The three medications are known as antithrombotic agents. Barry Massie, MD, UCSF professor of medicine and chief of cardiology at the SFVAMC, headed the study.
Results of the Warfarin and Antiplatelet Trial in Chronic Heart Failure (WATCH) -- the largest trial of antithrombotic therapies conducted in chronic heart failure patients -- were presented today at the annual meeting of the American College of Cardiology in New Orleans.
Study results showed no major differences among the three medications -- warfarin (Coumadin), aspirin and clopidogrel (Plavix)-- when investigators analyzed the primary endpoint, which was a combination of death, non-fatal heart attacks and strokes.
However, the study was terminated early, so clinically important differences cannot be excluded with certainty, according to the researchers. Massie noted that a second endpoint -- hospitalizations for worsening heart failure -- occurred significantly less frequently in patients treated with warfarin than in those receiving aspirin.
"We were not surprised by the finding of more heart failure with aspirin because it is consistent with findings from smaller studies. However, this result must be interpreted with caution because it was one of many analyses performed and the primary endpoints of the study did not show major differences between these agents," he said.
Earlier analyses and studies had suggested that aspirin itself may have a negative effect in CHF patients, possibly as a result of reducing the effectiveness of angiotensin converting enzymes (ACE) inhibitors, which are a cornerston
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Contact: Maureen McInaney
mmcinaney@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
9-Mar-2004