SOLVD

Studies of Left Ventricular Dysfunction — Treatment Trial

Patient / Population Intervention / Exposure Comparison Outcome

In 2,569 patients with symptomatic heart failure and EF ≤ 0.35, enalapril reduced all-cause mortality compared with placebo.

2,569

Design

Double-blind placebo-controlled RCT

Endpoint

All-cause mortality

Relevance

Result35.2% with enalapril vs 39.7% with placebo (16% relative risk reduction, 95% CI 5-26; P=0.0036) over mean 41.4 months; HF hospitalisations also reduced.

SOLVD Investigators (Yusuf S, et al). N Engl J Med. 1991;325(5):293-302. 10.1056/NEJM199108013250501

Discussion & critique

Predates modern background therapy (beta-blockers, MRAs, devices), so absolute benefit differs today. Foundational trial establishing ACE inhibitors as cornerstone therapy for symptomatic HFrEF.