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Long-Term Results of the Spanish Trial on Treatment and Survival of Patients with Predominantly Mild Heart Failure
Author(s) -
Juan Cosín-Aguilar,
Jaume Marrugat,
Ginés Sanz,
J. Massó,
M. Gil,
Ramón Vargas,
F. Pérez-Casar,
E Simarro,
D De Armas,
J. García-García,
José Azpitarte,
J. L. Diago,
G. Rodrigo-Trallero,
Iñaki Lekuona,
Enric Domingo,
E Marín-Huerta,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Jaume Marrugat,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
Ginés Sanz,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
J. Massó,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
M. Gil,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
Ramón Vargas,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
F. Pérez-Casar,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
E Simarro,
D. de Armas,
D. De Armas,
D. De Armas,
D. de Armas,
D. de Armas,
D. De Armas,
D. De Armas,
D. De Armas,
D. de Armas,
D. de Armas,
D. De Armas,
D. de Armas,
D. De Armas,
D. De Armas,
D. De Armas,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
J. García-García,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
José Azpitarte,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
J. L. Diago,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
G. Rodrigo-Trallero,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Iñaki Lekuona,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
Enric Domingo,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta,
E Marín-Huerta
Publication year - 1999
Publication title -
journal of cardiovascular pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.762
H-Index - 100
eISSN - 1533-4023
pISSN - 0160-2446
DOI - 10.1097/00005344-199905000-00009
Subject(s) - captopril , digoxin , medicine , heart failure , atrial fibrillation , randomized controlled trial , cardiology , enalapril , adverse effect , angiotensin converting enzyme , blood pressure
A randomized open-label clinical trial was conducted to determine whether mortality, readmission, or quality of life differed between heart failure patients managed with captopril plus diuretics and those with digoxin plus diuretics. A total of 345 heart failure patients in New York Heart Association functional classes 2 and 3 without atrial fibrillation, dyspnea of bronchopulmonary origin, or hypertension not controlled with diuretics was randomized for digoxin (n = 175) or captopril (n = 170) treatment and followed up for a median of 4.5 years. Socioeconomic, demographic, electrocardiographic, echocardiographic, spirometric, and chest radiograph data were obtained at the initial examination. In a random sample of half the patients, ergometric, echocardiographic, and Holter records were obtained at entry and at 3 and 18 months. Patients were followed up for > or = 3 years. The end points were mortality, hospitalization for cardiac events, deterioration in quality of life, worsening of functional class, and need for digoxin or captopril in the captopril and digoxin groups, respectively. The trial had to be terminated prematurely owing to the difficulty in finding candidates free of angiotensin-converting enzyme (ACE)-inhibitor treatment. Baseline patient characteristics were similar in both groups. From the clinical point of view, only the 48-month mortality was relevantly lower (20.9 vs. 31.9%, respectively) among patients treated with captopril than that in those receiving digoxin (log rank test, p = 0.07). No statistically or clinically relevant differences were found in other end points or adverse effects. The results suggest but do not confirm the hypothesis that captopril treatment in mild to moderate heart failure might provide better long-term survival than digoxin.

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