and preserved left ventricular systolic function Reference Yusuf S, Pfeffer MA, Swedberg K, et al. for the CHARM Investigators and Committees. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved trial. Lancet 2003;362:777–81. CHARM-Preserved:Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved- TRIAL DESIGN - Design Multicenter, multinational, randomized, double-blind, placebo-controlled Patients 3023 patients aged 18 years with symptomatic CHF (NYHA class II–IV), who had left ventricular ejection fraction 40% Follow up and primary endpoint Primary endpoint: cardiovascular death or hospital admission for CHF. Median 36.6 months follow up. Treatment Placebo or candesartan titrated to 32 mg once daily CHARM-Preserved:Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved- TRIAL DESIGN continued- CHARM-Preserved:Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Preserved- RESULTS - Nonsignificant trend to reduction in primary outcome of cardiovascular death or hospital admission for CHF in candesartan group compared with placebo (22 vs. 24.3%, P=0.118) Secondary outcomes – composites of primary outcome and MI, nonfatal stroke and coronary revascularization – also showed nonsignificant trend Total number of hospital admissions for CHF significantly reduced in candesartan group (402 vs. 566, P=0.014) All-cause mortality similar in both groups (244 vs. 237 patients) Permanent discontinuation due to adverse event or laboratory abnormality more frequent with candesartan (17.8 vs. 13.5%, P=0.001) CHARM-Preser