PMID- 2024543
OWN - NLM
STAT- MEDLINE
DCOM- 19910605
LR  - 20131121
IS  - 0300-5860 (Print)
IS  - 0300-5860 (Linking)
VI  - 80 Suppl 2
DP  - 1991
TI  - Effect of ACE-inhibition on renal function in severe congestive heart failure.
PG  - 50-4
AB  - The long-term prognosis in severe congestive heart failure is very poor. 
      Therapeutic regimens, in order to improve prognosis, should directly or 
      indirectly influence the compensatory systems that are activated, ACE-inhibitor 
      therapy has emerged as an important regimen in this context. In the 
      CONSENSUS-trial (3), we could demonstrate that the addition of enalapril to 
      conventional therapy in severe CHF significantly improved survival. The 
      experience from this study forms the background for the recommendations in this 
      work. 253 patients with severe heart failure (New York Heart Association (NYHA) 
      Classification functional class IV) were randomized at 35 Scandinavian centers to 
      placebo (n = 126) or enalapril (n = 127), in addition to their conventional 
      therapy. The treatment dose of enalapril varied between 2.5 and 40 mg daily (man 
      18.3 mg). Blood samples for measurement of serum electrolytes and serum 
      creatinine were taken repeatedly during follow-up. There seems to be about a 10% 
      increase in creatinine within 2 weeks of initiating enalapril therapy. This 
      increase seems to be independent of baseline creatinine level. Adverse experience 
      regarding serum creatinine was reported in 22 placebo-treated patients and in 51 
      patients in the enalapril group. This reporting was based upon the investigators' 
      feelings of significant importance of the observation and not on symptomatology. 
      This was the main reason for permanent withdrawal in 2 and 7 patients, 
      respectively. During initiation of enalapril therapy the blood pressure response 
      is important after the very first dose, but for renal function the response may 
      not appear until several days later. However, in most patients there are no 
      problems with starting enalapril.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Swedberg, K
AU  - Swedberg K
AD  - Department of Medicine, University of Goteborg, Sweden.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Z Kardiol
JT  - Zeitschrift fur Kardiologie
JID - 0360430
RN  - 69PN84IO1A (Enalapril)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Combined Modality Therapy
MH  - Creatinine/blood
MH  - Drug Therapy, Combination
MH  - Enalapril/adverse effects/*therapeutic use
MH  - Glomerular Filtration Rate/drug effects/physiology
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Hemodynamics/drug effects/physiology
MH  - Humans
MH  - Hypotension/chemically induced/physiopathology
MH  - *Kidney Function Tests
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  - Z Kardiol. 1991;80 Suppl 2:50-4.