Vasodilator Drugs Fight Advanced Heart Failure

Large study finds them superior to another class of medications

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WEDNESDAY, July 6, 2005 (HealthDay News) -- A study pitting two classes of heart failure drugs against each other found that one type, vasodilators, are more effective in treating hospitalized patients with the "acute decompensated" form of the illness.

Acute decompensated heart failure (ADHF) is a stage of heart failure characterized by increased severity and long hospital stays.

In treating heart failure patients, doctors often turn to vasodilator drugs, which cause blood vessels to dilate -- reducing the amount of effort needed by the heart to pump blood through the body. Another class of medicines, called positive inotropes, work by increasing the heart's pumping action.

Researchers at Ohio State University Medical Center conducted a retrospective study of over 65,000 ADHF patients treated intravenously with either of these types of drugs.

Reporting in the July 5 Journal of the American College of Cardiology, they found that those who received the vasodilators nitroglycerin and nesiritide had lower in-hospital death rates than those who received either of two positive inotrope drugs, dobutamine and milrinone.

The findings may surprise some in the medical community, particularly those who favor the use of positive inotropes, said study lead author Dr. William T. Abraham, director of cardiovascular medicine at the Richard M. Ross Heart Hospital at Ohio State University.

"This is a significant finding from a large population of patients and will certainly aid in the development of guidelines for treating patients with acute decompensated heart failure," Abraham said in a prepared statement.

"Our study suggests that inotropes be reserved for patients who fail with vasodilators or are so severely ill that vasodilators alone are likely to be inadequate treatment," he said.

The study was funded by Scios Inc., a biopharmaceutical company now owned by Johnson & Johnson.

More information

The American Heart Association has more about heart failure.

SOURCE: Ohio State University Medical Center, news release, July 4, 2005

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