Skip to main content
SpringerLink
Log in

Alterations in the Prognosis of Chronic Heart Failure: An Overview of the Major Mortality Trials

  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Abstract

Treatment of chronic heart failure (CHF) remains a major medical problem. Although in the last decades the benefits of several therapies in different patient populations with left ventricular dysfunction have been established, morbidity and mortality of CHF patients are high. Consequently, in the last decade improvement of survival has become the primary therapeutic endpoint in CHF studies, and the evaluation of the influence of (new) drugs on mortality has become crucial. In the present article an overview of the large mortality trials is given, and the shifts and alterations in the drug treatment strategy of CHF are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Leier CV. Clinical trial strategies and future challenges in the investigation of human congestive heart failure. Pharmacotherapy 1993;13:94S–99S.

    Google Scholar 

  2. Davies RH, Sheridan DJ. The treatment of heart failure—what next? Eur J Clin Pharmacol 1993;35:557–563.

    Google Scholar 

  3. Swan HJ, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med 1970;283:447–451.

    Google Scholar 

  4. Cohn JN, Archibald DG, Ziesche S, et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration Cooperative Study. N Engl J Med 1986;314:1547–1552.

    Google Scholar 

  5. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987;316:1429–1435.

    Google Scholar 

  6. Packer M, Carver JR, Rodeheffer RJ, et al. Effect of oral milrinone on mortality in severe chronic heart failure. N Engl J Med 1991;325:1468–1475.

    Google Scholar 

  7. The SOLVD investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fraction and congestive heart failure. N Engl J Med 1991;325:293–302.

    Google Scholar 

  8. Cohn JN, Johnson GJ, Ziesche S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991;325:303–310.

    Google Scholar 

  9. The SOLVD investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992;327:685–691.

    Google Scholar 

  10. Waagstein F, Bristow MR, Swedberg K, et al. Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Lancet 1993;342:1441–1446.

    Google Scholar 

  11. More gloom for heart failure drug development. SCRIP 1994; No, 1908, March 25th:26.

  12. Feldman AM, Bristow MR, Parmley WW, et al. Effects of vesnarinone on morbidity and mortality in patients with heart failure. N Engl J Med 1993;329:149–155.

    Google Scholar 

  13. CIBIS investigators and committees. A randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). Circulation 1994;90:1765–1773.

    Google Scholar 

  14. Doval HC, Nul DR, Grancelli HO, Perrone SV, Bortman GR, Curiel R. Randomised trial of low-dose amiodarone in severe congestive heart failure. Lancet 1994;344:493–498.

    Google Scholar 

  15. The Xamoterol in Severe Heart Failure Group. Xamoterol in severe heart failure. Lancet 1990;336:1–6.

    Google Scholar 

  16. Packer M, O'Connor CM, Ghali JK, et al. Effect of amlodipine on morbidity and mortality in severe chronic heart failure. N Engl J Med 1996;335:1107–1114.

    Google Scholar 

  17. Singh SN, Fletcher RD, Fisher SG, et al. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med 1995; 333:77–82.

    Google Scholar 

  18. Cohn JN, Ziesche SM, Loss LE, Anderson GF. Effect of felodipine on short-term exercise and neurohormone and long-term mortality in heart failure: Results of V-HeFT III (abstr). Circulation 1995;92(Suppl I):1–143.

    Google Scholar 

  19. The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med 1997;336:525–533.

    Google Scholar 

  20. Hampton JR, van Veldhuisen DJ, Kleber FX, et al. for the PRIME-II investigators. Randomized study of effect of ibopamine on survival in patients with advanced severe heart failure. Lancet 1997;349:971–977.

    Google Scholar 

  21. Hampton JR. Results of clinical trials with diuretics in heart failure. Br Heart J 1994;72(Suppl S):S68–S72.

    Google Scholar 

  22. Chadda K, Goldstein S, Byington R, Curb JD. Effect of propranolol after acute myocardial infarction in patients with congestive heart failure. Circulation 1986;73:503–510.

    Google Scholar 

  23. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996;334:1349–1355.

    Google Scholar 

  24. O'Connor CM, Belkin RN, Carson PE, et al. Effect of amlodipine on mode of death in severe chronic heart failure: The PRAISE trial. Circulation 1995;70:1–143.

    Google Scholar 

  25. Massie BM, Berk MR, Brozena SC, et al. Can further benefit be achieved by adding flosequinan to patients with congestive heart failure who remain symptomatic on diuretics, digoxin and an angiotensin converting enzyme inhibitor? Circulation 1993;88:492–501.

    Google Scholar 

  26. Furberg CD, Yusuf S, Thom TJ. Potential for altering the natural history of congestive heart failure: Need for large clinical trials. Am J Cardiol 1985;55:45A–47A.

    Google Scholar 

  27. Pfeffer MA, Stevenson LW. Beta-adrenergic blockers and survival in heart failure. N Engl J Med 1996;334:1396–1397.

    Google Scholar 

  28. Uretsky BF, Jessup M, Konstam MA, et al. Multicenter trial of oral enoximone in patients with moderate to moderately severe congestive heart failure. Circulation 1990;82:774–780.

    Google Scholar 

  29. Katz AM. Heart failure in 2001: A prophecy. Am J Cardiol 1992;70:126C–131C.

    Google Scholar 

  30. Stevenson WG, Stevenson LW, Middlekauff HR, et al. Improving survival for patients with advanced heart failure: A study of 737 consecutive patients. J Am Coll Cardiol 1995;26:1417–1423.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology/Thoraxcenter, University Hospital, Groningen, The Netherlands

    Balázs M. Szabó, Dirk J. van Veldhuisen, Pieter A. de Graeff & K.I. Lie

Authors
  1. Balázs M. Szabó
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dirk J. van Veldhuisen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pieter A. de Graeff
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K.I. Lie
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Szabó, B.M., van Veldhuisen, D.J., de Graeff, P.A. et al. Alterations in the Prognosis of Chronic Heart Failure: An Overview of the Major Mortality Trials. Cardiovasc Drugs Ther 11, 427–434 (1997). https://doi.org/10.1023/A:1007786019054

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007786019054

Search

Navigation