CardioScripts Classics – Vasodilators in HFrEF [Part 2]

0:00-0:43: Intro

0:44-1:04: Welcome back of Dr. Robert Page and Recap of Part 1

1:05-3:09: Discussion of ARB trials in HFrEF from highlighting ELITE I and II

3:10-7:42: What we learned from Val-HeFT and CHARM-ADDED

7:43-11:13: Angioedema approach, lessons from CHARM-ALTERNATIVE and HTN trials

11:14-14:10: PARADIGM-HF a shift in vasodilator therapy for HFrEF

14:11-16:48: Dose discussion: low vs. high-dose afterload reduction… Holding on to your money!

16:49-19:04: Final Thoughts from Dr. Page – Read CONSENSUS, SOLVD PREVENTION, SOLVD Treatment, SAVE, ATLAS

19:05-19:50: Renal function and safety thoughts

19:51-21:01: Closing

References:

  • Pitt B, Segal R, Martinez FA, et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet. 1997; 349:747-752.
  • Pitt B, Poole-Wilson PA, Segal R, et al. Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial – the Losartan Heart Failure Survival Study ELITE II. Lancet. 2000;355:1582-1587.
  • Cohn JN, Tognoni G, Valsartan Heart Failure Trial Investigators, et al. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure (Val-HeFT). New Engl J Med. 2001;345(23):1667-75.
  • McMurray JJ, Ostergren J, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: The CHARM-Added trial. The Lancet. 2003; 362(9386):767-771.
  • Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. New Engl J Med. 1999;341(10):709-717.
  • Granger CB, McMurray JJ, Yusuf S, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet. 2003;362(9386):772-6.
  • Beavers CJ, Dunn SP, Macaulay TE.  The role of angiotensin receptor blockers in patients with angiotensin-converting enzyme inhibitor-induced angioedema.  Ann Pharmacother. 2011;45:520-524.
  • Granger CB, McMurray JJV, Yusuf S, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. The Lancet. 2003. 362(9386):772-776.
  • McMurray JJV, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. New Engl J Med. 2014; 371(11):993-1004.
  • Vardeny O, Claggett B, Packer M, et al.  Efficacy of sacubitril/valsartan vs. enalapril at lower than target doses in heart failure with reduced ejection fractions: the PARADIGM-HF trial. European J of Heart Failure. 2016;18:1228-1234.
  • Packer M, Poole-Wilson PA, Armstrong PW, et al. Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor lisinopril on morbidity and mortality in chronic heart failure. Circulation. 1999;100:2312-2318.
  • Konstam MA, et al. Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure. The Lancet 2009. 374(9704):1840-1848.
  • CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure, results of the cooperative north Scandinavian enalapril survival study. New Engl J Med. 1987;316(23):1429-35.
  • Das SR, Drazner MH, Yancy CW, et al.  Effect of diabetes mellitus and ischemic heart disease on the progression from asymptomatic left ventricular dysfunction to symptomatic heart failure: a retrospective analysis from the Studies of Left Ventricular Dysfunction (SOLVD) Prevention trial. Am Heart J. 2004 Nov;148(5):883-8.
  • Glick H, Cook J, Kinosian B, et al.  Costs and effects of enalapril therapy in patients with symptomatic heart failure: an economic analysis of the studies of left ventricular dysfunction (SOLVD) treatment trial.  J Card Fail. 1995;1:371-80.
  • Pfeffer MA, Braunwald E, Moye LA, et al. Effect of Captopril on Mortality and Morbidity in Patients with Left Ventricular Dysfunction after Myocardial Infarction — Results of the Survival and Ventricular Enlargement Trial. New Engl J Med. 1992; 327:669-677.
  • Schoolwerth AC, Sica DA, Ballermann BJ, et al.  Renal considerations in angiotensin converting enzyme inhibitor therapy: A statement for healthcare professionals from the council on the kidney in cardiovascular disease and the council high blood pressure research of the american heart association. Circulation. 2001;104:1985-1991.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: