Multicenter clinical trial of angiotensin receptor blocker in patients with chronic heart failure: review of recent clinical trial

摘要

Angiotensin receptor blocker(ARB) is expected to be a substitute of ACE inhibitor for ACE inhibitor(ACEi) incompetent patient or an additive drug for the treatment of severe heart failure. Two large mega-trials(ELITE II & Val-HEFT) have been reported so far and one large trial(CHARM) is ongoing. In ELITE II study, there was no additional beneficial effects of ARB compared to ACEi(captopril). On the other hand, additive ARB may be beneficial for most of patients with heart failure, according to the Val-Heft trial. However, some adverse effects of ARB by the combinatory use with ACEi and beta-blocker should be taken into careful consideration. Ongoing CHARM trial may answer if ARB is ultimately useful for the treatment of heart failure.