Journal of Cardiac Failure
Volume 5, Issue 3 , Pages 195-200, September 1999

Effect of inotrope withdrawal on morbidity and mortality in patients with chronic heart failure: Results of the vesnarinone trial withdrawal substudy☆

  • Ozlem Soran, MD

      Affiliations

    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • James D. Young, MD

      Affiliations

    • The Cleveland Clinic Foundation, Cleveland, Ohio, USA
    • ,
  • Richard Holubkov, PhD

      Affiliations

    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • Susan Loftus, RN

      Affiliations

    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • Robert Bourge, MD

      Affiliations

    • The University of Alabama Health Sciences Center, Birmingham, Alabama, USA
    • ,
  • Peter Carson, MD

      Affiliations

    • Georgetown University School of Medicine, Washington, District of Columbia USA
    • ,
  • Brian Jaski, MD

      Affiliations

    • Sharp Hospital, San Diego, California, USA
    • ,
  • B.G. White, PhD

      Affiliations

    • Clinical Cardiovascular Research, Rockville, Maryland, USA
    • ,
  • Arthur M. Feldman, MD, PhD

      Affiliations

    • Corresponding Author InformationReprint requests: Arthur M. Feldman, MD, PhD, 200 Lothrop Street, S-572 Scaife Hall, Pittsburgh, PA 15213.
    • Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
    • ,
  • For The Vest Withdrawal Substudy Group

Received 22 March 1999; received in revised form 4 June 1999; accepted 8 June 1999.

Abstract 

Background: The use of inotropic agents in the therapy of patients with congestive heart failure (CHF) is controversial. One concern regarding inotropic therapy has been that drug withdrawal could be associated with a worsening of symptoms.

Methods and Results: We took advantage of the discontinuation of the recent trial of vesnarinone in the therapy of CHF to assess the effects of withdrawal of the inotropic agent, vesnarinone, in patients with chronic CHF who had been randomized to receive either placebo or 30 or 60 mg of vesnarinone. Contrary to our initial hypothesis, withdrawal of vesnarinone did not impact on either morbidity or mortality over a period of 6 months.

Conclusion: Although these results suggest vesnarinone withdrawal is safe, the applicability of these results to other inotropic agents remains unclear.

Keywords:  inotropic agents, congestive heart failure, survival

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☆ Supported in part by Otsuka Pharmaceutical, Osaka, Japan.

PII: S1071-9164(99)90003-9

Journal of Cardiac Failure
Volume 5, Issue 3 , Pages 195-200, September 1999

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