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A drug often used to treat worsening heart failure in hospitalized patients may cause low blood pressure and abnormal heart rhythms, says a recent study published in the March 27 Journal of the American Medical Association.
Mihai Gheorghiade, MD, of Northwestern University in Chicago, told the Associated Press that the findings suggest that the drug, milrinone, should be reserved for patients who do not respond to other medication.
The study is one of the few to compare a placebo with a drug for worsening heart failure. Despite the poor results, it shows that such studies can and should be done on similar drugs, Gheorghiade says.
The study looked at 951 patients admitted with an exacerbation of systolic heart failure not requiring intravenous inotropic support. The patients were randomly assigned to receive either a 48-hour infusion of milrinone or saline placebo. The median number of days hospitalized for cardiovascular causes within 60 days after randomization did not differ significantly between patients given milrinone (6 days) compared with placebo (7 days).
However, sustained hypotension requiring intervention (10.7% vs. 3.2%) and new atrial arrhythmias (4.6% vs. 1.5%) occurred more frequently in patients who received milrinone. The milrinone and placebo groups did not differ significantly in in-hospital mortality (3.8% vs. 2.3%), 60-day mortality (10.3% vs. 8.9%), or the composite incidence of death or readmission (35.0% vs. 35.3%), respectively.