Publication

EFFECTS OF ACETYLSALICYLIC-ACID ON PERIPHERAL HEMODYNAMICS IN PATIENTS WITH CHRONIC HEART-FAILURE TREATED WITH ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS

VANWIJNGAARDEN, J., SMIT, AJ., DEGRAEFF, PA., VANGILST, WH., VANDERBROEK, SAJ., VANVELDHUISEN, DJ., LIE, KI. & WESSELING, H., Feb-1994, In : Journal of Cardiovascular Pharmacology. 23, 2, p. 240-245 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

Cyclooxygenase inhibitors may affect the hemodynamic status of patients with heart failure adversely and may also block the vasodilatory effects of angiotensin-converting enzyme (ACE) inhibitors in such patients. Relatively low doses of the cyclooxygenase inhibitor acetylsalicylic acid (ASA) are now used routinely in ischemic heart disease, the most important cause of heart failure. Therefore, we investigated the hemodynamic interaction between ASA and captopril in heart failure. In a randomized, cross-over study, 13 patients with congestive heart failure (CHF) who were already receiving maintenance treatment with an ACE inhibitor received a single dose of 25 mg captopril combined with 236 mg ASA or placebo. Peripheral blood flow was studied noninvasively by venous occlusion plethysmography of the calves. Liver blood flow was estimated from indocyanine green (ICG) clearance. Administration of captopril alone significantly decreased blood pressure (BP), and ICG clearance. Calf blood flow remained unchanged. However, after arterial occlusion, hyperemic calf blood flow persisted for longer. Captopril alone did not significantly change the plasma levels of the vasodilating prostaglandins PGI(2) and PGE(2) or the vasoconstricting thromboxane A(2) (TXA(2)). In contrast, captopril combined with ASA reduced the plasma levels of these vasoactive substances, with significant decreases in PGE(2) and TXA(2) as compared with captopril alone, yet the hemodynamic alterations after captopril plus ASA were similar to those observed after captopril alone. A single antithrombotic dose of ASA (236 mg) in 13 patients with CHF [New York Heart Association (NYHA) class II-IV] undergoing chronic treatment with ACE inhibitors had no discernible effect on hemodynamic status. These results cannot be extrapolated to chronic ASA administration and must be interpreted with caution with regard to patients in NYHA stage IV of the disease.

Original languageEnglish
Pages (from-to)240-245
Number of pages6
JournalJournal of Cardiovascular Pharmacology
Volume23
Issue number2
Publication statusPublished - Feb-1994

    Keywords

  • CAPTOPRIL, ACETYLSALICYLIC ACID, CONGESTIVE HEART FAILURE, PROSTAGLANDINS, VENOUS OCCLUSION PLETHYSMOGRAPHY, PROSTAGLANDINS, ASPIRIN, DISEASE

ID: 6374437