title: Comparison of losartan and captopril on heart failure-related outcomes and symptoms from the losartan heart failure survival study (ELITE II).
abstract: BACKGROUND
  Blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors improves outcomes and symptoms in patients with heart failure (HF). We compared effects of losartan to captopril on mortality, morbidity, and functional status for patients in the ELITE II study.
  
  
  RESULTS
  A total of 3152 patients, aged 60 years or older, with New York Heart Association (NYHA) classes II to IV HF and ejection fraction < or = 40% were assigned to receive losartan 50 mg once daily or captopril 50 mg 3 times daily. Outcome measures included all-cause and HF-related mortality, hospitalizations, and discontinuations; change in NYHA class; and quality of life (QoL). HF-related outcomes were not significantly different between therapies. Similar improvements from baseline (P < .01) in NYHA class were observed within both treatment groups. Among 1856 QoL participants, 1343 patients survived at least 1 year; the QoL for 1-year survivors improved in both treatment groups (P < .001 vs baseline) and did not differ between groups.
  
  
  CONCLUSIONS
  In ELITE II, the effects of losartan on HF-related outcomes, NYHA class, and QoL were not superior to those of captopril. Although angiotensin-converting enzyme inhibitors remain the treatment of choice for patients with HF, the similarity of the findings in the present analysis supports a role for angiotensin-receptor antagonists in this patient population.
authors.affiliation: Division of Cardiology, Tufts-New England Medical Center, Boston, MA 02111, USA. mkonstam@tufts-nemc.org
authors.forename: Marvin A
authors.initials: MA
authors.lastname: Konstam
authors.forename: James D
authors.initials: JD
authors.lastname: Neaton
authors.forename: Philip A
authors.initials: PA
authors.lastname: Poole-Wilson
authors.forename: Bertram
authors.initials: B
authors.lastname: Pitt
authors.forename: Robert
authors.initials: R
authors.lastname: Segal
authors.forename: Divakar
authors.initials: D
authors.lastname: Sharma
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Dasbach
authors.forename: George W
authors.initials: GW
authors.lastname: Carides
authors.forename: Kenneth
authors.initials: K
authors.lastname: Dickstein
authors.forename: Günter
authors.initials: G
authors.lastname: Riegger
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Martinez
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Bradstreet
authors.forename: Leila S
authors.initials: LS
authors.lastname: Ikeda
authors.forename: Emanuela P
authors.initials: EP
authors.lastname: Santoro
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D013534:Survival
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D019808:Losartan