Comparative Effects of Therapy With Captopril and Digoxin in Patients With Mild to Moderate Heart Failure

Jay Cohn, Morton Hawkins, Herbert Levine, John Naughton, Elliot Rapaport, Sidney Goldstein, Bertram Pitt, Sidney Goldstein, Robert Cody, Prakash Deedwania, Leonard Dennick, Joseph Franciosa, Mark Mcgovern, Joseph Meyer, Bertram Pitt, Joseph Franciosa, Sidney Goldstein, Robert Cody, Prakash Deedwania, Alan GradmanBarry Massie, Milton Packer, James Doherty, Jacquelyn Gammill, William Cooper, Stanford Engel, Rita Fand, Barbara Hallows, Linda Kerwin, Debra A. Soltesz, John O. Parker, Karen Lahey, Prakash C. Deedwania, Enrique Carbajal, Pat Watson, Robert Dibianco, James A. Ronan, Dennis J. Donohue, Keith M. Lindgren, Louis J. Larca, Judy Freitag, Donna Lindemuth, Jeffrey B. Lakier, Howard S. Rosman, Mary Beth Wlodkowski, Robert J. Cody, Spencer H. Kubo, Mary Clark, Katie Pondolfino, Joseph A. Franciosa, Mary Wilen, Drexel Jordan, Sunil K. Das, John M. Nicklas, Mary Kay Foley, Michael B. Higginbotham, Frederick R. Cobb, Jean Wilson, David M. Berkson, Dragic Obradovic, Patricia Hershinow, N. Gary Nicholls, Hamid Ikram, Ian Crozier, Carl J. Pepine, John Culp, Marion Limacher, Kathy Mulvehill Verbust, D. John Farnham, Dorothy Adams, Norene Streicher, Carol Shanley, Mark A. Greenberg, Janet Strain, Mary Hewitt, Barbara Levine, D. Norman Sharpe, Robin Briant, Rene Coxon, Barry M. Massie, James W. Cornyn, Nina Topic, Harold Willens, Denise Antonishen, Dorothy Reinstein, Harry Colfer, Karen E. Graham, Gerald M. Perlow, Harvey S. Zarren, Barbara Bent, Marjorie Zicherman, Alan Gradman, Barry Zaret, Deborah Lawrason, Pat Tellier, Kathy O’keefe, Syed Mohiuddin, Lois Stengel, James D. Madison, Nancy Carruthers, Milton Packer, Fernando Elijovich, Mary O’sullivan, Uri Elkayam, Shabudin H. Rahimtoola, Laura Weber, Sheldon Gottlieb, Carol Brown, Mariell D. Jessup, Susan Ulrich, Jane Kronenthal, Denise Capaccio, Colin Grant, Edward Gillie, Pat Wood, Fetnat M. Fouad Tarazi, Kay Petey

Research output: Contribution to journalArticle

529 Citations (Scopus)

Abstract

This multicenter, double-blind, placebo-controlled study compares the effects of captopril treatment with those of digoxin treatment during maintenance diuretic therapy in patients with mild to moderate heart failure. Compared with placebo, captopril therapy resulted in significantly improved exercise time (mean increase, 82 s vs 35 s) and improved New York Heart Association class (41% vs 22%), but digoxin therapy did not. Digoxin treatment increased ejection fraction (4.4% increase) compared with captopril therapy (1.8% increase) and placebo (0.9% increase). The number of ventricular premature beats decreased 45% in the captopril group and increased 4% in the digoxin group in patients with more than ten ventricular premature beats per hour. Treatment failures, increased requirements for diuretic therapy, and hospitalizations were significantly more frequent in patients receiving placebo compared with those receiving either active drug. Transitory hypotension occurred more frequently with administration of captopril. Captopril treatment is significantly more effective than placebo and is an alternative to digoxin therapy in patients with mild to moderate heart failure who are receiving diuretic maintenance therapy.

