Evidence map›Paper›PMID 28980368›Full record

Trial reportEuropean journal of heart failure2018

Similar clinical benefits from below-target and target dose enalapril in patients with heart failure in the SOLVD Treatment trial.

Phillip H Lam, Daniel J Dooley, Gregg C Fonarow, Javed Butler, Deepak L Bhatt, Gerasimos S Filippatos, Prakash Deedwania, Daniel E Forman, Michel White, Ross D Fletcher and 11 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of heart failure, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
0.6field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 23 citations in OpenAlex.

  1. Trial
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 17 institutions in 5 countries.

Phillip H LamVeterans Affairs Medical Center, Washington, DC, USA.
Daniel J DooleyVeterans Affairs Medical Center, Washington, DC, USA.
Gregg C FonarowUniversity of California, Los Angeles, CA, USA.
Javed ButlerStony Brook University, Stony Brook, NY, USA.
Deepak L BhattBrigham and Women's Hospital Heart and Vascular Center, Boston, MA, USA.
Gerasimos S FilippatosAttikon University Hospital, Athens, Greece.
Prakash DeedwaniaUniversity of California, San Francisco, Fresno, CA, USA.
Daniel E FormanUniversity of Pittsburgh and VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Michel WhiteUniversité de Montréal, Montreal, Canada.
Ross D FletcherVeterans Affairs Medical Center, Washington, DC, USA.
Cherinne ArundelVeterans Affairs Medical Center, Washington, DC, USA.
Marc R BlackmanVeterans Affairs Medical Center, Washington, DC, USA.
Chris AdamopoulosSt Paul General Hospital, Thessaloniki, Greece.
Ioannis E KanonidisHippocration Hospital, Thessaloniki, Greece.
Inmaculada B AbanUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Kanan PatelUniversity of California, San Francisco, CA, USA.
Wilbert S AronowWestchester Medical Center and New York Medical College, Valhalla, NY, USA.
Richard M AllmanDepartment of Veterans Affairs, Geriatrics and Extended Care, Washington, DC, USA.
Stefan D AnkerDivision of Cardiology and Metabolism - Heart Failure, Cachexia and Sarcopenia, Department of Cardiology (CVK); and Berlin-Brandenburg Center for Regenerative Therapies (BCRT); Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) Berlin, Charité Universitätsmedizin Berlin, Germany.
Bertram PittUniversity of Michigan, Ann Arbor, MI, USA.
Ali AhmedVeterans Affairs Medical Center, Washington, DC, USA.
Veterans Health Administration · USGeorgetown University · USUniversity of California, San Francisco · USBerlin-Brandenburger Centrum für Regenerative Therapien · DEBrigham and Women's Hospital · USGeorge Washington University · USHippocration General Hospital · GRIppokrateio General Hospital of Thessaloniki · GRMedStar Georgetown University Hospital · USStony Brook University · USUniversité de Montréal · CAUniversity General Hospital Attikon · GRUniversity of Alabama at Birmingham · USUniversity of California, Los Angeles · USUniversity of Michigan · USVA Pittsburgh Healthcare System · USWestchester Medical Center · US

Funding

Maternal Morbidity and Mortality: Risk Factors, Early Detection and Personalized InterventionUL1TR001409 · NCATS · GEORGETOWN UNIVERSITY · PI GONDRE-LEWIS, MARJORIE C, MELLMAN, THOMAS A · 2015 to 2024
$37.8M
VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Caterina Rosano · 2004 to 2026
$28.6M
Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
NCATS NIH HHS UL1 TR001409NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01 HL097047NIA NIH HHS P30 AG024827
6 · The paper itself

Abstract

aimsTo examine associations of below-target and target dose of enalapril, an angiotensin-converting enzyme (ACE) inhibitor, with outcomes in patients with heart failure and reduced ejection fraction (HFrEF) in the Studies of Left Ventricular Dysfunction (SOLVD) Treatment trial. METHODS AND

resultsTwo thousand five hundred and sixty-nine patients with HFrEF (ejection fraction ≤35%) were randomized to below-target (5-10 mg/day) dose placebo (n = 1284) or enalapril (n = 1285). One month post-randomization, blind up-titration to target (20 mg/day) dose was attempted for both study drugs in 2458 patients. Among the 1444 patients who achieved dose up-titration (placebo, n = 748; enalapril, n = 696; mean dose for both groups, 20.0 mg/day), target dose enalapril (vs. target dose placebo) was associated with a 9% absolute lower risk of the combined endpoint of heart failure hospitalization or all-cause mortality [adjusted hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.60-0.81; P < 0.001] during 4 years of follow-up. Among the 1014 patients who could not achieve target dose (placebo, n = 486; enalapril, n = 528; mean dose for both groups, 8.8 mg/day), below-target dose enalapril (vs. below-target dose placebo) was associated with a 12% absolute lower risk of the combined endpoint of heart failure hospitalization or all-cause mortality (adjusted HR 0.68; 95% CI 0.57-0.81; P < 0.001). Among the 1224 patients receiving enalapril, target (vs. below-target) dose had no association with the combined endpoint of heart failure hospitalization or all-cause mortality (adjusted HR 1.04; 95% CI 0.87-1.23; P = 0.695).

conclusionIn patients with HFrEF, the clinical benefits of ACE inhibitors appear to be similar at both below-target and target doses.

Indexed as

Angiotensin-Converting Enzyme InhibitorsCanadaCause of DeathDose-Response Relationship, DrugDouble-Blind MethodEnalaprilEuropeFollow-Up StudiesHeart FailureHumansStroke VolumeSurvival RateTreatment OutcomeUnited StatesAngiotensin-Converting Enzyme InhibitorsEnalaprilACE inhibitorsEnalaprilHeart failurePlaceboTarget dose

Identifiers

PMID28980368
PMCPMC6500736
OpenAlexW2761429621

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.