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Clopidogrel is associated with a lesser increase in NT-proBNP when compared to aspirin in patients with ischemic

Borut Jug1, Miran Sebestjen, Miso Sabovic

  • 1Department of Vascular Diseases, University Clinical Centre, Ljubljana, Slovenia.

Journal of Cardiac Failure
|August 17, 2006
PubMed

Insights

Aspirin use in heart failure patients taking ACE inhibitors was linked to a significant rise in NT-proBNP levels, indicating worse outcomes. Clopidogrel showed a more favorable effect on heart failure progression.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biomarkers

Background:

  • Aspirin may worsen heart failure outcomes due to interactions with ACE inhibitors.
  • This study investigated clopidogrel versus aspirin in heart failure patients on ACE inhibitors.

Purpose of the Study:

  • To compare the effects of clopidogrel and aspirin on heart failure progression.
  • To assess changes in amino-terminal pro-brain natriuretic peptide (NT-proBNP) levels.

Main Methods:

  • Open-label, randomized, crossover study with 18 ischemic heart failure patients.
  • Patients received 8 weeks of aspirin then 8 weeks of clopidogrel, or vice versa.
  • NT-proBNP levels were measured using sandwich immunoassay.

Main Results:

  • Aspirin led to an 8-fold greater increase in log-transformed NT-proBNP compared to clopidogrel.
  • Average change in NT-proBNP: 4.757% with aspirin vs. 0.597% with clopidogrel (P = .0395).
  • No significant changes observed in functional class, 6-minute walking test, creatinine, or electrolytes.

Conclusions:

  • Aspirin therapy is associated with a greater increase in natriuretic peptides.
  • This suggests aspirin may be linked to more progressive heart failure in patients on ACE inhibitors.
Abstract

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