Original languageEnglish (US)
Pages (from-to)539-544
Number of pages6
JournalJAMA: The Journal of the American Medical Association
Volume259
Issue number4
DOIs
StatePublished - Jan 22 1988

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Digoxin
Captopril
Heart Failure
Placebos
Diuretics
Therapeutics
Ventricular Premature Complexes
Treatment Failure
Hypotension
Hospitalization
Maintenance
Exercise

Cite this

Comparative Effects of Therapy With Captopril and Digoxin in Patients With Mild to Moderate Heart Failure. / Cohn, Jay; Hawkins, Morton; Levine, Herbert; Naughton, John; Rapaport, Elliot; Goldstein, Sidney; Pitt, Bertram; Goldstein, Sidney; Cody, Robert; Deedwania, Prakash; Dennick, Leonard; Franciosa, Joseph; Mcgovern, Mark; Meyer, Joseph; Pitt, Bertram; Franciosa, Joseph; Goldstein, Sidney; Cody, Robert; Deedwania, Prakash; Gradman, Alan; Massie, Barry; Packer, Milton; Doherty, James; Gammill, Jacquelyn; Cooper, William; Engel, Stanford; Fand, Rita; Hallows, Barbara; Kerwin, Linda; Soltesz, Debra A.; Parker, John O.; Lahey, Karen; Deedwania, Prakash C.; Carbajal, Enrique; Watson, Pat; Dibianco, Robert; Ronan, James A.; Donohue, Dennis J.; Lindgren, Keith M.; Larca, Louis J.; Freitag, Judy; Lindemuth, Donna; Lakier, Jeffrey B.; Rosman, Howard S.; Wlodkowski, Mary Beth; Cody, Robert J.; Kubo, Spencer H.; Clark, Mary; Pondolfino, Katie; Franciosa, Joseph A.; Wilen, Mary; Jordan, Drexel; Das, Sunil K.; Nicklas, John M.; Foley, Mary Kay; Higginbotham, Michael B.; Cobb, Frederick R.; Wilson, Jean; Berkson, David M.; Obradovic, Dragic; Hershinow, Patricia; Nicholls, N. Gary; Ikram, Hamid; Crozier, Ian; Pepine, Carl J.; Culp, John; Limacher, Marion; Mulvehill Verbust, Kathy; Farnham, D. John; Adams, Dorothy; Streicher, Norene; Shanley, Carol; Greenberg, Mark A.; Strain, Janet; Hewitt, Mary; Levine, Barbara; Sharpe, D. Norman; Briant, Robin; Coxon, Rene; Massie, Barry M.; Cornyn, James W.; Topic, Nina; Willens, Harold; Antonishen, Denise; Reinstein, Dorothy; Colfer, Harry; Graham, Karen E.; Perlow, Gerald M.; Zarren, Harvey S.; Bent, Barbara; Zicherman, Marjorie; Gradman, Alan; Zaret, Barry; Lawrason, Deborah; Tellier, Pat; O’keefe, Kathy; Mohiuddin, Syed; Stengel, Lois; Madison, James D.; Carruthers, Nancy; Packer, Milton; Elijovich, Fernando; O’sullivan, Mary; Elkayam, Uri; Rahimtoola, Shabudin H.; Weber, Laura; Gottlieb, Sheldon; Brown, Carol; Jessup, Mariell D.; Ulrich, Susan; Kronenthal, Jane; Capaccio, Denise; Grant, Colin; Gillie, Edward; Wood, Pat; Fouad Tarazi, Fetnat M.; Petey, Kay.

In: JAMA: The Journal of the American Medical Association, Vol. 259, No. 4, 22.01.1988, p. 539-544.

