Author + information
- Received September 18, 1992
- Revision received February 10, 1993
- Accepted February 18, 1993
- Published online October 1, 1993.
- Bertram Pitt, MD, FACC∗
- ↵∗Address for correspondence: Bertram Pitt, MD, Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan.
The Studies of Left Ventricular Dysfunction (SOLVD) prevention trial evaluated 4,228 patients with a left ventricular ejection fraction ≤ 35% who were not receiving drug therapy for heart failure. Patients were randomized to treatment with enalapril or placebo in a dose of 2.5 to 20 mg/day. Patients randomized to enalapril showed a 37% reduction in the development of heart failure and a 36% reduction in hospitalization for heart failure (p ≤ 0.001). However, there was only an 8% reduction in total mortality and a 14% reduction in cardiovascular mortality (p = NS).
On the basis of the SOLVD prevention trial, patients with asymptomatic left ventricular dysfunction due to either ischemic or nonischemic cardiomyopathy should be started on treatment with an angiotensin-converting enzyme inhibitor to prevent the development of and hospitalisation for heart failure.
Milton Packer, MD, FACC, Chairman
- Received September 18, 1992.
- Revision received February 10, 1993.
- Accepted February 18, 1993.