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Long-term survival in severe heart failure in patients treated with enalapril. Ten year follow-up of CONSENSUS I
K Swedberg1, J Kjekshus, S Snapinn
1Department of Medicine, Sahlgrenska University HospitallOstra, Göteborg, Sweden.
European Heart Journal
|April 1, 1999
Summary
Enalapril significantly reduced mortality in severe heart failure patients. This benefit was sustained for years, prolonging overall survival by 50% in the long-term follow-up of the CONSENSUS trial.
Area of Science:
- Cardiology
- Pharmacology
Background:
- The CONSENSUS trial was the first to demonstrate prognostic improvement with an ACE inhibitor in NYHA class IV heart failure patients.
- Patients received either enalapril or placebo, with all offered open-label enalapril post-study.
Purpose of the Study:
- To report the 10-year survival follow-up of patients originally randomized in the CONSENSUS trial.
- To assess the long-term efficacy and sustained benefits of enalapril in severe heart failure.
Main Methods:
- A 10-year survival status questionnaire was sent to all 35 participating centers of the CONSENSUS I trial.
- Survival data was collected as of November 1, 1996.
Main Results:
- One patient was lost to follow-up; 5 long-term survivors were all in the enalapril group (P = 0.004).
- Averaged over the trial duration (double-blind and open-label), enalapril provided a 30% risk reduction (P = 0.008).
- Mortality was higher in patients not receiving open ACE inhibitor therapy post-double-blind study.
Conclusions:
- Enalapril demonstrated significant and sustained mortality reduction in severe heart failure patients for at least 4 years.
- The overall survival time was prolonged by 50% (from 521 to 781 days).
- This study provides the first full life-cycle follow-up in a heart failure trial.
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