Aspirin 325 mg/day significantly increased plasma BNP levels from 107 to 144 pg/ml (p=0.04) in heart failure patients on ACE inhibitors, whereas clopidogrel 75 mg/day had no effect (p=0.61).
RCT (n=36)
Double-blind
randomised
Does aspirin compared to clopidogrel increase plasma BNP levels in patients with stable heart failure receiving ACE inhibitors?
Aspirin 325 mg/day, but not clopidogrel 75 mg/day, significantly increases plasma BNP levels in stable heart failure patients treated with ACE inhibitors over a 14-day period.
p-value: p=0.04
BACKGROUND: By inhibiting prostaglandins, aspirin may be deleterious in heart failure (HF) and/or may counteract angiotensin-converting enzyme (ACE) inhibitor efficacy. Conversely, clopidogrel has no effect on prostaglandin metabolism. AIM: To investigate the effect of aspirin and clopidogrel on brain natriuretic peptide (BNP) levels in HF patients treated with ACE inhibitors. METHODS: 36 patients with stable HF (65+/-13 years, 24 males/12 females, NYHA class II to IV, ejection fraction <40%, 13 with coronary disease, all treated with ACE inhibitors) were enrolled in this prospective, double-blind study and randomised to aspirin 325 mg/day or clopidogrel 75 mg/day for 14 days. BNP was determined at day 0 and day 14. RESULTS: 19 patients were randomised to aspirin and 17 to clopidogrel. Baseline characteristics were similar in both groups. BNP levels increased in the aspirin group from day 0 to day 14 (107+/-103 to 144+/-149 pg/ml, p=0.04) whereas clopidogrel had no effect (104+/-107 and 97+/-99 pg/ml respectively, p=0.61). CONCLUSION: This study demonstrates an adverse effect of aspirin 325 mg/day on BNP plasma levels in HF patients treated with ACE inhibitors. In contrast clopidogrel 75 mg/day had no effect.
Meune et al. (2006) conducted an RCT in Heart Failure (n=36). Aspirin vs. Clopidogrel 75 mg/day was evaluated on Brain natriuretic peptide (BNP) levels at day 14 (p=0.04). Aspirin 325 mg/day significantly increased plasma BNP levels from 107 to 144 pg/ml (p=0.04) in heart failure patients on ACE inhibitors, whereas clopidogrel 75 mg/day had no effect (p=0.61).