Table 2.
Survival Rates in the Baseline HF drug therapy (BDT), Initial HF drug therapy (IDT) and Add on HF drug therapy (ADT) Groups in the HF Studies Used in the Reviewed HF Clinical Practice Guidelines.
| NAME OF STUDY | DRUGS USED IN THE TRIAL | DRUGS IN BASELINE HF THERAPY | “Baseline HF Therapy” (BDT) (SURVIVAL IN PLACEBO) |
“Initial HF Therapy” (IDT) (SURVIVAL IN TRIAL DRUG) |
“Add on HF Therapy” (ADT) (SURVIVAL BENEFIT OF TRIAL DRUG) |
BASELINE HF THERAPY MENTIONED |
|---|---|---|---|---|---|---|
| V-HeFT – 1 | Hydralazine + Isosorbide dinitrate | 100% on digoxin and diuretics | 53.1% | 63.8% | 10.7% | YES |
| SOLVD | Enalapril | 85% on diuretics, 65% on digoxin, 40% on nitrates, 7% on Bblockers | 60.3% | 64.8% | 4.5% | YES |
| V-HeFT-2 | Enalapril | 60% on vasodilators, 25% on antiarrhythmics | 61.8% | 67.2% | 5.4% | YES |
| CONSENSUS | Enalapril | 100% on diuretics, 94% digitalis, 50% vasodilators (mainly nitrates) | 46% | 61% | 15% | YES |
| CIBIS II | Bisoprolol | 99% on diuretics, 96% on ACEI or ARB, 58% on nitrates, 51% on digoxin | 82.7% | 88.2% | 5.5% | YES |
| MERIT-HF | Metoprolol CR/XL | >90% on diuretics, >90% on ACEI or ARB, >60% on digitalis | 89% | 92.8% | 3.8% | YES |
| COPERNICUS | Carvedilol | 99% on diuretics, 97% on ACEI, 65% on digoxin | 81.5% | 88.6% | 7.1% | YES |
| ELITE II | Losartan | 79% on diuretics, 50% on digoxin, 21% on Bblockers, 20% on ACEI | 88.3% | 89.6% | 1.3% | NO (but no benefit) |
| CHARM | Candesartan | 85% on diuretics, 55% on B-blockers, 43% on digoxin, 41% on ACEI | 75% | 78% | 3% | YES |
| Val-HeFT | Valsartan | 93% on ACEI, 83% on diuretics, 68% on digoxin, 35% on Bblockers | 80.3% | 80.7% | 0.4% | YES |
| V-HeFT III | Felodipine | 97% on ACEI, 90% on diuretics, 75% on digoxin | 86.2% | 87.2% | 1% | NO (but no benefit) |
| RALES | Spironolactone | 100% on diuretics, 94.5% on ACEI, 74.5% on Digoxin, 10.5% on B-blockers | 54% | 65% | 11% | YES |
| EMPHASIS-HF | Eplerenone | 84.3% on diuretics, 78.3% on ACE-1, 19.1% ACE1/ARB, 86.6% B-blockers, 26.6% Digitalis, 14.4% Anti-arrhythmic | 84.5% | 87.5% | 3% | YES |
| EVEREST | Tolvaptan | 84.3% ACE1/ARB, 70.8% B-blocker, 97.1% diuretics, 53.6% Aldosterone antagonists | 73.7% | 74.1% | 0.4% | YES |
| TOPCAT | Spironolactone | 81% diuretic, 84% ACEI/ARB, 78% beta blocker, 36% CCB, 15% Nitrates, 52% statin | 79.6% | 81.4% | 1.8% | YES |
Legend: Dig, digoxin; BB, beta-blocker; diu, diuretic; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; NO, nitrates; Mono, level of monotherapy; CONSENSUS, Cooperative North Scandinavian Enalapril Survival Study; SOLVD, Studies of Left Ventricular Dysfunction; V-HeFT, Vasodilator-Heart Failure Trial; CIBIS, Cardiac Insufficiency Bisoprolol Study; MERITHF, Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure; US CHF, US Carvedilol Heart Failure Study; COPERNICUS, Carvedilol Prospective Randomized Cumulative Survival study; CHARM, Candesartan in Heart Failure study; ELITE, Evaluation of Losartan in the Elderly trail; Val-HeFT, Valsartan Heart Failure Trial; DIG, Digoxin Investigation Group trial; RALES, Randomized Aldosterone Evaluation Study; EMPHASIS-HF, Eplerenone in HFrEF; EVEREST, Tolvaptan in acute HF in HFrEF; TOPCAT, Spironolactone for HFpEF.