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Study: Vasodilators first choice for some heart patients

Few front-line medications exist for treating hospitalized patients with acute decompensated heart failure, a stage of heart failure marked by heightened severity and often-lengthy hospital stays with frequent readmissions. Now, a study suggests the list of preferred drugs for treating the disease might be even shorter.

In a study released today (7/5) in the Journal of the American College of Cardiology, researchers found that two particular drugs were associated with substantially lower in-hospital mortality than two other drugs that also are commonly used for treating patients with acute decompensated heart failure (ADHF).

The retrospective study draws from a multi-institutional registry of 65,180 patients with ADHF. In comparisons of patients treated intravenously with nitroglycerin, nesiritide, dobutamine or milrinone, there was a lower in-hospital mortality rate for patients administered nitroglycerin or nesiritide than the drugs dobutamine or milrinone.

According to Dr. William T. Abraham, lead author of the study and director of cardiovascular medicine at the Richard M. Ross Heart Hospital at The Ohio State University, the findings may surprise some in the medical community, particularly those who favor the use of positive inotropes, the group of drugs that includes dobutamine and milrinone.

"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," said Abraham.

Congestive heart failure is characterized by a progressive loss in the heart's ability to pump blood. When a patient's condition suddenly or rapidly deteriorates to the point that hospitalization is required, the patient is described as having experienced acute heart failure or acute decompensated heart failure.

Positive inotropes increase the pumping action of the heart, while nitroglycerin and nesiritide act as vasodilators, causing the
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Contact: David Crawford
crawford.1@osu.edu
614-293-3737
Ohio State University Medical Center
4-Jul-2005


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