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ACC: Tilarginine Does Not Cut Cardiogenic Shock Death Risk

After six months, 58 percent of patients on tilarginine die, versus 59 percent on placebo

TUESDAY, March 27 (HealthDay News) -- The once-promising drug, tilarginine acetate, does not decrease mortality risk for patients up to six months after acute myocardial infarction and cardiogenic shock, researchers report in the March 26 online edition of the Journal of the American Medical Association. The findings were released early to coincide with the American College of Cardiology meeting in New Orleans.

Judith S. Hochman, M.D., of the New York University School of Medicine in New York City, and colleagues compared the effects of tilarginine with placebo in 658 unstable myocardial infarction patients with cardiogenic shock treated at 130 medical centers from January 2005 to August 2006.

The study was halted at 398 patients after reaching a pre-determined futility benchmark. At six-month follow-up, death rates were similar between patients on tilarginine and placebo, as were the duration of shock and its resolution.

After one month, 48 percent of tilarginine patients had heart failure, versus 51 percent on placebo. After six months, 58 percent of tilarginine patients died, versus 59 percent on placebo.

"Tilarginine, 1-mg/kg bolus and five-hour infusion, did not reduce mortality rates in patients with refractory cardiogenic shock complicating myocardial infarction, despite an open-infarct artery," the authors write. "Early mortality rates in this patient group are high."

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