PMID- 1725036
OWN - NLM
STAT- MEDLINE
DCOM- 19920428
LR  - 20161123
IS  - 0160-2446 (Print)
IS  - 0160-2446 (Linking)
VI  - 18 Suppl 2
DP  - 1991
TI  - A comparison of the efficacy and safety of ramipril and digoxin added to 
      maintenance diuretic treatment in patients with chronic heart failure.
PG  - S180-3
AB  - The efficacy and safety of ramipril were compared with that of digoxin in a 
      prospective, randomized, double-blind, crossover study of 35 patients with 
      congestive heart failure (CHF), New York Heart Association (NYHA) grades II to 
      IV, stabilized on diuretic maintenance therapy. Major assessments were conducted 
      at baseline and at the end of each 10-week treatment period: primary efficacy 
      variables were total exercise duration (modified Bruce, treadmill), NYHA grade, 
      and clinical signs and symptoms (by visual analogue score) of heart failure. 
      Twenty-seven patients completed the study. There were two deaths (one on each 
      study drug) and six patient withdrawals (one on ramipril and five on digoxin). 
      Although the NYHA grade was significantly better on ramipril than on digoxin, 
      there were no other important differences in the relief of either signs or 
      symptoms of heart failure. A significant order effect was observed with the 
      exercise testing data and therefore only data in the first active treatment 
      period were analyzed; no significant differences were noted. There were fewer 
      reports of adverse effects, and no clinically significant episodes of 
      hyperkalemia or renal impairment on ramipril. We conclude that ramipril seems to 
      be better tolerated and marginally more effective than digoxin in the management 
      of patients with moderate to severe chronic CHF, stabilized on maintenance 
      diuretic therapy.
FAU - Kholeif, M A
AU  - Kholeif MA
AD  - Blood Pressure Unit, Western Infirmary, Glasgow, Scotland.
FAU - Pringle, S
AU  - Pringle S
FAU - Kesson, E
AU  - Kesson E
FAU - Murray, G
AU  - Murray G
FAU - Kennedy, J A
AU  - Kennedy JA
FAU - Lorimer, A R
AU  - Lorimer AR
FAU - Stock, J K
AU  - Stock JK
FAU - Brown, J J
AU  - Brown JJ
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Bridged Bicyclo Compounds)
RN  - 0 (Diuretics)
RN  - 73K4184T59 (Digoxin)
RN  - L35JN3I7SJ (Ramipril)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/adverse effects/*therapeutic use
MH  - Antihypertensive Agents/adverse effects/*therapeutic use
MH  - Blood Pressure/drug effects
MH  - Bridged Bicyclo Compounds/adverse effects/*therapeutic use
MH  - Chronic Disease
MH  - Digoxin/adverse effects/*therapeutic use
MH  - Diuretics/adverse effects/*therapeutic use
MH  - Double-Blind Method
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Ramipril
EDAT- 1991/01/01 00:00
MHDA- 1991/01/01 00:01
CRDT- 1991/01/01 00:00
PHST- 1991/01/01 00:00 [pubmed]
PHST- 1991/01/01 00:01 [medline]
PHST- 1991/01/01 00:00 [entrez]
PST - ppublish
SO  - J Cardiovasc Pharmacol. 1991;18 Suppl 2:S180-3.