Copyright © 1998 by the European Society of Cardiology.
Candoxatril improves exercise capacity in patients with chronic heart failure receiving angiotensin converting enzyme inhibition
a Department of Cardiology, Royal Infirmary, Edinburgh, Scotland, U.K.
b Department of Cardiology, Western Infirmary, Glasgow, Scotland, U.K.
c Department of Cardiology, Western General Hospital, Edinburgh, Scotland, U.K.
accepted June 10, 1998
Aims
To assess the effect of candoxatril, a novel neutral endopeptidase inhibitor, on exercise capacity, clinical status and quality of life in patients with mild to moderate chronic heart failure receiving angiotensin converting enzyme inhibition.
Methods and Results
Patients were recruited from 16 centres throughout the United Kingdom. Following a 4-week single-blind placebo ‘run-in’ phase of weekly exercise tests, patients underwent double-blind randomization to receive either candoxatril (100mg twice daily) or placebo for the next 84 days. Patients were then reassessed every 28 days.
Of 110 patients randomized, 56 received candoxatril and 54 placebo. Over the study period, the overall improvement in mean total exercise time in the candoxatril group in comparison to the placebo group was 34·1s (P=0·02: 95% confidence interval: 5·1 to 63·0). There were no significant changes in functional class, clinical status or quality of life scores between the two groups. There was a trend for a small reduction in blood pressure in the candoxatril group.
Conclusion
Candoxatril confers an improvement in exercise capacity in patients with chronic heart failure who are receiving maintenance angiotensin converting enzyme inhibitor therapy.
Key Words: Chronic heart failure • candoxatril • NEP inhibition • ACE inhibition • exercise capacity.
f1 Correspondence: Professor H. J. Dargie, Clinical Research Initiative in Heart Failure, West Medical Building, University of Glasgow, Glasgow, G12 8QQ, Scotland, U.K.
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