Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
January 1, 1996Journal of Cardiovascular Pharmacology

Clinical Benefit of Angiotensin-Converting Enzyme Inhibitors in Chronic Heart Failure

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Do ACE inhibitors improve symptoms, prevent progression of left ventricular dysfunction, and reduce mortality in patients with chronic heart failure?

Population

Patients with chronic heart failure, with or without preceding myocardial infarction

Comparison

Angiotensin-converting enzyme inhibitors vs Placebo

Design

Review

Authors

WKWolfgang KiowskiHeart Failure / CardiomyopathyGSGabor SütschUniversity of ZurichLDL. DösseggerRoche (Switzerland)

Discussion

Loading...

Member takes

Implication

Supports ACE inhibitor use in chronic HF; leaves open integration with contemporary GDMT.

Key Points

  • To evaluate the clinical efficacy of angiotensin-converting enzyme (ACE) inhibitors on symptom relief, left ventricular dysfunction progression, and mortality in patients with chronic heart failure.
  • Reviewed evidence from multiple randomized clinical trials and meta-analyses, including a meta-analysis of six placebo-controlled, 3-month trials evaluating cilazapril.
  • Assessed landmark randomized clinical trials (including CONSENSUS I, SOLVD, V-HeFT-II, SAVE, AIRE, and SMILE) covering heart failure populations with and without prior myocardial infarction.
  • Meta-analysis and trial comparisons confirmed that ACE inhibitors improve exercise tolerance (such as 14% vs. 17% improvements observed for cilazapril and captopril vs. placebo) as a class effect.
  • Large-scale mortality trials consistently demonstrated that ACE inhibition slows the progression of left ventricular dysfunction and significantly reduces mortality.
  • Findings indicate potential secondary benefits on vascular health, including the stabilization of atherosclerotic plaques and potential reductions in post-infarction reinfarction rates.

Structured PICO

Do ACE inhibitors improve symptoms, prevent progression of left ventricular dysfunction, and reduce mortality in patients with chronic heart failure?

P
Population
Patients with chronic heart failure, with or without preceding myocardial infarction
I
Intervention
Angiotensin-converting enzyme (ACE) inhibitors (e.g., cilazapril, captopril)
C
Comparator
Placebo
O
Outcome
Exercise tolerance, progression of left ventricular dysfunction, and mortality

This review summarizes extensive evidence demonstrating that ACE inhibitors improve symptoms, prevent disease progression, and reduce mortality in patients with chronic heart failure.

Cite This Study

Kiowski et al. (1996) studied this question.

synapsesocial.com/papers/6a0f201cf822c924b6bdb67dhttps://doi.org/10.1097/00005344-199600002-00005

Topics

Heart failureHFrEF treatmentHFpEF management
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Influence of angiotensin converting enzyme inhibition on exercise performance and clinical symptoms in chronic heart failure: a multicentre, double-blind, placebo-controlled trial1993 · 24 citations
  2. 2Placebo-Controlled Study of Lisinopril in Congestive Heart Failure1987 · 90 citations
  3. 3Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. The Captopril-Digoxin Multicenter Research Group1988 · 124 citations
  4. 4Hemodynamic Effects and Pharmacokinetics of Oral Milrinone for Short-Term Support in Acute Heart Failure2008 · 22 citations
  5. 5Effect of Enalapril on Mortality and the Development of Heart Failure in Asymptomatic Patients with Reduced Left Ventricular Ejection Fractions1992 · 3,758 citations