Abstract | OBJECTIVES: This study was performed to assess the efficacy, safety and clinical consequences of abrupt cessation of quinapril therapy in a placebo-controlled, randomized, double-blind withdrawal trial. BACKGROUND: METHODS: After > or = 10 weeks of single-blind quinapril therapy, 224 patients with New York Heart Association class II or III heart failure were randomized in double-blind fashion to continue quinapril (n = 114) or to receive placebo (n = 110) for 16 weeks. Changes in treadmill exercise time, New York Heart Association functional class, quality of life and symptoms of heart failure were assessed. RESULTS: Patients withdrawn to placebo had a significant deterioration in exercise tolerance (median change -16 s with placebo vs. +3 s with quinapril, p = 0.015). New York Heart Association functional class (p = 0.004) and quality of life were improved and signs and symptoms of congestive heart failure were lessened in those remaining on quinapril therapy compared with those receiving placebo. During double-blind treatment, 18 patients were withdrawn from the placebo group because of worsening heart failure compared with 5 patients withdrawn from quinapril treatment (p < 0.001). Rather than a precipitous deterioration of clinical status or early incidence of adverse events, withdrawal from quinapril was associated with steady worsening of heart failure, beginning 4 to 6 weeks after randomization to placebo. CONCLUSIONS:
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Authors | P W Pflugfelder, M G Baird, M J Tonkon, R DiBianco, B Pitt |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 22
Issue 6
Pg. 1557-63
(Nov 15 1993)
ISSN: 0735-1097 [Print] United States |
PMID | 8227822
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Angiotensin-Converting Enzyme Inhibitors
- Isoquinolines
- Tetrahydroisoquinolines
- Quinapril
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Topics |
- Aged
- Analysis of Variance
- Angiotensin-Converting Enzyme Inhibitors
(adverse effects, therapeutic use)
- Chronic Disease
- Double-Blind Method
- Exercise
(physiology)
- Female
- Heart Failure
(drug therapy, physiopathology)
- Humans
- Isoquinolines
(adverse effects, therapeutic use)
- Linear Models
- Male
- Middle Aged
- Quinapril
- Substance Withdrawal Syndrome
(physiopathology)
- Tetrahydroisoquinolines
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