The Pharmaceutical Journal
Vol 270 No 7252 p784
7 June 2003

This article
Reprint
Photocopy

News summary

Related websites
The Lancet (www.thelancet.com)

Long-term survival benefit for enalapril

Enalapril given for three to four years improves long-term survival in patients with left ventricular systolic dysfunction.

Previous trials have found that the ACE inhibitor improves survival in patients with heart failure and left ventricular dysfunction (LVD), but no clear mortality reduction was seen in asymptomatic patients.

However, new follow-up data from these studies have identified a long-term benefit. Reporting in The Lancet (2003;361:1843), the authors estimate that treatment of 1,000 individuals with LVD with enalapril for about three years would prevent 56 premature deaths over 10 years.

In a heart failure prevention trial, 50.9 per cent of the enalapril group had died after 12 years, compared with 56.4 per cent of the placebo group. In a heart failure treatment trial, 79.8 per cent of the enalapril group had died compared with 80.8 per cent of the placebo group. Reductions in cardiac deaths were significant and similar in both trials. Combined analysis showed that enalapril extended median survival by 9.4 months and conferred a 0.9 hazard ratio for death.