6/28/23, 12:07 AM CHARM-Added Pathway Feedback Search Clinical Topics Home Studies CHARM Added CHARM Added Disease Heart failure Trial question What is the role of candesartan in patients with chronic HF and reduced left-ventricular systolic function taking ACEIs? Study design Multi-center Double blinded RCT Population Characteristics of study participants 21.0% female N = 2548 79.0% male 2548 patients (542 female, 2006 male) Inclusion criteria: patients with chronic HF and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors Key exclusion criteria: life-threatening adverse event; known bilateral renal artery stenosis; current symptomatic hypotension; persistent systolic or diastolic hypertension; stroke, acute myocardial infarction, or open heart surgery within the last 4 weeks; or previous heart transplant or heart transplant expected to be performed within the next 6 months Interventions N=1276 candesartan (target dose 32 mg once daily) N=1272 placebo (matching placebo) Primary outcome Cardiovascular death or hospital admission for CHF https://web.pathway.md/studies/recIoSXG7Rwk1eocu 1/2 6/28/23, 12:07 AM CHARM-Added Pathway 42.0 % 42 38 31.5 % 21.0 % Significant decrease 10.5 % NNT = 25 0.0 % Candesartan Placebo Significant decrease in cardiovascular death or hospital admission for CHF (38% vs. 42%; HR 0.85, 95% CI 0.75 to 0.96) Secondary outcomes Significant decrease in cardiovascular death, hospital admission for CHF, and MI (38.8% vs. 43.2%; HR 0.85, 95% CI 0.76 to 0.96) Safety outcomes Significant differences in drug discontinuation due to adverse event or abnormal laboratory value (24% vs. 18%, p = 0.0003). Conclusion In patients with chronic HF and reduced left-ventricular systolic function taking angiotensin- converting-enzyme inhibitors, candesartan was superior to placebo with respect to cardiovascular death or hospital admission for CHF. Reference McMurray JJ, Ostergren J, Swedberg K et al. 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. 2003 Sep 6;362(9386):767-71. Open reference URL https://web.pathway.md/studies/recIoSXG7Rwk1eocu 2/2