heart failure - angiotensin-Converting Enzyme Inhibitors - all type of heart failure clinical trials results meta-analysis

<h1> <a href="TM8-9-angiotensin-Converting Enzyme Inhibitors-heart failure" > <strong>heart failure</strong> - angiotensin-Converting Enzyme Inhibitors </a> - all type of heart failure trial results systematic overview and meta-analysis </h1> <h2>Main characteristics of the included studies</h2> <table> <tr> <th>Trial</th> <th>Treatments</th> <th>Patients</th> <th>Methods</th> </tr> <tr> <td> <a href="../TRC_t617.htm"> SOLVD treatment, 1991 </a> <br> NCT00000516 </td> <td> Enalapril initial dose 2·5 or 5 mg twice daily up to 10 mg twice daily<br>  <i>versus</i> <br> placebo </td> <td> MI >1 month,Congestive HF, LVEF <=35% </td> <td> follow-up 3.5 y<br> n=1285/1284<br> Parallel groups<br> Double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t619.htm"> SOLVD prevention, 1992 </a> <br> NCT00000516 </td> <td> Enalapril initial dose 2·5 or 5 mg twice daily up to 10 mg twice daily<br>  <i>versus</i> <br> placebo </td> <td> MI >1 month,No treatment for CHF, LVEF <=35% </td> <td> follow-up 3.1 y<br> n=2111/2117<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4076.htm"> Colfer, 1992 </a> <br> </td> <td> benazepriltitrated up to 20mg daily<br>  <i>versus</i> <br> placebo </td> <td> Patients with chronic New York Heart Association class II to IV symptoms of CHF and an ejection fraction by radionuclide scanning of less than or equal to 35% </td> <td> follow-up 12-week<br> n=114/58<br> <br> double blind <br> US </td> </tr> <tr> <td> <a href="../TRC_t4077.htm"> McGany, 1991 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=29/32<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4078.htm"> Magnani, 1986 </a> <br> </td> <td> captopril 25 mg t.i.d.<br>  <i>versus</i> <br> placebo </td> <td> patients on digitalis treatment for chronic congestive heart failure (NYHA class II-III) </td> <td> follow-up 1 year<br> n=48/46<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4079.htm"> Bussmann, 1987 </a> <br> </td> <td> captopril<br>  <i>versus</i> <br> placebo </td> <td> patients with severe heart failure (NYHA classes III and IV) on treatment with digitalis and diuretics </td> <td> follow-up 6 months<br> n=12/11<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4080.htm"> Captopril Digoxin Multicenter Research Group, 1988 </a> <br> </td> <td> captopril<br>  <i>versus</i> <br> placebo </td> <td> patients with mild to moderate heart failure </td> <td> follow-up <br> n=104/100<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4082.htm"> Barabino, 1991 </a> <br> </td> <td> captopril (37.5-75 mg/day)<br>  <i>versus</i> <br> placebo </td> <td> old patients (>75y) under treatment with digitalis and/or diuretics </td> <td> follow-up 6 months<br> n=52/49<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4083.htm"> Munich MHFT (Kleber), 1992 </a> <br> </td> <td> captopril 25 mg twice a day<br>  <i>versus</i> <br> placebo </td> <td> patients with congestive heart failure New York Heart Association (NYHA) functional class I-III on standard treatment </td> <td> follow-up 2.7y (median)<br> n=83/87<br> Parallel groups<br> Double blind <br> Germany </td> </tr> <tr> <td> <a href="../TRC_t4084.htm"> Drexler, 1989 </a> <br> </td> <td> cilazapril<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic heart failure </td> <td> follow-up 3 months<br> n=11/10<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4085.htm"> Cleland, 1985 </a> <br> </td> <td> enalapril titrated up to 40mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patients with New York Heart Association functional class II to IV heart failure who were clinically stable on digoxin and diuretic therapy </td> <td> follow-up 8 weeks<br> n=10/10<br> Cross over<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4086.htm"> Rucinska-b (enalapril), 1991 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=55/55<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4087.htm"> CONSENSUS, 1987 </a> <br> </td> <td> enalapril (2.5 to 40 mg per day)<br>  <i>versus</i> <br> placebo </td> <td> severe congestive heart failure (New York Heart Association [NYHA] functional class IV) </td> <td> follow-up 188 days<br> n=127/126<br> Parallel groups<br> double blind <br> Finland, Sweden, Norway </td> </tr> <tr> <td> <a href="../TRC_t4088.htm"> Enalapril CHF investigators, 1987 