Irbesartan in patients with heart failure and preserved ejection fraction

Massie, Barry M., Carson, Peter E., McMurray, John J., Komajda, Michel, McKelvie, Robert, Zile, Michael R., Anderson, Susan, Donovan, Mark, Iverson, Erik, Staiger, Christoph and Ptaszynska, Agata (2008) Irbesartan in patients with heart failure and preserved ejection fraction. New England Journal of Medicine, 359 23: 2456-2467. doi:10.1056/NEJMoa0805450

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Author Massie, Barry M.
Carson, Peter E.
McMurray, John J.
Komajda, Michel
McKelvie, Robert
Zile, Michael R.
Anderson, Susan
Donovan, Mark
Iverson, Erik
Staiger, Christoph
Ptaszynska, Agata
Title Irbesartan in patients with heart failure and preserved ejection fraction
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 0028-4793
1533-4406
Publication date 2008-12-04
Year available 2008
Sub-type Article (original research)
DOI 10.1056/NEJMoa0805450
Open Access Status File (Publisher version)
Volume 359
Issue 23
Start page 2456
End page 2467
Total pages 12
Place of publication Waltham, MA, United States
Publisher Massachusetts Medical Society
Language eng
Abstract Background: Approximately 50% of patients with heart failure have a left ventricular ejection fraction of at least 45%, but no therapies have been shown to improve the outcome of these patients. Therefore, we studied the effects of irbesartan in patients with this syndrome.
Formatted abstract
Background: Approximately 50% of patients with heart failure have a left ventricular ejection fraction of at least 45%, but no therapies have been shown to improve the outcome of these patients. Therefore, we studied the effects of irbesartan in patients with this syndrome.

Methods: We enrolled 4128 patients who were at least 60 years of age and had New York Heart Association class II, III, or IV heart failure and an ejection fraction of at least 45% and randomly assigned them to receive 300 mg of irbesartan or placebo per day. The primary composite outcome was death from any cause or hospitalization for a cardiovascular cause (heart failure, myocardial infarction, unstable angina, arrhythmia, or stroke). Secondary outcomes included death from heart failure or hospitalization for heart failure, death from any cause and from cardiovascular causes, and quality of life.

Results: During a mean follow-up of 49.5 months, the primary outcome occurred in 742 patients in the irbesartan group and 763 in the placebo group. Primary event rates in the irbesartan and placebo groups were 100.4 and 105.4 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% confidence interval [CI], 0.86 to 1.05; P = 0.35). Overall rates of death were 52.6 and 52.3 per 1000 patient-years, respectively (hazard ratio, 1.00; 95% CI, 0.88 to 1.14; P = 0.98). Rates of hospitalization for cardiovascular causes that contributed to the primary outcome were 70.6 and 74.3 per 1000 patient-years, respectively (hazard ratio, 0.95; 95% CI, 0.85 to 1.08; P = 0.44). There were no significant differences in the other prespecified outcomes.

Conclusions: Irbesartan did not improve the outcomes of patients with heart failure and a preserved left ventricular ejection fraction. (ClinicalTrials.gov number, NCT00095238.) Copyright
Keyword Medicine, General & Internal
General & Internal Medicine
MEDICINE, GENERAL & INTERNAL
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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