A Comparison of Enalapril with Hydralazine–Isosorbide Dinitrate in the Treatment of Chronic Congestive Heart Failure
| Autor: | W. Bruce Dunkman, Henry S. Loeb, C. Vincent Hughes, Ralph Shabetai, Susan Ziesche, Geetha Bhat, Ross D. Fletcher, Raphael F. Smith, Steven Goldman, Maylene Wong, Peter E. Carson, Gary R. Johnson, Guillermo Cintron, Felix E. Tristani, Jay N. Cohn, Frederick R. Cobb, James J. Doherty, Gary S. Francis, Clair Haakenson |
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| Rok vydání: | 1991 |
| Předmět: | |
| Zdroj: | New England Journal of Medicine. 325:303-310 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejm199108013250502 |
| Popis: | Background and Methods. To define better the efficacy of vasodilator therapy in the treatment of chronic congestive heart failure, we compared the effects of hydralazine and isosorbide dinitrate with those of enalapril in 804 men receiving digoxin and diuretic therapy for heart failure. The patients were randomly assigned in a double-blind manner to receive 20 mg of enalapril daily or 300 mg of hydralazine plus 160 mg of isosorbide dinitrate daily. The latter regimen was identical to that used with a similar patient population in the effective-treatment arm of our previous Vasodilator—Heart Failure Trial. Results. Mortality after two years was significantly lower in the enalapril arm (18 percent) than in the hydralazine—isosorbide dinitrate arm (25 percent) (P = 0.016; reduction in mortality, 28.0 percent), and overall mortality tended to be lower (P = 0.08). The lower mortality in the enalapril arm was attributable to a reduction in the incidence of sudden death, and this beneficial effect was m... |
| Databáze: | OpenAIRE |
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