Breve presentación de un conocido estudio sobre los beneficios del Enalapril

1. CONSENSUS
Cooperative North Scandinavian
Enalapril Survival Study
Byron Toapanta

2. NEJM 1987
Show prognostic improvement by an ACE inhibitor.
STUDIED TREATMENT: Enalapril (2.5 a 40 mg per day)
CONTROL TREATMENT: Placebo
The CONSENSUS trial

3. RANDOMIZED EFFECTIVES: 127/126 (Enp. vs Cnt.)
DESIGN: Parallel Groups
TYPE: Double Blind
DURATION: 188 days
AREA: Finland, Sweeden, Norway
PRIMARY ENDPOINT: Mortality
Method and design

4. severe congestive heart failure (New York Heart
Association [NYHA] functional class IV)
PATIENTS
ISCHEMIC ORIGIN: 73%
FEMALE: 30%
AGE: 70
DILATED CARDIOMYOPATHY: 16%
HYPERTENSION: 21%

5. RESULTS

10. Mortality was reduced by 31 percent at one year
A significant improvement in NYHA classification was
observed in the enalapril group, together with a
reduction in heart size and a reduced requirement for
other medication for heart failure.
the addition of enalapril to conventional therapy in
patients with severe congestive heart failure can
reduce mortality and improve symptoms.
RESULTS

11. Surviving CONSENSUS patients were followed for an
additional 10 years after termination of the trial, at
which time five patients remained alive, all from the
enalapril group.

12. published in 1992
studied the effect of IV Enalaprilat and later oral
Enalapril after Acute MI.
This study did not show any benefit with Enalapril,
probably because the Thrombolytic era had already
begun and the effects of Enalapril were
overshadowed by the benefits of Thrombolysis.
The CONSENSUS II trial