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September 3, 1992New England Journal of Medicine

Effect of Enalapril on Mortality and the Development of Heart Failure in Asymptomatic Patients with Reduced Left Ventricular Ejection Fractions

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Why the study?

Does enalapril reduce mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions (≤0.35)?

Population

n=4,228 asymptomatic patients with reduced left ventricular ejection fractions who were not receiving drug…

Comparison

Enalapril 2.5 to 20 mg per day vs Placebo

Design

RCT, Randomly assigned, Double-blind

Follow-up

averaged 37.4 months

Discussion

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Overview

Supports enalapril initiation in asymptomatic LVEF ≤0.35 to delay symptomatic HF; extends ACE inhibitor evidence to prevention.

Structured PICO

Does enalapril reduce mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions (≤0.35)?

P
Population
n=4,228 asymptomatic patients with reduced left ventricular ejection fractions (≤0.35) who were not receiving drug treatment for heart failure.
I
Intervention
Enalapril 2.5 to 20 mg per day
C
Comparator
Placebo
O
Outcome
Total mortality, mortality from cardiovascular causes, development of heart failure, and hospitalization for heart failurehard clinical

In patients with asymptomatic left ventricular dysfunction, enalapril significantly delays the onset of symptomatic heart failure and reduces heart failure hospitalizations.

Cite This Study

A 1992 study studied this question.

synapsesocial.com/papers/6a7cde28efc0738ab25aed06https://doi.org/10.1056/nejm199209033271003
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Also Consider

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

  1. 1Effects of Enalapril on Mortality in Severe Congestive Heart Failure1987 · 5,137 citations
  2. 2Changes in hypertension treatment and in congestive heart failure mortality in the United States.1989 · 149 citations
  3. 3Effect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure1991 · 8,072 citations
  4. 4The Natural History of Congestive Heart Failure: The Framingham Study1971 · 3,492 citations
  5. 5Regression Models and Life-Tables1972 · 39,932 citations