CHARM

Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity — Overall Programme

Paciente / Población Intervención / Exposición Comparación Desenlace

In 7,601 patients with symptomatic chronic heart failure, candesartan reduced cardiovascular death and heart-failure hospitalisation compared with placebo.

7601

Diseño

Pooled analysis of three double-blind placebo-controlled RCTs

Desenlace

All-cause mortality (overall programme)

Relevancia

Resultado23% with candesartan vs 25% with placebo (unadjusted HR 0.91, 95% CI 0.83-1.00, P=0.055; covariate-adjusted HR 0.90, P=0.032); CV death and HF hospitalisations significantly reduced.

Pfeffer MA, et al. Lancet. 2003;362(9386):759-766. 10.1016/S0140-6736(03)14282-1

Discusión y crítica

Overall all-cause mortality endpoint only borderline (significant after adjustment), and the programme pooled distinct HFrEF and HFpEF populations. Established candesartan as an ACEi alternative and add-on in HFrEF.