EFFECTS OF ENALAPRIL ON LONG-TERM MORTALITY IN SEVERE CONGESTIVE-HEART-FAILURE
EFFECTS OF ENALAPRIL ON LONG-TERM MORTALITY IN SEVERE CONGESTIVE-HEART-FAILURE
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DOI：
10.1016/0002-9149(92)90683-p
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发表时间：
1992-01-01
影响因子：
2.8
通讯作者：
SNAPINN, S
中科院分区：
文献类型：
--
作者：
KJEKSHUS, J;SWEDBERG, K;SNAPINN, S
在一项比较依那普利和安慰剂对严重充血性心力衰竭患者生存影响的双盲研究中，所有幸存的患者在停止试验后都被推荐使用活性药物治疗。盲法试验结束后的两年随访表明，在最初分配给依那普利组的127名患者中，有77名幸存者，其中38名仍然存活。在126名被分配到安慰剂组的患者中，58人在盲法研究中幸存下来，经过2年的随访，26人仍然活着。因此，原始治疗组之间的差异仍然存在，尽管依那普利治疗对所有存活的患者都有效，并且依那普利组的患者在基线时病情比安慰剂组的患者更严重。如果开依那普利，死亡率为47%，而不开依那普利的死亡率为75%。生命表分析表明，在两个治疗组的死亡率变得相当之前，依那普利组的治疗有明显的延续效应，持续长达15个月。这强烈提示依那普利对衰竭心肌具有结构性保护作用。
All surviving patients in a double-blind study comparing the effects of enalapril and placebo on survival in severe congestive heart failure were recommended to be treated with active drug after stopping the trial. Two-year follow-up from the end of the blinded trial demonstrated that among 77 survivors of 127 patients originally allocated to the group with enalapril, 38 were still alive. Of 126 patients allocated to the group with placebo 58 survived the blinded study, and after 2-year follow-up 26 were still alive. Thus, the difference between the original treatment groups remained, despite that treatment with enalapril was made available to all surviving patients and that those in the group with enalapril were sicker at baseline than those in the group with placebo. If enalapril was prescribed, the mortality was 47% compared with 75% if it was not. Life-table analysis suggests a marked carry-over effect of treatment in the group with enalapril that lasted for up to 15 months before mortality rates became comparable in the 2 treatment groups. This strongly suggests that enalapril confers structural protection to the failing myocardium.