Do evidence-based treatments provide incremental benefits to patients with congestive heart failure already receiving angiotensin-converting enzyme inhibitors? A secondary analysis of one-year outcomes from the Assessment of Treatment with Lisinopril and Survival (ATLAS) study

Clinical Therapeutics
Sumit R MajumdarATLAS Study Group

Abstract

In patients with congestive heart failure (CHF), use of submaximal doses of angiotensin-converting enzyme (ACE) inhibitors (ie, low-dose ACE inhibitors) represents usual care in routine clinical practice, whereas high-dose ACE inhibitors, beta-blockers, and digoxin have each been shown to improve outcomes. We examined whether treatment with high dose-ACE inhibitors, beta-blockers, and digoxin would each provide incremental benefits over that achieved with usual care and whether concurrent use of high-dose ACE inhibitors, beta-blockers, and digoxin would provide maximal benefits. We conducted a secondary analysis of a randomized, controlled, active-comparator trial. Specifically, we studied 1-year outcomes data from the Assessment of Treatment with Lisinopril and Survival trial (ATLAS), which assessed high-dose ACE inhibitors (mean dosage, 33.2 mg daily lisinopril) versus low-dose ACE inhibitors (mean dosage, 4.5 mg daily lisinopril) in patients of any age with advanced CHF in 287 centers in 19 countries in the 1990s. In our analysis, patients were classified by their use of low-dose or high-dose ACE inhibitors, beta-blockers, and/or digoxin at the time of randomization. The primary outcome of interest was the ATLAS composite en...Continue Reading

References

Jan 7, 2000·The American Journal of Medicine·E F PhilbinP L Jenkins

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Citations

Apr 7, 2006·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·R ReibisH Völler
Sep 13, 2006·The Journal of Cardiovascular Nursing·Kathleen L Grady
Sep 1, 2007·BMJ : British Medical Journal·Dean T EurichJeffrey A Johnson
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Jul 1, 2004·Language, Speech, and Hearing Services in Schools
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Dec 31, 2020·Drug, Healthcare and Patient Safety·Teklehaimanot Fentie Wendie, Mulugeta Tarekegn Angamo

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