CHARM-Added研究课件（PPT 8页）.ppt

CHARM Added: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Added Purpose To determine whether addition of the angiotensin II receptor blocker candesartan is beneficial in patients with chronic heart failure (CHF) who are taking angiotensin converting enzyme (ACE) inhibitors Reference McMurray JJV, ?stergren J, Swedberg K, et al. for the CHARM Investigators and Committees. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet 2003;362:767–71. CHARM Added: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Added- TRIAL DESIGN - Design Multicenter, multinational, randomized, double-blind, placebo-controlled Patients 2548 patients aged 18 years with symptomatic CHF (NYHA class II–IV), who had left ventricular ejection fraction 40% and were receiving ACE inhibitors Follow up and primary endpoint Primary endpoint: cardiovascular death or hospital admission for CHF. Median 41 months follow up. Treatment Placebo or candesartan titrated to 32 mg once daily CHARM Added: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Added- TRIAL DESIGN continued- CHARM Added: Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity - Added- RESULTS - Primary outcome of cardiovascular death or hospital admission for CHF significantly reduced in candesartan group compared with placebo (37.9 vs. 42.3%, hazard ratio 0.85, 95% CI 0.75–0.96, P=0.011): each component was reduced significantly Secondary outcomes – composites of primary outcome and MI, nonfatal stroke and coronary revascularization – also significantly reduced All-cause mortality not significantly reduced (30 vs. 32%, hazard ratio 0.89, 95% CI 0.77–1.02, P=0.086) Benefits similar in patients taking beta-blockers and those who were not (P=0.