Research output: Contribution to journalArticle

Cohn, J, Hawkins, M, Levine, H, Naughton, J, Rapaport, E, Goldstein, S, Pitt, B, Goldstein, S, Cody, R, Deedwania, P, Dennick, L, Franciosa, J, Mcgovern, M, Meyer, J, Pitt, B, Franciosa, J, Goldstein, S, Cody, R, Deedwania, P, Gradman, A, Massie, B, Packer, M, Doherty, J, Gammill, J, Cooper, W, Engel, S, Fand, R, Hallows, B, Kerwin, L, Soltesz, DA, Parker, JO, Lahey, K, Deedwania, PC, Carbajal, E, Watson, P, Dibianco, R, Ronan, JA, Donohue, DJ, Lindgren, KM, Larca, LJ, Freitag, J, Lindemuth, D, Lakier, JB, Rosman, HS, Wlodkowski, MB, Cody, RJ, Kubo, SH, Clark, M, Pondolfino, K, Franciosa, JA, Wilen, M, Jordan, D, Das, SK, Nicklas, JM, Foley, MK, Higginbotham, MB, Cobb, FR, Wilson, J, Berkson, DM, Obradovic, D, Hershinow, P, Nicholls, NG, Ikram, H, Crozier, I, Pepine, CJ, Culp, J, Limacher, M, Mulvehill Verbust, K, Farnham, DJ, Adams, D, Streicher, N, Shanley, C, Greenberg, MA, Strain, J, Hewitt, M, Levine, B, Sharpe, DN, Briant, R, Coxon, R, Massie, BM, Cornyn, JW, Topic, N, Willens, H, Antonishen, D, Reinstein, D, Colfer, H, Graham, KE, Perlow, GM, Zarren, HS, Bent, B, Zicherman, M, Gradman, A, Zaret, B, Lawrason, D, Tellier, P, O’keefe, K, Mohiuddin, S, Stengel, L, Madison, JD, Carruthers, N, Packer, M, Elijovich, F, O’sullivan, M, Elkayam, U, Rahimtoola, SH, Weber, L, Gottlieb, S, Brown, C, Jessup, MD, Ulrich, S, Kronenthal, J, Capaccio, D, Grant, C, Gillie, E, Wood, P, Fouad Tarazi, FM & Petey, K 1988, 'Comparative Effects of Therapy With Captopril and Digoxin in Patients With Mild to Moderate Heart Failure', JAMA: The Journal of the American Medical Association, vol. 259, no. 4, pp. 539-544. https://doi.org/10.1001/jama.1988.03720040031022
Cohn, Jay ; Hawkins, Morton ; Levine, Herbert ; Naughton, John ; Rapaport, Elliot ; Goldstein, Sidney ; Pitt, Bertram ; Goldstein, Sidney ; Cody, Robert ; Deedwania, Prakash ; Dennick, Leonard ; Franciosa, Joseph ; Mcgovern, Mark ; Meyer, Joseph ; Pitt, Bertram ; Franciosa, Joseph ; Goldstein, Sidney ; Cody, Robert ; Deedwania, Prakash ; Gradman, Alan ; Massie, Barry ; Packer, Milton ; Doherty, James ; Gammill, Jacquelyn ; Cooper, William ; Engel, Stanford ; Fand, Rita ; Hallows, Barbara ; Kerwin, Linda ; Soltesz, Debra A. ; Parker, John O. ; Lahey, Karen ; Deedwania, Prakash C. ; Carbajal, Enrique ; Watson, Pat ; Dibianco, Robert ; Ronan, James A. ; Donohue, Dennis J. ; Lindgren, Keith M. ; Larca, Louis J. ; Freitag, Judy ; Lindemuth, Donna ; Lakier, Jeffrey B. ; Rosman, Howard S. ; Wlodkowski, Mary Beth ; Cody, Robert J. ; Kubo, Spencer H. ; Clark, Mary ; Pondolfino, Katie ; Franciosa, Joseph A. ; Wilen, Mary ; Jordan, Drexel ; Das, Sunil K. ; Nicklas, John M. ; Foley, Mary Kay ; Higginbotham, Michael B. ; Cobb, Frederick R. ; Wilson, Jean ; Berkson, David M. ; Obradovic, Dragic ; Hershinow, Patricia ; Nicholls, N. Gary ; Ikram, Hamid ; Crozier, Ian ; Pepine, Carl J. ; Culp, John ; Limacher, Marion ; Mulvehill Verbust, Kathy ; Farnham, D. John ; Adams, Dorothy ; Streicher, Norene ; Shanley, Carol ; Greenberg, Mark A. ; Strain, Janet ; Hewitt, Mary ; Levine, Barbara ; Sharpe, D. Norman ; Briant, Robin ; Coxon, Rene ; Massie, Barry M. ; Cornyn, James W. ; Topic, Nina ; Willens, Harold ; Antonishen, Denise ; Reinstein, Dorothy ; Colfer, Harry ; Graham, Karen E. ; Perlow, Gerald M. ; Zarren, Harvey S. ; Bent, Barbara ; Zicherman, Marjorie ; Gradman, Alan ; Zaret, Barry ; Lawrason, Deborah ; Tellier, Pat ; O’keefe, Kathy ; Mohiuddin, Syed ; Stengel, Lois ; Madison, James D. ; Carruthers, Nancy ; Packer, Milton ; Elijovich, Fernando ; O’sullivan, Mary ; Elkayam, Uri ; Rahimtoola, Shabudin H. ; Weber, Laura ; Gottlieb, Sheldon ; Brown, Carol ; Jessup, Mariell D. ; Ulrich, Susan ; Kronenthal, Jane ; Capaccio, Denise ; Grant, Colin ; Gillie, Edward ; Wood, Pat ; Fouad Tarazi, Fetnat M. ; Petey, Kay. / Comparative Effects of Therapy With Captopril and Digoxin in Patients With Mild to Moderate Heart Failure. In: JAMA: The Journal of the American Medical Association. 1988 ; Vol. 259, No. 4. pp. 539-544.
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abstract = "This multicenter, double-blind, placebo-controlled study compares the effects of captopril treatment with those of digoxin treatment during maintenance diuretic therapy in patients with mild to moderate heart failure. Compared with placebo, captopril therapy resulted in significantly improved exercise time (mean increase, 82 s vs 35 s) and improved New York Heart Association class (41{\%} vs 22{\%}), but digoxin therapy did not. Digoxin treatment increased ejection fraction (4.4{\%} increase) compared with captopril therapy (1.8{\%} increase) and placebo (0.9{\%} increase). The number of ventricular premature beats decreased 45{\%} in the captopril group and increased 4{\%} in the digoxin group in patients with more than ten ventricular premature beats per hour. Treatment failures, increased requirements for diuretic therapy, and hospitalizations were significantly more frequent in patients receiving placebo compared with those receiving either active drug. Transitory hypotension occurred more frequently with administration of captopril. Captopril treatment is significantly more effective than placebo and is an alternative to digoxin therapy in patients with mild to moderate heart failure who are receiving diuretic maintenance therapy.",
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AU - Cohn, Jay

