Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1998 Nov;74(877):658–661. doi: 10.1136/pgmj.74.877.658

Recent advances in the drug treatment of heart failure.

F A McAlister 1, K K Teo 1
PMCID: PMC2431609  PMID: 10197196

Abstract

A number of important questions surrounding the treatment of systolic congestive heart failure have been answered by randomised clinical trials completed within the past 2 years. In particular, these studies have established that high-dose angiotensin-converting enzyme (ACE) inhibition is more beneficial than low dose therapy, and that angiotensin II receptor antagonists are an acceptable alternative in patients unable to tolerate ACE inhibitors. Digoxin has been shown to be the only inotropic agent not associated with increased mortality, while amiodarone exerts a modest survival benefit in arrhythmiaprone patients. Beta-blockers appear to be beneficial for selected patients although their precise role remains to be defined by ongoing studies.

Full text

PDF
658

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Borzak S., Ridker P. M. Discordance between meta-analyses and large-scale randomized, controlled trials. Examples from the management of acute myocardial infarction. Ann Intern Med. 1995 Dec 1;123(11):873–877. doi: 10.7326/0003-4819-123-11-199512010-00010. [DOI] [PubMed] [Google Scholar]
  2. Doughty R. N., Rodgers A., Sharpe N., MacMahon S. Effects of beta-blocker therapy on mortality in patients with heart failure. A systematic overview of randomized controlled trials. Eur Heart J. 1997 Apr;18(4):560–565. doi: 10.1093/oxfordjournals.eurheartj.a015297. [DOI] [PubMed] [Google Scholar]
  3. Fonarow G. C., Stevenson L. W., Walden J. A., Livingston N. A., Steimle A. E., Hamilton M. A., Moriguchi J., Tillisch J. H., Woo M. A. Impact of a comprehensive heart failure management program on hospital readmission and functional status of patients with advanced heart failure. J Am Coll Cardiol. 1997 Sep;30(3):725–732. doi: 10.1016/s0735-1097(97)00208-8. [DOI] [PubMed] [Google Scholar]
  4. Garg R., Yusuf S. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials. JAMA. 1995 May 10;273(18):1450–1456. [PubMed] [Google Scholar]
  5. Hampton J. R., van Veldhuisen D. J., Kleber F. X., Cowley A. J., Ardia A., Block P., Cortina A., Cserhalmi L., Follath F., Jensen G. Randomised study of effect of ibopamine on survival in patients with advanced severe heart failure. Second Prospective Randomised Study of Ibopamine on Mortality and Efficacy (PRIME II) Investigators. Lancet. 1997 Apr 5;349(9057):971–977. doi: 10.1016/s0140-6736(96)10488-8. [DOI] [PubMed] [Google Scholar]
  6. McAlister F. A., Teo K. K. Antiarrhythmic therapies for the prevention of sudden cardiac death. Drugs. 1997 Aug;54(2):235–252. doi: 10.2165/00003495-199754020-00003. [DOI] [PubMed] [Google Scholar]
  7. McAlister F. A., Teo K. K. The management of congestive heart failure. Postgrad Med J. 1997 Apr;73(858):194–200. doi: 10.1136/pgmj.73.858.194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Niebauer J., Coats A. J. Treating chronic heart failure: time to take stock. Lancet. 1997 Apr 5;349(9057):966–967. doi: 10.1016/S0140-6736(97)22014-3. [DOI] [PubMed] [Google Scholar]
  9. Pacher R., Stanek B., Globits S., Berger R., Hülsmann M., Wutte M., Frey B., Schuller M., Hartter E., Ogris E. Effects of two different enalapril dosages on clinical, haemodynamic and neurohumoral response of patients with severe congestive heart failure. Eur Heart J. 1996 Aug;17(8):1223–1232. doi: 10.1093/oxfordjournals.eurheartj.a015040. [DOI] [PubMed] [Google Scholar]
  10. Packer M., Bristow M. R., Cohn J. N., Colucci W. S., Fowler M. B., Gilbert E. M., Shusterman N. H. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. N Engl J Med. 1996 May 23;334(21):1349–1355. doi: 10.1056/NEJM199605233342101. [DOI] [PubMed] [Google Scholar]
  11. Parameshwar J., Shackell M. M., Richardson A., Poole-Wilson P. A., Sutton G. C. Prevalence of heart failure in three general practices in north west London. Br J Gen Pract. 1992 Jul;42(360):287–289. [PMC free article] [PubMed] [Google Scholar]
  12. Pitt B., Segal R., Martinez F. A., Meurers G., Cowley A. J., Thomas I., Deedwania P. C., Ney D. E., Snavely D. B., Chang P. I. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE) Lancet. 1997 Mar 15;349(9054):747–752. doi: 10.1016/s0140-6736(97)01187-2. [DOI] [PubMed] [Google Scholar]
  13. Waldo A. L., Camm A. J., deRuyter H., Friedman P. L., MacNeil D. J., Pauls J. F., Pitt B., Pratt C. M., Schwartz P. J., Veltri E. P. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. Lancet. 1996 Jul 6;348(9019):7–12. doi: 10.1016/s0140-6736(96)02149-6. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES