CHARM Added trial

The CHARM-Added trial recruited 2548 patients with heart failure due to left ventricular dysfunction. All patients were being treated with an ACE inhibitor and were randomised to receive, in addition, either candesartan or placebo.

There was no reduction in overall mortaility however there was a small but significant reduction in the primary endpoint of "cardiovascular death or heart failure hospitalization".

There had been suggestions that triple therapy with ACE inhibitor/candesartan/beta-blocker might be dangerous. This study did not support these ideas because the small benefit of adding candesartan was also seen in patients taking beta-blockers.

Reference:

McMurray JJ, Ostergren J, Swedberg K, Granger CB, Held P, Michelson EL, Olofsson B, Yusuf S, Pfeffer MA; CHARM Investigators and Committees. (2003). Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet 362(9386):767-71.