Document Detail

Clopidogrel is associated with a lesser increase in NT-proBNP when compared to aspirin in patients with ischemic heart failure.
MedLine Citation:
PMID:  16911911     Owner:  NLM     Status:  MEDLINE    
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 +/- 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 NT-proBNP levels), implying that aspirin therapy is associated with a more progressive course of heart failure.
Borut Jug; Miran Sebestjen; Miso Sabovic; Irena Keber
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  12     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-16     Completed Date:  2006-10-12     Revised Date:  2007-03-12    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  446-51     Citation Subset:  IM    
Department of Vascular Diseases, University Clinical Centre, Ljubljana, Slovenia.
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MeSH Terms
Aged, 80 and over
Aspirin / adverse effects,  therapeutic use*
Cardiac Output, Low / blood,  drug therapy*,  etiology,  physiopathology*
Cross-Over Studies
Disease Progression
Middle Aged
Myocardial Ischemia / complications
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Platelet Aggregation Inhibitors / adverse effects,  therapeutic use*
Ticlopidine / adverse effects,  analogs & derivatives*,  therapeutic use
Reg. No./Substance:
0/Peptide Fragments; 0/Platelet Aggregation Inhibitors; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comment In:
J Card Fail. 2007 Feb;13(1):75-6   [PMID:  17339006 ]

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