AU - Hawkins, Morton

AU - Levine, Herbert

AU - Naughton, John

AU - Rapaport, Elliot

AU - Goldstein, Sidney

AU - Pitt, Bertram

AU - Goldstein, Sidney

AU - Cody, Robert

AU - Deedwania, Prakash

AU - Dennick, Leonard

AU - Franciosa, Joseph

AU - Mcgovern, Mark

AU - Meyer, Joseph

AU - Pitt, Bertram

AU - Franciosa, Joseph

AU - Goldstein, Sidney

AU - Cody, Robert

AU - Deedwania, Prakash

AU - Gradman, Alan

AU - Massie, Barry

AU - Packer, Milton

AU - Doherty, James

AU - Gammill, Jacquelyn

AU - Cooper, William

AU - Engel, Stanford

AU - Fand, Rita

AU - Hallows, Barbara

AU - Kerwin, Linda

AU - Soltesz, Debra A.

AU - Parker, John O.

AU - Lahey, Karen

AU - Deedwania, Prakash C.

AU - Carbajal, Enrique

AU - Watson, Pat

AU - Dibianco, Robert

AU - Ronan, James A.

AU - Donohue, Dennis J.

AU - Lindgren, Keith M.

AU - Larca, Louis J.

AU - Freitag, Judy

AU - Lindemuth, Donna

AU - Lakier, Jeffrey B.

AU - Rosman, Howard S.

AU - Wlodkowski, Mary Beth

AU - Cody, Robert J.

AU - Kubo, Spencer H.

AU - Clark, Mary

AU - Pondolfino, Katie

AU - Franciosa, Joseph A.

AU - Wilen, Mary

AU - Jordan, Drexel

AU - Das, Sunil K.

AU - Nicklas, John M.

