Posted on June 10: McMaster researchers conduct follow-up study on patients with low heart pump functioning

A McMaster study, led by researchers Philip Jong and Salim Yusuf, established that patients with low heart pump functioning benefit from drug intervention even when they are not experiencing symptoms of heart failure.

The study was published in the May 31 issue of The Lancet.

In a previous study of left ventricular dysfunction (SOLVD), the angiotensin converting enzyme (ACE) inhibitor enalapril, reduced mortality in patients with symptomatic but not asymptomatic left ventricular systolic dysfunction.

Jong and Yusuf recently completed an extended study (X-SOLVED), a 12-year follow up, to establish if the mortality reduction with enalapril among patients with heart failure was sustained, and whether a subsequent reduction in mortality would emerge among those with asymptomatic ventricular dysfunction.

Of the 6,797 patients previously enrolled in the SOLVD prevention and treatment trials, they ascertained the subsequent vital status of 5,165 individuals who were alive when the trials had been completed.

Follow-up was done through direct contacts in Belgium and linkages with national death registries and federal beneficiary or historic tax summary files in the USA and Canada. The reductions in cardiac deaths were significant and similar in both trials.

Researchers concluded that treatment with enalapril for three to four years led to a sustained improvement in life expectancy by more than nine months.

Jong says, “ACE inhibitors should be used in patients with reduced heart pump function as early as possible, even when they do not have symptoms or signs of heart failure, because it is this group that derives the greatest survival benefit from the drug years later. Heart failure is preventable, but as this study shows, benefits of drugs used to treat heart failure, such as ACE inhibitors, take a while to manifest.”