Rationale,design and baseline characteristics of a study to evaluate effects of candesartan on cardiovascular events after drug-eluting stent implantation in patients with ischemic heart disease

Aim: few multicenter studies have assessed the effects of angiotensin receptor blockers on cardiovascular events after drug-eluting stent implantation in patients with ischemic heart disease. methods: an open-label multicenter randomized prospective study is in progress to evaluate the effects of candesartan on cardiovascular events in patients with ischemic heart disease after implantation of sirolimus- and/or paclitaxel-eluting stents. results: a total of 1,145 patients were enrolled at 39 institutes in the candesartan for prevention of cardiovascular events after cypher or taxus coronary stenting (4c trial). patients were randomized into a group treated with candesartan (n=602) and a group treated with standard medical therapy without candesartan (n=543). the primary endpoint of the 4c trial is a composite of all-cause death,successful resuscitation after cardiopulmonary arrest and cardiovascular events including non-fatal myocardial infarction,unstable angina requiring emergent hospitalization,congestive heart failure requiring emergent hospitalization and cerebrovascular attacks. all patients will be followed-up for 36 months. conclusions: the 4c trial will be the first multicenter study to elucidate the effects of candesartan after drug-eluting stent implantation and may provide new information to optimize medical therapy after percutaneous coronary interventions.