Summary: Evaluated candesartan with and without an ACE inhibitor vs. placebo in patients with symptomatic heart failure. Candesartan reduced the primary endpoint of all-cause mortality. There was a reduction of cardiovascular death and heart failure hospitalizations.
There were three subtrials:
CHARM-Added: Candesartan in addition to an ACE inhibitor reduced composite endpoint of combined cardiovascular death and heart failure hospitalization.
CHARM-Alternative: Candesartan in place of an ACE inhibitor reduced composite endpoint of combined cardiovascular death and heart failure hospitalization.
CHARM-Preserved: Candesartan showed no benefit in patients with left ventricular ejection fractions > 40%.
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Eponym: Candesartan in Heart failure - Assessment of moRtality and Morbidity
Note: The “CHARMED-Added Trial” refers to adding candesartan to an ACE inhibitor, while the “CHARMED-Alternative Trial” refers to using candesartan in place of an ACE inhibitor. The “CHARMED-Preserved Trial” refers to using candesartan in heart failure patients with preserved left ventricular systolic function.