Effect of angiotensin-II-receptor antagonists used in patients with chronic congestive heart failure

Objective:To evaluate the effect of angiotensin-Ⅱ-receptor antagonists(ARB) in patients with chronic congestive heart failure(CHF) who were intolerant to angiotensin-converting enzyme inhibitors(ACEI).Methods:The 23 cases(NYHA Ⅲ~Ⅳ,ejection fraction40%) intolerant to ACEIs and given by ARBs had been regularity followed up for 5 years(ARB group).The CHF cases treated with ACEI were regard as control group.Clinical characteristics were compared between two groups.The data before and after five years in survival CHF patients of ARB group were also studied.Results:(1)The mortality of ARB group was not significantly different from that of ACEI group(52.17%∶48.39%,P0.05);(2)There were higher mortality in older patients and with lower creatinine clearance rate(Ccr)(P0.01) in patients used ARBs;(3)The patients mostly died from deterioration of heart function(75%) and the five-year mortality was 52.2% in ARB group.The LVEF and left ventricular end-diastolic dimension(LVEDd) of the survival CHF patients were better than those of five-year before in ARB group(P0.05~0.01).Conclusion:Patients with CHF intolerant to ACEI would have a better prognosis if given ARB long-term.