Candesartan and heart failure: the allure of CHARM

Abstract

This issue of The Lancet includes four fast-tracked papers from the Candesartan in Heart Failure Assessment of Reduction in Mortality and Morbidity (CHARM)-Overall Programme—the largest trial programme ever undertaken in heart failure patients. The CHARM investigators compared the angiotensin-receptor blocker, candesartan, with a placebo in three different populations with class II-IV heart failure. CHARM-Added randomised 2548 patients with ejection fractions of 40% or less treated with optimum doses of angiotensin-converting-enzyme inhibitors (ACEIs). CHARM-Alternative randomised 2028 patients with ejection fractions of 40% or less who were intolerant of ACEIs. And CHARM-Preserved randomised 3025 patients with ejection fractions of more than 40%. Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programmeCandesartan was generally well tolerated and significantly reduced cardiovascular deaths and hospital admissions for heart failure. Ejection fraction or treatment at baseline did not alter these effects. Published online Sept 1, 2003 http://image.thelancet.com/extras/03art7416web.pdf Full-Text PDF Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trialThe addition of candesartan to ACE inhibitor and other treatment leads to a further clinically important reduction in relevant cardiovascular events in patients with CHF and reduced left-ventricular ejection fraction. Published online Sept 1, 2003 http://image.thelancet.com/extras/03art7417web.pdf Full-Text PDF Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trialCandesartan was generally well tolerated and reduced cardiovascular mortality and morbidity in patients with symptomatic chronic heart failure and intolerance to ACE inhibitors. Published online Sept 1, 2003 http://image.thelancet.com/extras/03art7418web.pdf Full-Text PDF Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved TrialCandesartan has a moderate impact in preventing admissions for CHF among patients who have heart failure and LVEF higher than 40%. Published online Sept 1, 2003 http://image.thelancet.com/extras/03art7419web.pdf Full-Text PDF