6/29/23, 11:44 PM SOLVD Pathway Feedback Search Clinical Topics Home Studies SOLVD SOLVD Disease Heart failure Trial question What is the role of enalapril in patients with HF with a reduced ejection fraction? Study design Multi-center Double blinded RCT Population Characteristics of study participants 20.0% female N = 2569 80.0% male 2569 patients (504 female, 2065 male) Inclusion criteria: patients with HF with a reduced ejection fraction and receiving conventional treatment Key exclusion criteria: age > 80 years, hemodynamically serious valvular disease requiring surgery, unstable angina pectoris, myocardial infarction during the previous month, severe pulmonary disease, or serum creatinine level > 177 mcmol/L Interventions N=1285 enalapril (at doses of 2.5 to 20 mg/day) N=1284 placebo (matching placebo daily) Primary outcome https://web.pathway.md/studies/recJ25hKBJYcXzRhW 1/2 6/29/23, 11:45 PM SOLVD Pathway Death 39.7 % 39.7 35.2 29.8 % 19.9 % Significant increase 9.9 % NNH = 22 0.0 % Enalapril Placebo Significant increase in death (35.2% vs. 39.7%; RR 16, 95% CI 5 to 26) Secondary outcomes Significant increase in death or hospitalization for worsening HF (47.7% vs. 57.3%; RR 26, 95% CI 18 to 34) Conclusion In patients with HF with a reduced ejection fraction and receiving conventional treatment, enalapril was superior to placebo with respect to death. Reference SOLVD Investigators, Yusuf S, Pitt B et al. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991 Aug 1;325(5):293- 302. Open reference URL https://web.pathway.md/studies/recJ25hKBJYcXzRhW 2/2