title: Results of the veterinary enalapril trial to prove reduction in onset of heart failure in dogs chronically treated with enalapril alone for compensated, naturally occurring mitral valve insufficiency.
abstract: OBJECTIVE
  To determine the efficacy of long-term enalapril administration in delaying the onset of congestive heart failure (CHF).
  
  
  METHODS
  Placebo-controlled, double-blind, multicenter, randomized trial.
  
  
  METHODS
  124 dogs with compensated mitral valve regurgitation (MR).
  
  
  METHODS
  Dogs randomly assigned to receive enalapril or placebo were monitored for the primary endpoint of onset of CHF for < or = 58 months. Secondary endpoints included time from study entry to the combined endpoint of CHF-all-cause death; number of dogs free of CHF at 500, 1,000, and 1,500 days; and mean number of CHF-free days.
  
  
  RESULTS
  Kaplan-Meier estimates of the effect of enalapril on the primary endpoint did not reveal a significant treatment benefit. Chronic enalapril administration did have a significant benefit on the combined endpoint of CHF-all-cause death (benefit was 317 days [10.6 months]). Dogs receiving enalapril remained free of CHF for a significantly longer time than those receiving placebo and were significantly more likely to be free of CHF at day 500 and at study end.
  
  
  CONCLUSIONS
  Chronic enalapril treatment of dogs with naturally occurring, moderate to severe MR significantly delayed onset of CHF, compared with placebo, on the basis of number of CHF-free days, number of dogs free of CHF at days 500 and study end, and increased time to a combined secondary endpoint of CHF-all-cause death. Improvement in the primary endpoint, CHF-free survival, was not significant. Results suggest that enalapril modestly delays the onset of CHF in dogs with moderate to severe MR.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
authors.forename: Clarke E
authors.initials: CE
authors.lastname: Atkins
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Keene
authors.forename: William A
authors.initials: WA
authors.lastname: Brown
authors.forename: Julie R
authors.initials: JR
authors.lastname: Coats
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Crawford
authors.forename: Teresa C
authors.initials: TC
authors.lastname: DeFrancesco
authors.forename: N Joel
authors.initials: NJ
authors.lastname: Edwards
authors.forename: Phillip R
authors.initials: PR
authors.lastname: Fox
authors.forename: Linda B
authors.initials: LB
authors.lastname: Lehmkuhl
authors.forename: Michael W
authors.initials: MW
authors.lastname: Luethy
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Meurs
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Petrie
authors.forename: Frank S
authors.initials: FS
authors.lastname: Pipers
authors.forename: Steven L
authors.initials: SL
authors.lastname: Rosenthal
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Sidley
authors.forename: Justin H
authors.initials: JH
authors.lastname: Straus
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D016757:Death, Sudden, Cardiac / Q000662:veterinary; D018450:Disease Progression; D018572:Disease-Free Survival; D004283:Dog Diseases / Q000401:mortality / Q000517:prevention & control*; D004285:Dogs; D004311:Double-Blind Method; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000517:prevention & control / Q000662:veterinary*; D053208:Kaplan-Meier Estimate; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000662:veterinary*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004656:Enalapril