University to study the treatment of chronic heart failure

28 March 2011

The University of Hull’s Department of Cardiology has secured £5 million to study the effect of Clopidogrel and Aspirin on patients with chronic heart failure.

Professor John ClelandThe Clopidogrel vs Aspirin in Chronic Heart Failure (CACHE) study is the first of its kind in the UK. The five year study will involve 3000 patients from 350 sites across the UK and is funded by the Health Technology Assessment (HTA) programme.

< Professor John Cleland

Aspirin and clopidogrel both reduce the stickiness of platelets in the blood in order to inhibit blood clotting, but whether one is better than the other is unknown. The National Institute for Clinical Excellent (NICE) recommends aspirin for patients with heart failure but many other international guidelines have concerns about the use of aspirin in such patients because, unlike clopidogrel, it may reduce the efficacy of other treatments. Whether or not clopidogrel is as good as or better than aspirin for patients with heart failure is uncertain. With the move towards evidence-based practice, it is important that both medicines are properly assessed and compared in a large scale study.

Patients will be assessed for their suitability for the study and will then be prescribed either aspirin or clopidogrel by their family doctor. There is one formal assessment at 6 months but every two months the patient will be asked to report on how they are feeling, the severity of their symptoms and on any side effects, so that the research team can build up a picture of how each drug performs. 

The study is pioneering because, instead of doctors and nurses evaluating patients locally, which is expensive and time-consuming, patients communicate directly by telephone and postal questionnaires with a national monitoring office based in Hull. Also, GPs and hospitals will send copies of medical records periodically rather than completing forms. This cuts costs by up to 90% compared to conventional trials.

The study is led by Professor John Cleland and involves colleagues from the Post Graduate Medical Institute, Hull York Medical School and the Hull and East Yorkshire NHS Trust.

Professor John Cleland explains: “Most patients with heart failure are treated with aspirin to try and reduce the risks of heart attack and stroke but aspirin may reduce the benefits of other treatments such as ACE inhibitors*. Clopidogrel may be a better alternative but we can’t just assume that; we have to prove it.”


Page last updated by Andrea Luquesi on 3/31/2011

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Notes to Editors

*ACE inhibitors are medicines that are used in the treatment of various disorders. Their correct name is Angiotensin Converting Enzyme Inhibitors. They include: captopril, cilazapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril, ramipril and trandolapril. Each of these medicines also has various different brand names.

About Professor John Cleland
John Cleland is Professor of Cardiology at the University of Hull. His main area of interest is in heart failure, extending from its epidemiology and prevention, to drug discovery and thence to the large randomized trials required to prove which treatments are effective and the development and implementation of guidelines for the application of current knowledge.

Particular current interests include the role of myocardial hibernation contributing to heart failure and its treatment (including beta-blockers and revascularisation), diastolic heart failure in the elderly, the potential deleterious effect of aspirin in heart failure, ventricular resynchronization, telemonitoring, implantable haemodynamic monitoring devices, atrial fibrillation in heart failure and new interventions for acute decompensated heart failure.

Professor Cleland heads The Academic Unit of Cardiology that includes 3 Senior Lecturers and a team of basic and clinical scientists, technicians and research nurses dedicated to the above research programme.

Professor Cleland is Past Chairman of the British Society for Heart Failure, The Founding Editor of the European Journal of Heart Failure (an official sub-specialty journal of the European Society of Cardiology), an editor on the Cochrane Collaborations Cardiovascular Group that promotes evidence-based medicine by way of systematic reviews and a regional cardiovascular representative for cardiovascular medicine for the Comprehensive Clinical Research Network at the National Institute of Health Research.