AU - Foley, Mary Kay

AU - Higginbotham, Michael B.

AU - Cobb, Frederick R.

AU - Wilson, Jean

AU - Berkson, David M.

AU - Obradovic, Dragic

AU - Hershinow, Patricia

AU - Nicholls, N. Gary

AU - Ikram, Hamid

AU - Crozier, Ian

AU - Pepine, Carl J.

AU - Culp, John

AU - Limacher, Marion

AU - Mulvehill Verbust, Kathy

AU - Farnham, D. John

AU - Adams, Dorothy

AU - Streicher, Norene

AU - Shanley, Carol

AU - Greenberg, Mark A.

AU - Strain, Janet

AU - Hewitt, Mary

AU - Levine, Barbara

AU - Sharpe, D. Norman

AU - Briant, Robin

AU - Coxon, Rene

AU - Massie, Barry M.

AU - Cornyn, James W.

AU - Topic, Nina

AU - Willens, Harold

AU - Antonishen, Denise

AU - Reinstein, Dorothy

AU - Colfer, Harry

AU - Graham, Karen E.

AU - Perlow, Gerald M.

AU - Zarren, Harvey S.

AU - Bent, Barbara

AU - Zicherman, Marjorie

AU - Gradman, Alan

AU - Zaret, Barry

AU - Lawrason, Deborah

AU - Tellier, Pat

AU - O’keefe, Kathy

AU - Mohiuddin, Syed

AU - Stengel, Lois

AU - Madison, James D.

AU - Carruthers, Nancy

AU - Packer, Milton

AU - Elijovich, Fernando

AU - O’sullivan, Mary

AU - Elkayam, Uri

AU - Rahimtoola, Shabudin H.

AU - Weber, Laura

AU - Gottlieb, Sheldon

AU - Brown, Carol

AU - Jessup, Mariell D.

AU - Ulrich, Susan

AU - Kronenthal, Jane

AU - Capaccio, Denise

AU - Grant, Colin

AU - Gillie, Edward

AU - Wood, Pat

AU - Fouad Tarazi, Fetnat M.

AU - Petey, Kay

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N2 - This multicenter, double-blind, placebo-controlled study compares the effects of captopril treatment with those of digoxin treatment during maintenance diuretic therapy in patients with mild to moderate heart failure. Compared with placebo, captopril therapy resulted in significantly improved exercise time (mean increase, 82 s vs 35 s) and improved New York Heart Association class (41% vs 22%), but digoxin therapy did not. Digoxin treatment increased ejection fraction (4.4% increase) compared with captopril therapy (1.8% increase) and placebo (0.9% increase). The number of ventricular premature beats decreased 45% in the captopril group and increased 4% in the digoxin group in patients with more than ten ventricular premature beats per hour. Treatment failures, increased requirements for diuretic therapy, and hospitalizations were significantly more frequent in patients receiving placebo compared with those receiving either active drug. Transitory hypotension occurred more frequently with administration of captopril. Captopril treatment is significantly more effective than placebo and is an alternative to digoxin therapy in patients with mild to moderate heart failure who are receiving diuretic maintenance therapy.

AB - This multicenter, double-blind, placebo-controlled study compares the effects of captopril treatment with those of digoxin treatment during maintenance diuretic therapy in patients with mild to moderate heart failure. Compared with placebo, captopril therapy resulted in significantly improved exercise time (mean increase, 82 s vs 35 s) and improved New York Heart Association class (41% vs 22%), but digoxin therapy did not. Digoxin treatment increased ejection fraction (4.4% increase) compared with captopril therapy (1.8% increase) and placebo (0.9% increase). The number of ventricular premature beats decreased 45% in the captopril group and increased 4% in the digoxin group in patients with more than ten ventricular premature beats per hour. Treatment failures, increased requirements for diuretic therapy, and hospitalizations were significantly more frequent in patients receiving placebo compared with those receiving either active drug. Transitory hypotension occurred more frequently with administration of captopril. Captopril treatment is significantly more effective than placebo and is an alternative to digoxin therapy in patients with mild to moderate heart failure who are receiving diuretic maintenance therapy.

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