PMID- 12189330
OWN - NLM
STAT- Publisher
LR  - 20191120
IS  - 1751-7133 (Electronic)
IS  - 1527-5299 (Linking)
VI  - 5
IP  - 1
DP  - 1999 Jan-Feb
TI  - Effects of fosinopril on exercise tolerance, symptoms, and clinical outcomes in 
      patients with decompensated heart failure.
PG  - 27-34
AB  - The purpose of this prospective, multicenter, randomized, double blind, placebo 
      controlled study was to determine the clinical effects of fosinopril in patients 
      with decompensated or worsening heart failure (HF). Patients >/=18 years with New 
      York Heart Association (NYHA) functional class II-IV HF who had been hospitalized 
      or seen in the ER or outpatient clinic for treatment of worsening or 
      decompensated HF were eligible. Patients had to be on diuretic therapy and have a 
      left ventricular ejection fraction (LVEF) </=35% and a treadmill exercise 
      tolerance test (ETT) duration of </=8 minutes. Randomized patients began 12 weeks 
      of fosinopril 10 mg (or placebo) qAM and were titrated within 4 weeks to 
      fosinopril 20 mg and then to 40 mg (or placebo) qAM (if seated, systolic blood 
      pressure (SBP) >/=90 mm Hg). ETTs (modified Naughton protocol) were performed at 
      weeks 1, 3, 6, and 12. A total of 206 patients (mean age 62 years) were 
      randomized to fosinopril (n=102) or placebo (n=104). Most patients were NYHA 
      functional class III (58%) or IV (30%) at presentation; 145 patients completed 12 
      weeks of treatment (fosinopril, n=85; placebo, n=60). After adjustment for 
      baseline imbalances and investigator effects, fosinopril-treated patients had a 
      513 second mean exercise duration at endpoint vs. a 489 second duration in 
      placebo-treated patients (p=0.353). When the analysis was adjusted for the impact 
      of dropouts on ETT time, fosinopril-treated patients had a greater exercise 
      duration than those treated with placebo (p=0.043). Fewer patients in the 
      fosinopril group were discontinued from study medication (p=0.008) or 
      hospitalized (p=0.005) for worsening HF. At endpoint, more patients improved 
      their NYHA Functional Class and fewer had worsened with fosinopril vs. placebo 
      (p=0.018); fosinopril-treated patients showed improvements in dyspnea (p=0.054), 
      fatigue (p=0.052), edema (p=0.012), and paroxysmal nocturnal dyspnea (p=0.003) 
      vs. the placebo group. Once-daily fosinopril had a favorable effect on 
      dropout-adjusted exercise tolerance, reduced the frequency of discontinuations or 
      hospitalizations for worsening HF, improved HF signs and symptoms, and was safe 
      and well tolerated. (c)1999 by CHF, Inc.
FAU - Shettigar, U
AU  - Shettigar U
AD  - Bay Pines VA Medical Center, Bay Pines, FL.
FAU - Hare, T
AU  - Hare T
FAU - Gelperin, K
AU  - Gelperin K
FAU - Ilgenfritz, J P
AU  - Ilgenfritz JP
FAU - Deitchman, D
AU  - Deitchman D
FAU - Blumenthal, M
AU  - Blumenthal M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Congest Heart Fail
JT  - Congestive heart failure (Greenwich, Conn.)
JID - 9714174
EDAT- 2002/08/22 10:00
MHDA- 2002/08/22 10:00
CRDT- 2002/08/22 10:00
PHST- 2002/08/22 10:00 [pubmed]
PHST- 2002/08/22 10:00 [medline]
PHST- 2002/08/22 10:00 [entrez]
PST - ppublish
SO  - Congest Heart Fail. 1999 Jan-Feb;5(1):27-34.