ELITE trial

Last reviewed 02/2023

The ELITE trial was a double-blind, randomised, captopril- controlled trial of losartan in the management of heart failure in the elderly.

722 patients over 65 years old with New York Heart Association class II-IV heart failure and ejection fractions less than 40% were randomised to losartan or captopril.

Drug doses were titrated up to 50 mg losartan once daily or 50 mg captopril three times daily.

Patients were followed for 48 months. Data was analysed on an intention to treat basis.

The primary endpoint was the frequency of persistent renal dysfunction, defined as an increase in serum creatinine of >26.5 microgram/L. Renal dysfunction occurred with equal frequency in both arms (10.5%).

Fewer patients were intolerant of losartan (12.2% vs. 20.8% p=0.002).

All cause mortality was significantly lower in the losartan group (4.8% vs. 8.7%; risk reduction 46% [95% CI 5-69%], p=0.035).

The was a non-significant trend towards fewer deaths or admissions with heart failure in the losartan-treated patients.

Reference:

• Pitt, B. et al. (1997). Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet, 349, 747-752.