Effects of fosinopril on exercise tolerance and clinical deterioration in patients with chronic congestive heart failure not taking digitalis

Brown, Edward J.; Chew, Paul H.; MacLean, A. H.; Gelperin, Kate; Ilgenfritz, John; Blumenthal, Mel

doi:10.1016/s0002-9149(99)80624-9

Cited by 42 publications

(21 citation statements)

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“…[28][29][30] In the few trials that have reported worsening of symptoms, quality of life, or functional class, active treatments produced a meaningful reduction in the risk of clinical worsening only when missing data were imputed or when patients who died were included in the analysis and assigned the worst possible score. 29,[31][32][33] In contrast, the PARADIGM-HF study is among the first trials to demonstrate a reduction of clinical worsening of surviving patients, which is not only of paramount importance to those afflicted with the disease and their families, but also to the physicians who care for them and the insurers who pay for the intensification of treatments.…”

Section: Discussionmentioning

confidence: 99%

Angiotensin Receptor Neprilysin Inhibition Compared With Enalapril on the Risk of Clinical Progression in Surviving Patients With Heart Failure

et al. 2015

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Packer et al Angiotensin Neprilysin Inhibition in Heart Failure 55Background-Clinical trials in heart failure have focused on the improvement in symptoms or decreases in the risk of death and other cardiovascular events. Little is known about the effect of drugs on the risk of clinical deterioration in surviving patients. Methods and Results-We compared the angiotensin-neprilysin inhibitor LCZ696 (400 mg daily) with the angiotensinconverting enzyme inhibitor enalapril (20 mg daily) in 8399 patients with heart failure and reduced ejection fraction in a double-blind trial. The analyses focused on prespecified measures of nonfatal clinical deterioration. In comparison with the enalapril group, fewer LCZ696-treated patients required intensification of medical treatment for heart failure (520 versus 604; hazard ratio, 0.84; 95% confidence interval, 0.74-0.94; P=0.003) or an emergency department visit for worsening heart failure (hazard ratio, 0.66; 95% confidence interval, 0.52-0.85; P=0.001). The patients in the LCZ696 group had 23% fewer hospitalizations for worsening heart failure (851 versus 1079; P<0.001) and were less likely to require intensive care (768 versus 879; 18% rate reduction, P=0.005), to receive intravenous positive inotropic agents (31% risk reduction, P<0.001), and to have implantation of a heart failure device or cardiac transplantation (22% risk reduction, P=0.07). The reduction in heart failure hospitalization with LCZ696 was evident within the first 30 days after randomization. Worsening of symptom scores in surviving patients was consistently more common in the enalapril group. LCZ696 led to an early and sustained reduction in biomarkers of myocardial wall stress and injury (N-terminal pro-Btype natriuretic peptide and troponin) versus enalapril. Conclusions-Angiotensin-neprilysin inhibition prevents the clinical progression of surviving patients with heart failure more effectively than angiotensin-converting enzyme inhibition. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255. (Circulation. 2015;131:54-61.

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Section: Discussionmentioning

confidence: 99%

Angiotensin Receptor Neprilysin Inhibition Compared With Enalapril on the Risk of Clinical Progression in Surviving Patients With Heart Failure

et al. 2015

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“…Most of the participants in these studies had NYHA class CHF and left ventricular ejection fractions of <35% to 40%. Administration of fosinopril for 6 months to patients with CHF resulted in an increase in exercise duration and a reduction in symptoms when compared with placebo-treated patients (9). In a separate study in CHF patients, 3 months of fosinopril also resulted in both improved exercise duration and a significant lessening of CHF symptoms (29).…”

Section: Congestive Heart Failurementioning

confidence: 98%

Fosinopril: Emerging Considerations and Implications for Angiotensin‐Converting Enzyme Inhibitor Therapy

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Gehr

Kelleher

et al. 1998

Cardiovascular Drug Reviews

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“…111 The SOLVD trial demonstrated that the enalapril group had a 26% reduction in the risk of death or hospitalization for worsening heart failure compared with the placebo group. 127 One cost consequence analysis, based on clinical trial results, 128 has shown that use of the ACE inhibitor fosinopril achieved an overall cost savings of $1.6 million per 1,000 patients. 129,130 Another study, a cost-effectiveness analysis of the ACE inhibitor captopril for heart failure patients, using SAVE data, found that use of captopril therapy resulted in a cost per life year saved of $1,460.…”

Section: Diabetesmentioning

confidence: 99%

Impact of Appropriate Pharmaceutical Therapy for Chronic Conditions on Direct Medical Costs and Workplace Productivity: A Review of the Literature

et al. 2004

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Effects of fosinopril on exercise tolerance and clinical deterioration in patients with chronic congestive heart failure not taking digitalis

Cited by 42 publications

References 8 publications

Angiotensin Receptor Neprilysin Inhibition Compared With Enalapril on the Risk of Clinical Progression in Surviving Patients With Heart Failure

Angiotensin Receptor Neprilysin Inhibition Compared With Enalapril on the Risk of Clinical Progression in Surviving Patients With Heart Failure

Fosinopril: Emerging Considerations and Implications for Angiotensin‐Converting Enzyme Inhibitor Therapy

Impact of Appropriate Pharmaceutical Therapy for Chronic Conditions on Direct Medical Costs and Workplace Productivity: A Review of the Literature

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