Author/Editor     Jug, Borut; Šebeštjen, Miran; Šabovič, Mišo; Keber, Irena
Title     Clopidogrel is associated with a lesser increase in NT-proBNP when compared to aspirin in patients with ischemic heart failure
Type     članek
Source     J Card Fail
Vol. and No.     Letnik 12, št. 6
Publication year     2006
Volume     str. 446-51
ISSN     1071-9164
Language     eng
Abstract     Background: Aspirin has been associated with adverse heart failure outcomes, probably because of a blunting interaction with angiotensin-converting enzyme (ACE) inhibitors. Therefore, we hypothesized that clopidogrel when compared with aspirin would be associated with a slower progression of heart failure as determined by levels of amino-terminal pro-brain natriuretic peptide (NT-proBNP). Methods and Results: In an open-label, randomized, 2-treatment, 2-period crossover study, 18 patients with ischemic heart failure (14 post-myocardial infarction, left ventricular ejection fraction 0.32 f 0.08), median age 73, New York Heart Association class II (11 patients) or III (7 patients), all taking ACE inhibitors were included. Patients were randomized to 8 weeks of aspirin 100 mg/day followed by 8 weeks of clopidogrel 75 mg/day, or the reversed sequence. Blood levels of NT-proBNP were measured using sandwich immunoassay. Patients on aspirin experienced an 8-times greater increase in log-transformed values of NT-proBNP compared with patients on clopidogrel (average change 4.757% versus 0.597%; P = .0395 for intervention, P = .4453 for period, P = .4046 for sequence). We observed no change in functional class, 6-minute walking test, creatinine levels, or electrolytes. Conclusion: Aspirin is associated with a greater increase in natriuretic peptides (log-transformed NTproBNP levels), implying that aspirin therapy is associated with a more progressive course of heart failure.
Descriptors     HEART FAILURE, CONGESTIVE
ASPIRIN
CARDIAC OUTPUT, LOW
NATRIURETIC HORMONE
TICLOPIDINE
MIDDLE AGE
AGED
SEX FACTORS
CROSS-OVER STUDIES
DISEASE PROGRESSION
MYOCARDIAL ISCHEMIA
PEPTIDE FRAGMENTS
PLATELET AGGREGATION INHIBITORS