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  • Title: [Observations on the natural history of heart failure. Changes due to the therapeutic use of captopril].
    Author: Ziletti G, Spotti A, Carini M, Distante R, Astorri E.
    Journal: Minerva Cardioangiol; 1992 Mar; 40(3):71-8. PubMed ID: 1630678.
    Abstract:
    The purpose of this research was a retrospective evaluation of the mortality rate in 138 patients, considered after the first hospitalisation due to heart failure. After 5 years, the mortality rate was higher in the 54 patients with dilatative cardiomyopathy (74.3%), compared to the 44 patients with coronary heart disease (54.5%), while the 40 patients with valvular heart disease showed a lower mortality (37.5%). The mortality rate was higher in patients admitted in higher NYHA class. The primary aim of this research was to assess the effects of captopril on mortality in 101 treated patients, compared to 37 non treated patients, both receiving conventional treatment for heart failure. Between the 2 groups, the mortality rate showed lower percentage values for patients treated with captopril, with significant difference (p less than 0.01) at controls carried out every 12 months, until 5 years. Progressive heart failure was the greater cause of death in both groups, while the deaths classified as due to arrhythmia without pump failure were less frequent. Deaths due to reinfarction in patients with coronary heart disease showed lesser percentage values in patients treated with captopril. This research demonstrated the high mortality rate affecting a group of patients after the first hospitalisation due to heart failure. The addition of captopril to conventional treatment for heart failure significantly reduced mortality.
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