Do angiotensin-converting enzyme inhibitors prolong life in patients with heart failure treated in clinical practice?
Key result
The ATLAS trial was launched to compare the effects of low and high doses of the ACE inhibitor lisinopril on survival in patients with heart failure.
Why the study?
Does high dose lisinopril improve survival compared to low dose lisinopril in patients with heart failure?
Population
Patients with heart failure
Comparison
High dose lisinopril vs Low dose lisinopril
Design
Review, double-blind
Authors
Discussion
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Implication
Optimal ACE inhibitor dosing for survival in heart failure remains unclear; ATLAS launch leaves the question open for randomized testing.
Key Points
- The aim is to determine if higher doses of ACE inhibitors lead to better survival rates in heart failure patients.
- Conducted a large multinational, double-blind clinical trial (ATLAS) to compare low and high doses of lisinopril.
- Included heart failure patients who were eligible for ACE inhibitor treatment.
- Higher doses of lisinopril produced greater hemodynamic benefits without additional toxicity.
- If higher doses improve mortality, current low-dose practices may limit potential benefits in heart failure treatment.
Study Design
Type
RCT
Blinding
Double-blind
Multicenter
Yes
Structured PICO
Does high dose lisinopril improve survival compared to low dose lisinopril in patients with heart failure?
P
Population
Patients with heart failure
I
Intervention
High dose lisinopril
C
Comparator
Low dose lisinopril
O
Outcome
Survivalhard clinical
This paper outlines the rationale for the ATLAS trial to determine if high doses of ACE inhibitors are necessary to achieve optimal survival benefits in heart failure patients compared to the widely used low doses.
Cite This Study
Milton Packer (1996) conducted an RCT in Heart failure. Lisinopril vs. Low dose lisinopril was evaluated on Survival. The ATLAS trial was launched to compare the effects of low and high doses of the ACE inhibitor lisinopril on survival in patients with heart failure.