Meeting highlights: highlights of the 72nd Scientific Sessions of the American Heart Association.

Abstract

The following studies were presented at the 72nd Scientific Sessions of the American Heart Association, November 7–10, 1999 in Atlanta, Georgia. ### ELITE II (Evaluation of Losartan in the Elderly) Presenters: Bertram Pitt, University of Michigan, Ann Arbor, Mich; Philip Poole-Wilson, National Heart & Lung Institute, London, England, UK. The study: A large-scale multicenter (289 clinical sites in 46 countries) randomized, controlled trial of Losartan (an angiotensin receptor blocker) in patients with heart failure. A total of 3152 patients with class II to IV heart failure and an EF ≤40% were randomized to captopril (50 mg TID, n=1574) or Losartan (50 mg/d, n=1578). To qualify for the study, patients could not have been on prior ACE inhibitor therapy for ≥7 days. Patients were subsequently followed for a mean of 558 days. The primary endpoint of the study was all-cause mortality. The results: There was no significant difference in all-cause mortality in the 2 groups (captopril 15.9%; losartan 17.7%). Mortality in both groups was approximately 11%/year. Sudden death tended to be slightly lower (but not significantly) in the captopril group. In analyses of various clinical subsets, patients on β-blockers and patients with an EF>32% showed more benefit with captopril. There were also no significant differences between group in the composite of sudden death and resuscitated cardiac arrest, in hospitalization rates, and the composite of all cause mortality and hospitalization. Captopril patients were significantly more likely to withdraw from therapy (14.5% versus 9.4% with Losartan). Summary: In contrast to the previous ELITE trial, the larger scale ELITE II trial showed no mortality advantage for the ARB losartan. ACE-inhibit therapy remains the therapy of choice in patients with heart failure. ARBs may be considered if ACE inhibitors are not tolerated. ### IMPRESS Presenter : Jean Rouleau, Toronto Hospital, Canada. The study: A multicenter, randomized, controlled trial of omapatrilat (a novel vasopeptidase inhibitor that blocks …