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Candesartan in Heart Failure

CHARM Trial. Candesartan in Heart Failure. Presented at European Society of Cardiology 2003. CHARM Trial. 7,601 patients with heart failure 3 Individual component randomized trials with the ARB candesartan (4 or 8 mg/day, titrated to target dose of 32 mg) or placebo . CHARM Preserved

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Candesartan in Heart Failure

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  1. CHARM Trial Candesartan in Heart Failure Presented at European Society of Cardiology 2003

  2. CHARM Trial 7,601 patients with heart failure 3 Individual component randomized trials with the ARB candesartan (4 or 8 mg/day, titrated to target dose of 32 mg) or placebo • CHARM Preserved • Patients with LVEF >40% with or without ACE-inhibitor • CHARM Added • Patients with LVEF <40% and treated with an ACE-inhibitor • CHARM Alternative • Patients with LVEF <40% and ACE-inhibitor intolerant • Endpoints (follow-up minimum 2 years): • Primary – Component trials: cardiovascular mortality or CHF hospitalization • Primary – Overall trial results: All-cause mortality European Society of Cardiology 2003

  3. CHARM Overall Program CV Mortality orCHF Hospitalization HR 0.84 p<0.0001 All-cause mortality HR 0.91 95% CI 0.83-1.00 p=0.055 European Society of Cardiology 2003

  4. CHARM Added Trial CV Mortality HR 0.84 p=0.02 CV Mortality or CHF hospitalization HR 0.85 p=0.011 European Society of Cardiology 2003

  5. CHARM Alternative Trial CV Mortality or CHF hospitalization HR 0.77 p=0.0004 CV Mortality HR 0.85 p=0.072 European Society of Cardiology 2003

  6. CHARM Preserved Trial CV Mortality or CHF hospitalization HR 0.89 p=0.118 CV Mortality HR 0.99 p=0.918 European Society of Cardiology 2003

  7. CHARM Trial • CHARM Overall: Among symptomatic heart failure patients, treatment with ARB candesartan was associated with lower CV mortality and a trend toward lower all-cause mortality compared with placebo • CHARM Added: Among patients with symptomatic heart failure and an ejection fraction <40% treated with an ACE-inhibitor, additional treatment with the ARB candesartan was associated with reduction in the primary endpoint of cardiovascular death or heart failure hospitalizations

  8. CHARM Trial • CHARM Alternative: Among patients with symptomatic heart failure and an ejection fraction <40% who were ACE-inhibitor intolerant, treatment with the ARB candesartan was associated with reduction in the primary endpoint of cardiovascular death or heart failure hospitalizations • CHARM Preserved: Among patients with symptomatic heart failure and an ejection fraction >40%, treatment with the ARB candesartan was associated with a non-significant reduction in the primary endpoint of cardiovascular death or heart failure hospitalizations

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