PMID- 8682023
OWN - NLM
STAT- MEDLINE
DCOM- 19960816
LR  - 20190512
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 16
IP  - 12
DP  - 1995 Dec
TI  - Fosinopril attenuates clinical deterioration and improves exercise tolerance in 
      patients with heart failure. Fosinopril Efficacy/Safety Trial (FEST) Study Group.
PG  - 1892-9
AB  - This study was a 12-week, double-blind, placebo-controlled, multinational trial 
      of fosinopril in 308 patients with mild to moderately severe heart failure (New 
      York Heart Association [NYHA] functional class IIS 17%, IIM 48%, and III 35%; 
      mean ejection fraction [+/-SD] 26.5% [+/-6.9%]; bicycle exercise duration 1 to 11 
      min). An initial dose of 10 mg once daily was titrated as tolerated to 40 mg once 
      daily. Patients all received diuretic therapy; digoxin was optional. The primary 
      endpoint was maximal bicycle exercise time; a secondary endpoint was occurrence 
      of the following prospectively defined, ordered clinical events indicative of 
      worsening heart failure: death, study discontinuation, hospitalization, emergency 
      room visits, and need for supplemental diuretic. At study endpoint (last value 
      obtained for each patient), bicycle exercise time increased more with fosinopril 
      (38.1 s) than with placebo (23.5 s) (P = 0.101 by ANCOVA and 0.010 by 
      prospectively defined dropout-adjusted endpoint analysis). More patients remained 
      free of clinical events indicative of worsening heart failure when treated with 
      fosinopril (89%) than with placebo (75%), and the worst events of 
      fosinopril-treated patients tended to be less severe than those of placebo 
      patients (P = 0.001). Analysis of the occurrence of individual clinical events 
      showed that the need for supplemental diuretic was markedly reduced with 
      fosinopril (8% vs 20%, of patients, P = 0.002), as were hospitalizations (3% vs 
      12% of patients, P = 0.002) and study discontinuations (2% vs 12% of patients, P 
      < 0.001) for worsening heart failure; the two groups had similar incidences of 
      death (3% of patients in the fosinopril group vs 2% in the placebo group, P = 
      0.723). In addition, symptoms of dyspnoea (P = 0.017), fatigue (P = 0.019), and 
      NYHA functional class (P = 0.008) improved with fosinopril relative to placebo. 
      In conclusion, fosinopril, at an initial dose of 10 mg once daily, subsequently 
      titrated as tolerated to 40 mg once daily, increased exercise tolerance and 
      reduced the frequency of clinical events indicative of worsening heart failure.
FAU - Erhardt, L
AU  - Erhardt L
AD  - Malmo University Hospital, Sweden.
FAU - MacLean, A
AU  - MacLean A
FAU - Ilgenfritz, J
AU  - Ilgenfritz J
FAU - Gelperin, K
AU  - Gelperin K
FAU - Blumenthal, M
AU  - Blumenthal M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - R43D2573WO (Fosinopril)
SB  - IM
MH  - Angiotensin-Converting Enzyme Inhibitors/adverse effects/*therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Drug Administration Schedule
MH  - Exercise Test/*drug effects
MH  - Fosinopril/adverse effects/*therapeutic use
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Hemodynamics/*drug effects/physiology
MH  - Humans
MH  - Prospective Studies
MH  - Treatment Outcome
EDAT- 1995/12/01 00:00
MHDA- 1995/12/01 00:01
CRDT- 1995/12/01 00:00
PHST- 1995/12/01 00:00 [pubmed]
PHST- 1995/12/01 00:01 [medline]
PHST- 1995/12/01 00:00 [entrez]
AID - 10.1093/oxfordjournals.eurheartj.a060844 [doi]
PST - ppublish
SO  - Eur Heart J. 1995 Dec;16(12):1892-9. doi: 
      10.1093/oxfordjournals.eurheartj.a060844.