SOLVD
Trial question
What is the role of enalapril in patients with HF with a reduced ejection fraction?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
20.0% female
80.0% male
N = 2569
2569 patients (504 female, 2065 male).
Inclusion criteria: patients with HF with a reduced ejection fraction and receiving conventional treatment.
Key exclusion criteria: age > 80 years, hemodynamically serious valvular disease requiring surgery, unstable angina pectoris, MI during the previous month, severe pulmonary disease, or serum creatinine level > 177 mcmol/L.
Interventions
N=1285 enalapril (at doses of 2.5 to 20 mg/day).
N=1284 placebo (matching placebo daily).
Primary outcome
Death
35.2%
39.7%
39.7 %
29.8 %
19.9 %
9.9 %
0.0 %
Enalapril
Placebo
Significant
decrease ▼
NNT = 22
Significant decrease in death (35.2% vs. 39.7%; RR -16, 95% CI -26 to 5).
Secondary outcomes
Significant decrease in death or hospitalization for worsening HF (47.7% vs. 57.3%; RR -26, 95% CI -34 to -18).
Conclusion
In patients with HF with a reduced ejection fraction and receiving conventional treatment, enalapril was superior to placebo with respect to death.
Reference
SOLVD Investigators, Yusuf S, Pitt B et al. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991 Aug 1;325(5):293-302.
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