© 2007 European Society of Cardiology
Effects of aspirin and clopidogrel on plasma brain natriuretic peptide in patients with heart failure receiving ACE inhibitors
a Department of Cardiology, Cochin Hospital Paris, France
b Department of Nuclear Medicine, Cochin Hospital Paris, France
c Department of Cardiology, Beaujon Hospital Clichy, France
d Department of Internal Medicine-Therapeutic Research Unit, Lariboisière Hospital Paris, France
* Corresponding author. Department of Cardiology, Cochin Hospital, 27 rue du fg Saint-Jacques, 75014 Paris, France. Tel.: +33 1 58 41 22 80; fax: +33 1 58 41 16 05. E-mail address: christophe.meune{at}cch.ap-hop-paris.fr
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Abstract |
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Background: By inhibiting prostaglandins, aspirin may be deleterious in heart failure (HF) and/or may counteract angiotensin-converting enzyme (ACE) inhibitor efficacy. Conversely, clopidogrel has no effect on prostaglandin metabolism.
Aim: To investigate the effect of aspirin and clopidogrel on brain natriuretic peptide (BNP) levels in HF patients treated with ACE inhibitors.
Methods: 36 patients with stable HF (65±13 years, 24 males/12 females, NYHA class II to IV, ejection fraction <40%, 13 with coronary disease, all treated with ACE inhibitors) were enrolled in this prospective, double-blind study and randomised to aspirin 325 mg/day or clopidogrel 75 mg/day for 14 days. BNP was determined at day 0 and day 14.
Results: 19 patients were randomised to aspirin and 17 to clopidogrel. Baseline characteristics were similar in both groups. BNP levels increased in the aspirin group from day 0 to day 14 (107±103 to 144±149 pg/ml, p=0.04) whereas clopidogrel had no effect (104±107 and 97±99 pg/ml respectively, p=0.61).
Conclusion: This study demonstrates an adverse effect of aspirin 325 mg/day on BNP plasma levels in HF patients treated with ACE inhibitors. In contrast clopidogrel 75 mg/day had no effect.
Key Words: Angiotensin converting enzyme inhibitor • Aspirin • Brain natriuretic peptide • Clopidogrel
Received June 30, 2005; Revised January 18, 2006; Accepted June 12, 2006
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