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Angiotensin-Receptor Blocker of No Benefit in Patients with Heart Failure, Preserved Systolic Function
The angiotensin-receptor blocker irbesartan does not improve outcomes in patients with heart failure and preserved left-ventricular ejection fractions, according to an industry-supported study published online by the New England Journal of Medicine.
Some 4000 patients aged 60 or older with heart failure and ejection fractions of at least 45% were randomized to receive irbesartan (titrated up to 300 mg daily) or placebo. During roughly 4 years' follow-up, overall mortality and hospitalization for cardiovascular causes did not differ significantly between the groups.
Writing in Journal Watch Cardiology, Harlan M. Krumholz concludes: "With these findings, irbesartan takes its place on the list of pharmacologic strategies that have failed to improve outcomes in patients with heart failure and preserved systolic function. There is currently no indication for an angiotensin-receptor blocker in these patients."
LINK(S):
NEJM article (Free)
Reuters story (Free)
Journal Watch Cardiology summary (Subscription required)
Published in Physician's First Watch November 12, 2008
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