Developments in Brief : Drug Cuts Deaths From Severe Heart Failure

Compiled by Times staff and wire service reports

The drug enalapril can increase the survival rate for people with severe congestive heart failure by up to 40%, according to results of a Scandinavian study released last week. Currently, the prognosis for such patients is poor.

"It has been argued that patients with advanced heart failure are so ill and have such extensive (heart) damage that no important prolongation of survival by any medical treatment can be expected," the researchers said in the current issue of the New England Journal of Medicine. "However, our data suggests that enalapril can reduce mortality."

Nearly 200,000 Americans die as a result of the condition each year.

Enalapril is among a group of drugs used to treat the symptoms of severe heart failure for about a decade. But it is only in the last year that studies have been published that indicate the impact of such drugs on survival rates.

In the latest study, researchers in Finland, Norway and Sweden gave enalapril to 127 patients and a placebo to 126 others over a 20-month period.

They found that enalapril inhibited the progression of the disease and improved the chances of survival by 40% after six months, 31% after one year and 27% by the end of the study last December. At that time, 68 patients had died in the placebo group and 50 in the enalapril group.

They said that there was no difference in the incidence of sudden heart attacks in the two groups, but there was a 50% reduction in mortality due to a gradual progression of heart failure in the enalapril-treated group.

Also, among patients who were still alive at the end of the study, heart size, a critical factor in heart disease, was reduced in the enalapril group by 9.6% contrasted with 3.2% in the placebo group.

The results of the enalapril treatment were so successful that an international Ethical Review Committee recommended that the study be cut short four months ahead of schedule, the researchers said.

Enalapril and other so-called vasodilator drugs work by dilating the arteries that feed blood to the heart. Constriction of these arteries is one of the causes of congestive heart disease.

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