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=126/130<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4089.htm"> Dickstein, 1991 </a> <br> </td> <td> enalapril<br>  <i>versus</i> <br> placebo </td> <td> men with symptomatic heart failure (functional class II or III) and documented myocardial infarction greater than 6 months previously </td> <td> follow-up 48 weeks<br> n=20/21<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4091.htm"> Rucinska-a (enalapril), 1991 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=67/65<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4092.htm"> Zwehl, 1990 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=183/92<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4093.htm"> Giles, 1990 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=130/63<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4094.htm"> Rucinska-c (lisinopril), 1000 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=28/30<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4095.htm"> Gilbert, 1993 </a> <br> </td> <td> lisinopril<br>  <i>versus</i> <br> placebo </td> <td> subjects with heart failure </td> <td> follow-up 12 weeks<br> n=14/14<br> Cross over<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4096.htm"> Lechat, 1993 </a> <br> </td> <td> perindopril, 2 mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patients with grade II or III New York Heart Association chronic congestive heart failure on baseline diuretic therapy </td> <td> follow-up 3-month<br> n=61/64<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4097.htm"> Riegger, 1990 </a> <br> </td> <td> quinapril (5mg bid, 10 mg bid, 20mg bid)<br>  <i>versus</i> <br> placebo </td> <td> patients with mild to moderate congestive heart failure (CHF) due to arterial hypertension and ischemic heart disease </td> <td> follow-up 12 weeks<br> n=169/56<br> <br> double-blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4098.htm"> Northridge, 1991 </a> <br> </td> <td> quinapril 20mg/d <br>  <i>versus</i> <br> placebo </td> <td> patient with mild heart failure </td> <td> follow-up 8 weeks<br> n=32/32<br> Cross over<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4099.htm"> Uprichard-a, 1994 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=114/110<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4100.htm"> Uprichard-b, 1994 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=105/103<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4101.htm"> Uprichard-c, 1994 </a> <br> </td> <td> <br>  <i>versus</i> <br> </td> <td> </td> <td> follow-up <br> n=139/47<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4103.htm"> Maass-a, 1991 </a> <br> </td> <td> ramipril<br>  <i>versus</i> <br> placebo </td> <td> patients with heart failure </td> <td> follow-up <br> n=87/45<br> <br> <br> </td> </tr> <tr> <td> <a href="../TRC_t4104.htm"> Gordon, 1991 </a> <br> </td> <td> ramipril 10mg/d<br>  <i>versus</i> <br> placebo </td> <td> patients with herat failure and LVFE<=35% </td> <td> follow-up 12 weeks<br> n=94/98<br> Parallel groups<br> double blind <br> USA </td> </tr> <tr> <td> <a href="../TRC_t4105.htm"> Maass-b, 1991 </a> <br> </td> <td> ramirpil 5 or 10 mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patient with NYHA II-III heart failure and LVFE<=40% </td> <td> follow-up 12 weeks<br> n=329/171<br> Parallel groups<br> double blind <br> Europe </td> </tr> <tr> <td> <a href="../TRC_t4106.htm"> Maass-c, 1991 </a> <br> </td> <td> ramipril 10mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patient with heart failure with LVFE<=35% </td> <td> follow-up 12 weeks<br> n=47/48<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t4107.htm"> Lemarie, 1992 </a> <br> </td> <td> ramipril 2.5mg twice daily<br>  <i>versus</i> <br> placebo </td> <td> patient with NYHA II-III heart failure </td> <td> follow-up 24 weeks<br> n=42/43<br> Parallel groups<br> double blind <br> France </td> </tr> <tr> <td> <a href="../TRC_t7265.htm"> Magnani, 1990 </a> <br> </td> <td> captopril<br>  <i>versus</i> <br> placebo </td> <td> patients with congestive heart failure </td> <td> follow-up <br> n=16/16<br> Cross over<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7266.htm"> CMRG, 1983 </a> <br> </td> <td> captopril<br>  <i>versus</i> <br> placebo </td> <td> patients with heart failure refractory to digitalis and diuretic therapy </td> <td> follow-up 12 