TY - JOUR
T1 - Clinical characteristics of patients in Studies of Left Ventricular Dysfunction (SOLVD)
AU - Johnstone, David
AU - Limacher, Marian
AU - Rousseau, Michel
AU - Liang, Chang Seng
AU - Ekelund, Lars
AU - Herman, Michael
AU - Stewart, Douglas
AU - Guillotte, Maureen
AU - Bjerken, Gina
AU - Gaasch, William
AU - Held, Peter
AU - Verter, Joel
AU - Stewart, Dawn
AU - Yusuf, Salim
AU - The SOLVD Investigators, SOLVD Investigators
N1 - Funding Information:
From the Division of Epidemiology and Clinical Applications Clinical Trials Branch, the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda,M aryland. Thii study was supportedi n part by the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda,M aryland. Manuscript received November 4,199 1; revised manuscript received and acceptedJ une 8.1992.
PY - 1992/10/1
Y1 - 1992/10/1
N2 - The Studies of Left Ventricular Dysfunction (SOLVD) trials were designed to evaluate the effects of enalapril on long-term mortality in patients with severe left ventricular (LV) dysfunction. Patients with LV ejection fractions ≤0.35 and symptoms of congestive heart failure (CHF) were enrolled in the treatment trial, whereas those with no history of overt CHF and taking no treatment directed for LV dysfunction were enrolled in the prevention trial. The baseline clinical characteristics of SOLVD patients were compared to characterize differences between patients in these 2 separate but concurrent trials. From over 70,000 patients screened with LV dysfunction, 4,228 patients were enrolled in the prevention trial and 2,569 patients in the treatment trial. Ischemic heart disease was the primary cause of LV dysfunction in both prevention (83%) and treatment (71%) trial patients. Prior myocardial infarction was present in 80% of the prevention and 66% of the treatment trial patients (p < 0.001). In the prevention trial, infarction was recent (≤6 months) in 27% patients and remote (>6 months) in 57% patients. Treatment trial patients had proportionately more women (20 vs 13%; p < 0.001) and non-Caucasians (20 vs 14%; p < 0.001), as well as the coexisting risk factors of hypertension (42 vs 37%; p < 0.001) and diabetes (26 vs 15%; p < 0.001) than did prevention trial patients. Treatment trial patients were more likely to have the clinical signs associated with CHF and had a lower mean LV ejection fraction (0.25 ± 0.07 vs 0.28 ± 0.06, p < 0.001) than prevention trial patients. Clinical characteristics of patients in both trials were influenced by the gender and race of enrolled patients. Similarly, coronary artery bypass surgery was performed less often in women and non-Caucasians. Thus, the baseline database of patients enrolled in the SOLVD trials demonstrates the varied clinical features associated with severe LV dysfunction and highlights the impact of symptomatic status, gender and race on clinical presentation.
AB - The Studies of Left Ventricular Dysfunction (SOLVD) trials were designed to evaluate the effects of enalapril on long-term mortality in patients with severe left ventricular (LV) dysfunction. Patients with LV ejection fractions ≤0.35 and symptoms of congestive heart failure (CHF) were enrolled in the treatment trial, whereas those with no history of overt CHF and taking no treatment directed for LV dysfunction were enrolled in the prevention trial. The baseline clinical characteristics of SOLVD patients were compared to characterize differences between patients in these 2 separate but concurrent trials. From over 70,000 patients screened with LV dysfunction, 4,228 patients were enrolled in the prevention trial and 2,569 patients in the treatment trial. Ischemic heart disease was the primary cause of LV dysfunction in both prevention (83%) and treatment (71%) trial patients. Prior myocardial infarction was present in 80% of the prevention and 66% of the treatment trial patients (p < 0.001). In the prevention trial, infarction was recent (≤6 months) in 27% patients and remote (>6 months) in 57% patients. Treatment trial patients had proportionately more women (20 vs 13%; p < 0.001) and non-Caucasians (20 vs 14%; p < 0.001), as well as the coexisting risk factors of hypertension (42 vs 37%; p < 0.001) and diabetes (26 vs 15%; p < 0.001) than did prevention trial patients. Treatment trial patients were more likely to have the clinical signs associated with CHF and had a lower mean LV ejection fraction (0.25 ± 0.07 vs 0.28 ± 0.06, p < 0.001) than prevention trial patients. Clinical characteristics of patients in both trials were influenced by the gender and race of enrolled patients. Similarly, coronary artery bypass surgery was performed less often in women and non-Caucasians. Thus, the baseline database of patients enrolled in the SOLVD trials demonstrates the varied clinical features associated with severe LV dysfunction and highlights the impact of symptomatic status, gender and race on clinical presentation.
UR - http://www.scopus.com/inward/record.url?scp=0026666348&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(92)90734-G
DO - 10.1016/0002-9149(92)90734-G
M3 - Article
C2 - 1529944
AN - SCOPUS:0026666348
SN - 0002-9149
VL - 70
SP - 894
EP - 900
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 9
ER -