Several studies have evaluated a po...

Several studies have evaluated a possible interaction between aspirin and angiotensin-converting enzyme (ACE) inhibitors in the treatment of congestive heart failure. near studies have suggested that aspirin therapy may attenuate the benefit of ACE inhibitors in heart failure survival. Others have base that aspirin does not negatively affect heart failure survival when combined with ACE inhibitors. The use of different aspirin dosages in the studies may have l to the conflicting proceeds In one study, low-dose aspirin did not interfere with ACE inhibitor therapy. Aumegeat and associates mode of actioned a retrospective analysis to assess the validity of aspirin on survival in stable patients with left ventricular systolic dysfunction who had congestive heart failure and were treated with ACE inhibitors.

Patients were eligible for the reflection if they were ambulatory and symptomatically stable for the preceding couple months. They were evaluated by the agency of echocardiography and cardiopulmonary exercise testing. The air of nonischemic or ischemic cardiomyopathy was identified. Medications and dosages were recorded at the start of the research and information on medication changes was obtained during the follow-up period. The major cessation points were cardiovascular-related deaths and cardiovascular events

Of 755 patients enlisted in the study, 328 had ischemic cardiomyopathy, 693 were receiving ACE inhibitors, and 317 were receiving aspirin therapy. Of the patients receiving aspirin, 74 percent were taking 200 mg or les through day. The median follow-up period was 1996 days. During this period, 273 cardiac deaths, 14 imperative cardiac transplantations, 71 nonurgent transplantations, and 46 noncardiac-related deaths occurr When testing for a possible interaction between aspirin therapy and ACE inhibitors, there were no significant differences in survival rates in the assign places to that received both medications and the dispose that received only ACE inhibitors. There also were no significant differences in survival rates in patients with ischemic or nonischemic cardiomyopathy.

The authors end that in patients with stable congestive heart failure, there is no interaction between ACE inhibitors and aspirin that affects survival. They note that the patients in their inquiry used small dosages of aspirin. They commend that aspirin dosages of les than 200 mg by means of day be used in patients with stable congestive heart failure who have known coronary artery disease or peripheral atherosclerosis.

Aumegeat V et al. Aspirin does not adversely affect survival in patients with stable congestive heart failure treated with angiotensin-converting enzyme inhibitors. Chest October 2003;124:1250-8

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