weeks<br> n=50/42<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7267.htm"> Rieger, 1991 </a> <br> </td> <td> quinalapril 10, 20, or 40 mg/d<br>  <i>versus</i> <br> placebo </td> <td> patients with mild to moderate heart failure </td> <td> follow-up 12 weeks<br> n=225/0<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7268.htm"> Dosseger, 1993 </a> <br> </td> <td> cilazapril titrated up to 2.5 mg/d<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic heart failure (NYHA class II to IV) stabilized on digitalis and/or diuretics </td> <td> follow-up 12 weeks<br> n=7/35<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7269.htm"> Gundersen, 1994 </a> <br> </td> <td> ramipril titrated from 1.25 mg to a maximum of 10 mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patients with NYHA II-III CHF, LVFE<=40% and size of the heart >600ml/m2 for mean or >550ml/m2 for women </td> <td> follow-up 12 weeks<br> n=104/91<br> Parallel groups<br> double blind <br> four Nordic countries </td> </tr> <tr> <td> <a href="../TRC_t7270.htm"> Brown, 1995 </a> <br> </td> <td> fosinopril 10 or 20 mg/day<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic congestive heart failure (NYHA II-III) not taking digitalis </td> <td> follow-up 24 weeks<br> n=116/125<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7271.htm"> Cilazapril-Captopril Multi-centre Group, 1995 </a> <br> </td> <td> cilazapril 1-2.5 mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic heart failure (New York Heart Association classes II-IV) </td> <td> follow-up 12 weeks<br> n=221/114<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7272.htm"> FEST (Erhardt), 1996 </a> <br> </td> <td> fosinopril 40 mg once daily titrated<br>  <i>versus</i> <br> placebo </td> <td> patients with mild to moderately severe heart failure (NYHA II-III) </td> <td> follow-up 12 weeks<br> n=155/153<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7273.htm"> Hampton, 1998 </a> <br> </td> <td> trandolapril titrated up to 4mg/d<br>  <i>versus</i> <br> placebo </td> <td> patients with moderate (New York Heart Association Grades II and III) heart failure </td> <td> follow-up 16 weeks<br> n=144/148<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7274.htm"> Sharpe, 1984 </a> <br> </td> <td> enalapril 5mg twice day<br>  <i>versus</i> <br> placebo </td> <td> patients with New York Heart Association functional class II to III heart failure who were clinically stable on digoxin and diuretic therapy </td> <td> follow-up 3 months<br> n=18/18<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7275.htm"> McGrath, 1985 </a> <br> </td> <td> enalapril<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic congestive cardiac failure </td> <td> follow-up 12 week<br> n=13/12<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7276.htm"> Chrysant, 1985 </a> <br> </td> <td> enalapril<br>  <i>versus</i> <br> placebo </td> <td> patients with congestive heart failure (CHF), New York Heart Association class II-III </td> <td> follow-up 14 weeks<br> n=-9/-9<br> <br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7281.htm"> Nussberger, 1994 </a> <br> </td> <td> quinapril (2.5, 5 or 10 mg b.i.d.)<br>  <i>versus</i> <br> placebo </td> <td> patients with moderate heart failure (ejection fraction < or = 35%) </td> <td> follow-up 12 weeks<br> n=55/0<br> Parallel groups<br> double blind <br> Switzerland, Germany </td> </tr> <tr> <td> <a href="../TRC_t7282.htm"> Quinapril Heart Failure Trial Investigators, 1993 </a> <br> </td> <td> quinapril<br>  <i>versus</i> <br> placebo </td> <td> patients with New York Heart Association class II or III heart failure </td> <td> follow-up 16 weeks<br> n=114/110<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7297.htm"> PEP CHF, 2006 </a> <br> </td> <td> perindopril, 4 mg/day<br>  <i>versus</i> <br> placebo </td> <td> patients aged >=70 years with a diagnosis of heart failure, treated with diuretics and an echocardiogram suggesting diastolic dysfunction and excluding substantial LV systolic dysfunction or valve disease </td> <td> follow-up 26.2 months (range 12-54.2m)<br> n=424/426<br> Parallel groups<br> double blind <br> Europe </td> </tr> <tr> <td> <a href="../TRC_t7301.htm"> Cilazapril-Captopril Multi-centre Group (capt vs pbo), 1995 </a> <br> </td> <td> cilazapril 1-2.5 mg once daily<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic heart failure (New York Heart