Candesartan a better treatment for patients with heart failure - Book Report/Review Example

Funding: The study is marked as an ‘original contribution’ in the Journal and no reference has been made in the paper as far as funds were concerned. It appears that the study was conducted in a cooperative manner by the researchers solely out of interest in this particular field, under the aegis of Department of Cardiology, South Hospital, Sweden, after getting due sanction from the ethics committee set up for the purpose. Study Objective: The authors suspected that the choice of the drug molecule type while prescribing Angiotensin II Receptor Blockers (ARBs) for patients at risk of acute heart failure had far reaching effects on subsequent patient survivability and believed that there was a need to analyze patient data for the benefits of choosing one type of ARB over the other.

The authors suspected that Losartan might be inferior to Candesartan in terms of overall patient survivability due to the variation in affinity between the two drugs for the AT1 receptor, the site of their action. Background: Based on the fact that ARBs had beneficial effects in reducing mortality of patients with cardiovascular disorders, specifically those susceptible to risk of acute heart failure (AHF) associated with reduced left ventricular ejection (LVEF), the authors’ hypothesized that the use of one type of the commonly prescribed ARB drugs in combination with other cardiovascular drugs might be having more beneficial actions in overall patient survivability, and felt the need for conducting a comparative survey of patient data for two selected ARB drug molecules, Losartan and Candesartan which were prescribed in majority of the patients in Sweden in the past few years.

Methods Design: The authors intended to explore all patient data from the official Swedish patient heart failure registry (HR) encompassing a period of nine years from 2000-2009, during which majority of the patients had been prescribed the drugs under investigation. Subsequently they intended to compare the effects of the two drugs using advanced statistical tools and determine whether one accounted for better patient survivability figures over the other or not. Setting: The setting for the study was 62 hospitals and 60 outpatient clinics in Sweden which contributed patient data to the official Swedish HR registry over the span of period under investigation by the authors and was therefore likely to yield pertinent data for this study.

Sample Population: Out of a total of 30254 patients, 5139 patients were identified to have been treated with either of the chosen drugs for this study. Almost identical number of patients for either of the drugs, Losartan (n=2500) and Candesartan (n=2639) were identified, which offered data for a healthy statistical comparison. Inclusion Criteria: History of susceptibility to acute heart failure with LVEF and prescription of either of the two drugs under investigation. Exclusion Criteria: Treatment with other ARBs rather than the two drugs under investigation.

Intervention: Treatment either with Losartan or Candesartan in combination with other drugs usually prescribed for patients at risk of AHF. Outcome Measures: Mortality figures due to all causes at 1 and 5 years in patients prescribed these drugs. Statistical Analysis: Data obtained