6/28/23, 12:16 AM CONSENSUS Pathway Feedback Search Clinical Topics Home Studies CONSENSUS CONSENSUS Disease Heart failure Trial question What is the role of enalapril in patients with congestive HF and NYHA class IV symptoms? Study design Multi-center Double blinded RCT Population Characteristics of study participants 30.0% female N = 253 70.0% male 253 patients (75 female, 178 male) Inclusion criteria: patients with congestive HF and NYHA class IV symptoms who were taking conventional treatment for HF Key exclusion criteria: acute pulmonary edema, hemodynamically important aortic or mitral valve stenosis, myocardial infarction within the previous two months, or unstable angina Interventions N=127 enalapril (initial dose of 5 mg BID, maximum dose of 20 mg BID) N=126 placebo (matching placebo BID) Primary outcome Death at 6 months 44.0 % 44 33.0 % https://web.pathway.md/studies/recVNcwpGKN9vdbYP 1/2 6/28/23, 12:16 AM CONSENSUS Pathway 26 22.0 % Significant decrease 11.0 % NNT = 6 0.0 % Enalapril Placebo Significant decrease in death at 6 months (26% vs. 44%; RR 0.65, 95% CI 0.24 to 1.06) Secondary outcomes Significant decrease in cardiac death due to progression of congestive HF (17.3% vs. 34.9%; RR 0.5, 95% CI 0.2 to 0.8) Safety outcomes No significant difference in overall withdrawal rates. Significant difference in hypotension requiring withdrawal (7 vs. 0). Conclusion In patients with congestive HF and NYHA class IV symptoms who were taking conventional treatment for HF, enalapril was superior to placebo with respect to death at 6 months. Reference 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 Jun 4;316(23):1429-35. Open reference URL https://web.pathway.md/studies/recVNcwpGKN9vdbYP 2/2