PMID- 11127445
OWN - NLM
STAT- MEDLINE
DCOM- 20010111
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 36
IP  - 7
DP  - 2000 Dec
TI  - Outcome of patients with congestive heart failure treated with standard versus 
      high doses of enalapril: a multicenter study. High Enalapril Dose Study Group.
PG  - 2090-5
AB  - OBJECTIVES: We sought to prospectively and randomly compare survival with 
      clinical and hemodynamic variables in patients with congestive heart failure 
      (CHF) treated with standard versus high doses of enalapril. BACKGROUND: 
      Angiotensin-converting enzyme (ACE) inhibitors produce hemodynamic and 
      symptomatic benefits in patients with CHF, but there is still controversy about 
      the optimal dose in this clinical setting. METHODS: Two hundred and forty-eight 
      patients with advanced CHF (age 56.3+/-12 years) were randomized to receive a 
      maximal tolerated dose of enalapril, up to 20 mg/day in group 1 (mean dose 
      achieved 17.9+/-4.3 mg/day, n = 122) and 60 mg/day in group 2 (mean dose achieved 
      42+/-19.3 mg/day, n = 126). RESULTS: At enrollment, patients in group 1 were in 
      New York Heart Association (NYHA) functional class 2.6+/-0.7 and had a mean 
      systolic blood pressure (SBP) of 117+/-18 mm Hg, a mean heart rate (HR) of 
      85+/-16 beats/min and a left ventricular ejection fraction (LVEF) of 20.0+/-9.8%. 
      In group 2, patients were in NYHA class 2.6+/-0.7; their SBP was 118+/-17 mm Hg, 
      HR 83+/-15 beats/min and LVEF 18.8+/-8.1%. There were no significant differences 
      in these characteristics between the two groups of patients at enrollment. After 
      12 months of follow-up, 22 (18%) of 122 patients in group 1 and 23 (18%) of 126 
      patients in group 2 had died (p = 0.995, with 80% power of the study to detect a 
      delta difference of 13%). The NYHA class was the same (1.9+/-0.7) in both groups; 
      SBP was 111+/-16 and 111+/-17 mm Hg, HR 77+/-12 and 79+/-13 beats/min and LVEF 
      31+/-19% and 30+/-12% in groups 1 and 2, respectively. These differences were not 
      statistically significant. The study had a power of 80% to detect (p = 0.05) the 
      following changes: 13% in death rate, 0.25 units in NYHA class, 6 mm Hg in SBP, 5 
      beats/min in HR and 6% in LVEF. CONCLUSIONS: No significant differences were 
      found in survival and clinical and hemodynamic variables between patients 
      receiving standard and those receiving high doses of enalapril.
FAU - Nanas, J N
AU  - Nanas JN
AD  - University of Athens School of Medicine, Department of Clinical Therapeutics, 
      Alexandra Hospital, Greece.
FAU - Alexopoulos, G
AU  - Alexopoulos G
FAU - Anastasiou-Nana, M I
AU  - Anastasiou-Nana MI
FAU - Karidis, K
AU  - Karidis K
FAU - Tirologos, A
AU  - Tirologos A
FAU - Zobolos, S
AU  - Zobolos S
FAU - Pirgakis, V
AU  - Pirgakis V
FAU - Anthopoulos, L
AU  - Anthopoulos L
FAU - Sideris, D
AU  - Sideris D
FAU - Stamatelopoulos, S F
AU  - Stamatelopoulos SF
FAU - Moulopoulos, S D
AU  - Moulopoulos SD
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 69PN84IO1A (Enalapril)
SB  - IM
CIN - J Am Coll Cardiol. 2000 Dec;36(7):2096-7. PMID: 11127446
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/*administration & dosage
MH  - Enalapril/*administration & dosage
MH  - Female
MH  - Heart Failure/*drug therapy/mortality/physiopathology
MH  - Hemodynamics/drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2000/12/29 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/12/29 11:00
PHST- 2000/12/29 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/12/29 11:00 [entrez]
AID - S0735109700010251 [pii]
AID - 10.1016/s0735-1097(00)01025-1 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2000 Dec;36(7):2090-5. doi: 10.1016/s0735-1097(00)01025-1.