Enalapril for Congestive Heart Failure

Hallstrom, Al; Gillespie, Mary Jo; Channer, Kevin S.; Rogers, Tyson; Roberts, CJ; Rees, Judy R.; Dennick, Leonard G.; Maskin, Carol S.; Meyer, J.; Schotz, W.E.; Squibb, Eliza; Brown, Breanna; Zatuchni, Jacob; Kjekshus, John; Wilhelmsen, K. L. Swedberg; Packer, Milton

doi:10.1056/nejm198711193172112

Cited by 17 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 13 , 14 , 23 , 24 , 25 Angiotensin‐converting enzyme inhibitors (ACE‐Is) were the first RAAS inhibitors to demonstrate a reduction in the risk of mortality and HF hospitalization and an improvement in functional class. 26 , 27 , 28 The level of recommendation with angiotensin II receptor blockers (ARBs) has changed over time as no clinical trial has demonstrated a reduction of all‐cause mortality with these drugs in patients with HFrEF and now, they are recommended when ACE‐I or sacubitril–valsartan cannot be prescribed due to side effects. 29 , 30 Finally, mineralocorticoid receptor antagonists (spironolactone or eplerenone) added to standard therapy have also demonstrated reduced mortality and HF hospitalization in clinical trials.…”

Section: Need For a Comprehensive Treatment Of Patients With Heart Fa...mentioning

confidence: 99%

Role of vericiguat in management of patients with heart failure with reduced ejection fraction after worsening episode

Olivella,

Almenar‐Bonet,

Moliner

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

Worsening heart failure (HF) is a vulnerable period in which the patient has a markedly high risk of death or HF hospitalization (up to 10% and 30%, respectively, within the first weeks after episode). The prognosis of HF patients can be improved through a comprehensive approach that considers the different neurohormonal systems, with the early introduction and optimization of the quadruple therapy with sacubitril–valsartan, beta‐blockers, mineralocorticoid receptor antagonists, and inhibitors. Despite that, there is a residual risk that is not targeted with these therapies. Currently, it is recognized that the cyclic guanosine monophosphate deficiency has a negative direct impact on the pathogenesis of HF, and vericiguat, an oral stimulator of soluble guanylate cyclase, can restore this pathway. The effect of vericiguat has been explored in the VICTORIA study, the largest chronic HF clinical trial that has mainly focused on patients with recent worsening HF, evidencing a significant 10% risk reduction of the primary composite endpoint of cardiovascular death or HF hospitalization (number needed to treat 24), after adding vericiguat to standard therapy. This benefit was independent of background HF therapy. Therefore, optimization of treatment should be performed as earlier as possible, particularly within vulnerable periods, considering also the use of vericiguat.

show abstract

Section: Need For a Comprehensive Treatment Of Patients With Heart Fa...mentioning

confidence: 99%

Role of vericiguat in management of patients with heart failure with reduced ejection fraction after worsening episode

Olivella,

Almenar‐Bonet,

Moliner

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

show abstract

“…[ 24 ] Similarly, in former RCTs on renin–angiotensin system (RAS) inhibitors and mineralocorticoid receptor antagonists (MRA), the mean age was well below 70 years. [ 26 , 29 – 33 ] The progressive aging of the general HF population should have been translated into a change in the patients eligible for inclusion in RCTs. Instead, in the most recent studies, the mean age at enrolment ranged from 63 years in the PARADIGM-HF trial to 67 years in the VICTORIA study.…”

Section: Real-world and Randomised Clinical Trials: Two Distinct Enti...mentioning

confidence: 99%

Evidence-based Therapy in Older Patients with Heart Failure with Reduced Ejection Fraction

2022

View full text Add to dashboard Cite

Older patients are becoming prevalent among people with heart failure (HF) as the overall population ages. However, older patients are largely under-represented, or even excluded, from randomised controlled trials on HF with reduced ejection fraction, limiting the generalisability of trial results in the real world and leading to weaker evidence supporting the use and titration of guideline-directed medical therapy (GDMT) in older patients with HF with reduced ejection fraction. This, in combination with other factors limiting the application of guideline recommendations, including a fear of poor tolerability or adverse effects, the heavy burden of comorbidities and the need for multiple therapies, classically leads to lower adherence to GDMT in older patients. Although there are no data supporting the under-use and under-dosing of HF medications in older patients, large registry-based studies have confirmed age as one of the major obstacles to treatment optimisation. In this review, the authors provide an overview of the contemporary state of implementation of GDMT in older groups and the reasons for the lower use of treatments, and discuss some measures that may help improve adherence to evidence-based recommendations in older age groups.

show abstract

Real‐world outcomes in cardiac resynchronization therapy patients: design and baseline demographics of the SMART‐ Registry

et al. 2021

View full text Add to dashboard Cite

Aims The SMART (Strategic MAnagement to optimize response to cardiac Resynchronization Therapy) Registry was designed to assess real-world outcomes for patients receiving a cardiac resynchronization therapy defibrillator (CRT-D) and to better understand which programming and optimization techniques are used and how effective they are. Methods and results The SMART Registry is a global, multicentre, prospective, observational, post-market CRT-D registry with a planned enrolment of 2000 subjects from a maximum of 200 sites in Europe, North America, and Asia-Pacific region. Each subject will be followed up for a minimum of 12 months. The primary endpoint of CRT response rate at 12 months is defined by a clinical composite score of all-cause mortality, heart failure events, New York Heart Association Class, and quality of life as assessed by a patient global assessment instrument. A subgroup composed of the first 103 consecutive European subjects implanted with an NG4 device will have left ventricular multisite pacing feature enabled at any time during the initial 12 months of follow-up. The primary endpoint for this sub-analysis will be the NG4 PG-related complication-free rate at 36 months. Conclusions The SMART Registry achieved its recruitment target in August 2019, with 2014 patients enrolled. The baseline demographics demonstrated that patients were generally older, with greater co-morbidity, and on more contemporary medical therapy than in the key CRT trials. The results of the SMART Registry will determine which programming and optimization techniques are effective in this real-world population.

show abstract

Enalapril for Congestive Heart Failure

Cited by 17 publications

References 10 publications

Role of vericiguat in management of patients with heart failure with reduced ejection fraction after worsening episode

Role of vericiguat in management of patients with heart failure with reduced ejection fraction after worsening episode

Evidence-based Therapy in Older Patients with Heart Failure with Reduced Ejection Fraction

Real‐world outcomes in cardiac resynchronization therapy patients: design and baseline demographics of the SMART‐ Registry

Contact Info

Product

Resources

About