Association classes II-IV) </td> <td> follow-up 12 weeks<br> n=108/114<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7302.htm"> Cilazapril-Captopril Multi-centre Group (cila vs capt), 1995 </a> <br> </td> <td> cilazapril 1-2.5 mg once daily<br>  <i>versus</i> <br> captopril 25-50mg three times daily </td> <td> patients with chronic heart failure (New York Heart Association classes II-IV) </td> <td> follow-up 12 weeks<br> n=221/108<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t7303.htm"> packer, 1986 </a> <br> </td> <td> captopril 150 mg/d<br>  <i>versus</i> <br> enalapril 40mg/d </td> <td> patient with severe chronic heart failure </td> <td> follow-up 1-3 months<br> n=21/21<br> Parallel groups<br> open <br> </td> </tr> <tr> <td> <a href="../TRC_t8863.htm"> CASSIS (enalapril), 1995 </a> <br> </td> <td> enalapril 5-10mg daily<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic congestive heart failure of NYHA classes II-IV </td> <td> follow-up 12 weeks<br> n=48/48<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t8864.htm"> CASSIS (spirapril), 1995 </a> <br> </td> <td> spirapril 1.5 mg, 3 mg, 6 mg daily<br>  <i>versus</i> <br> placebo </td> <td> patients with chronic congestive heart failure of NYHA classes II-IV </td> <td> follow-up 12 weeks<br> n=-948/48<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t8866.htm"> International Study Group (Lewis), 1989 </a> <br> </td> <td> lisnopril titrated up to 10mg daily<br>  <i>versus</i> <br> placebo </td> <td> patients with congestive heart failure NYHA II-IV </td> <td> follow-up 12 weeks<br> n=87/43<br> Parallel groups<br> double blind <br> New Zealand </td> </tr> <tr> <td> <a href="../TRC_t8867.htm"> NETWORK (2.5 bid vs 10 bid), 1998 </a> <br> </td> <td> enalapril 2.5 mg twice daily<br>  <i>versus</i> <br> enalapril 10 mg twice daily </td> <td> patients with NYHA II-IV heart failure </td> <td> follow-up 6 months<br> n=506/516<br> Parallel groups<br> double blind <br> UK </td> </tr> <tr> <td> <a href="../TRC_t8868.htm"> ATLAS, 1999 </a> <br> </td> <td> lisinopril low dose 2.5-5 mg daily<br>  <i>versus</i> <br> lisnopril high dose 32.5-35 mg daily </td> <td> patients with New York Heart Association class II to IV heart failure and an ejection fraction <=30% </td> <td> follow-up 39 to 58 months<br> n=1596/1568<br> Parallel groups<br> double blind <br> 19 countries </td> </tr> <tr> <td> <a href="../TRC_t8869.htm"> V-HeFT II, 1991 </a> <br> </td> <td> enalapril 20mg daily <br>  <i>versus</i> <br> hydralazine 300 mg plus isosorbide dinitrate 160 mg daily </td> <td> men with chronic congestive heart failure and cardiac dilatation (CT ratio>0.55) or LVEF <45% in association with reduced exercise tolerance and diuretic therapy </td> <td> follow-up 2.5y (range 0.5-5.7y)<br> n=403/401<br> Parallel groups<br> double blind <br> </td> </tr> <tr> <td> <a href="../TRC_t8870.htm"> NETWORK (5 bid vs 10 bid), 1998 </a> <br> </td> <td> enalapril 5 mg twice daily <br>  <i>versus</i> <br> enalapril 10 mg twice daily </td> <td> patients with NYHA II-IV heart failure </td> <td> follow-up 6 months<br> n=510/516<br> Parallel groups<br> double blind <br> UK </td> </tr> </table> <h2>References</h2> <p> <b>SOLVD treatment, 1991 : </b> Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators <i>N Engl J Med 1991;325:293-302</i> [PMID 2057034] </p> <p> <b>SOLVD prevention, 1992 : </b> Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. The SOLVD Investigattors <i>N Engl J Med 1992;327:685-91</i> [PMID 1463530] </p> <p> <b>SAVE, 0 : </b> Pfeffer MA, Braunwald E, Moye LA, Basta L, Brown EJ Jr, Cuddy TE, Davis BR, Geltman EM, Goldman S, Flaker GCEffect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. <i>N Engl J Med 1992 Sep 3;327:669-77</i> [PMID 1386652] </p> <p> <b>AIRE, 0 : </b> Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. <i>Lancet 1993 Oct 2;342:821-8</i> [PMID 8104270] </p> <p> <b>TRACE, 1995 : </b> Kober L, Torp-Pedersen C, Carlsen JE, Bagger H, Eliasen P, Lyngborg K, Videbaek J, Cole DS, Auclert L, Pauly NCA clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group. <i>N Engl J Med 1995 Dec 21;333:1670-6</i> [PMID 7477219] </p> <p> <b>CONSENSUS 2, 0 : </b> Swedberg K, Held P, Kjekshus J, Rasmussen K, Ryden L, Wedel HEffects of the early administration of enalapril on mortality in patients with acute myocardial infarction. 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