The Angiotensin Converting Enzyme (ACE) Inhibitor SwitchBack Study
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ClinicalTrials.gov Identifier: NCT01162980
Verified July 2010 by McGill University Health Center. Recruitment status was: Recruiting
ACE inhibitors have been studied extensively in the treatment of heart failure and have been shown to be beneficial in all its stages. Studies with the use of angiotensin receptor blockers (ARBs) in chronic heart failure have not shown equivalent results. Many patients are on an ARB for a variety of reasons. Some of these may have had cough as a symptom of heart failure and not due to medication side effect. According to guidelines, angiotensin converting enzyme inhibitors (ACEi) are still first-line therapy in the treatment of heart failure. As ACEi have been extensively studied showing improvement in morbidity and mortality all patients should be on this treatment unless absolutely contraindicated.
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Ages Eligible for Study:
Child, Adult, Senior
Sexes Eligible for Study:
Accepts Healthy Volunteers:
heart failure patients followed in heart failure clinics in Canada
heart failure patients who have indications for ACEi but are currently on ARBs with no absolute contraindications to ACEi
patients with an ejection fraction of < or = 35% verified in the last 12 months by echo, angio, or nuc med who are NYHA class I to IV and followed in a heart failure clinic for three months
on beta-blockers, unless contra-indicated
stable on current meds for 3 months (except dose of diuretics)
able to give informed consent
documented angioedema/anaphylaxis with prior ACEi use
documented worsening renal failure, hyperkalemia, cough and gastrointestinal symptoms that are definitely believed to be due to ACEi