SAVE (captopril)
Trial question
What is the role of captopril in patients with asymptomatic LV dysfunction after MI?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
17.0% female
83.0% male
N = 2231
2231 patients (390 female, 1841 male).
Inclusion criteria: patients with asymptomatic LV dysfunction after MI.
Key exclusion criteria: contraindications to an ACE inhibitor, serum creatinine > 2.5 mg/dL, or comorbidities believed to limit survival.
Interventions
N=1115 captopril (target dose 25 mg PO TID).
N=1116 placebo (matching capsules).
Primary outcome
All-cause death
20%
25%
25.0 %
18.8 %
12.5 %
6.3 %
0.0 %
Captopril
Placebo
Significant
increase ▲
NNH = 20
Significant increase in all-cause death (20% vs. 25%; RR 19, 95% CI 3 to 32).
Secondary outcomes
Significant increase in CV death (44.5% vs. 55.4%; RR 21, 95% CI 5 to 35).
Significant increase in new-onset severe HF (11% vs. 16%; RR 37, 95% CI 20 to 50).
Conclusion
In patients with asymptomatic LV dysfunction after MI, captopril was superior to placebo with respect to a all-cause death.
Reference
Pfeffer MA, Braunwald E, Moye LA et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. N Engl J Med. 1992 Sep 3;327(10):669-77.
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