Effect of Enalapril on Long-Term Survival among Patients with Left Ventricular Systolic Dysfunction: a 25-Year Near-Full Life-Cycle Follow-Up of SOLVD in Belgium

BACKGROUND: We previously reported that in-trial enalapril therapy was associated with a post-trial mortality benefit in a 12-year follow-up of the Studies of Left Ventricular Dysfunction (SOLVD). We reported here the effect of enalapril on long-term survival in a SOLVD cohort from Belgium that had reached a near-full life-cycle follow-up after 25 years. METHODS: Among the 558 Belgium patients originally enrolled in SOLVD (398 in prevention arm and 160 in treatment arm), post-trial mortality data were prospectively collected on all 433 survivors (218 in enalapril group vs. 215 in placebo group) at closeout. All patients received enalapril therapy after the trial ended. RESULTS: No patients were lost to follow-up. The median duration of follow-up was 25.3 years since randomization or 22.1 years since closeout. In all, 91% of patients had died. Kaplan-Meier event rate for all-cause mortality was lower in the enalapril group than the placebo group over the entire follow-up period (88% vs. 94%, p=0.02). When ...