The Angiotensin Converting Enzyme (ACE) Inhibitor SwitchBack Study

The ACEi SwitchBack Study

Status

UNKNOWN

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT01162980

Enrollment

100

Registered

2010-07-15

Start date

2010-07-31

Completion date

2012-07-31

Last updated

2010-07-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart Failure

Keywords

ACE inhibitors, ARBs

Brief summary

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.

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Healthy volunteers

Inclusion criteria

* 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

Exclusion criteria

* 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 * potassium \>5.0 mmol/L

Design outcomes

Primary

Measure	Time frame	Description
proportion of patients on ARB who are switched back to ACEi and\ who tolerate ACEi	6 months	Patients with heart failure who are on ARB who do not clear contra-indication to ACEi will be switched to an ACei. their tolrance to this will be evaluated

Countries

Canada

Outcome results