A Pharmacogenomic Study of Candesartan in Heart Failure

Principal Inclusion Criteria:

• Male or female > or = 18 years old.
• Symptomatic CHF corresponding to NYHA class II-IV symptoms for at least 4 weeks prior randomization.
• LVEF < or = 40%
• Treatment with an optimal and stable dose of ACE inhibitor for at least 4 weeks prior to enrolment in the study.

Principal Exclusion Criteria:

• Treatment with an ARB within 8 weeks prior to randomization.
• Known hypersensitivity to ARBs or ACE inhibitors.
• Creatinine clearance < 30 ml/min or serum creatinine > 221
• Current serum potassium > or = 5.0 mmol/L or a history of marked ACE inhibitor or ARB induced hyperkalemia.
• Known bilateral renal artery stenosis.
• Current symptomatic hypotension and/or systolic B.P. < 90 mmHg.
• Decompensated heart failure described as hospitalization or I.V. administration of medication in emergency room or heart failure clinic within 4 weeks
• Stroke, acute coronary syndrome, PCI within the last 4 weeks before randomization.
• Connective tissue disease or chronic inflammatory condition
• Acute inflammatory process such as an infection or gout attack in the last 2 weeks.
• Pregnant or lactating women or women of childbearing potential who are not protected from pregnancy by an accepted method of contraception.