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September 30, 2008 by admin
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Myosin-Activating Agent Boosts Systolic Function, but Please Don’t Call it an “Inotrope”
September 27, 2008 by admin
Filed under Heart Happenings
www.theheart.org (read the full article)
September 26, 2008 |
Toronto, ON – Would that which is called an inotrope, by any other name, be safer in heart failure? A small dose-ranging study in patients with stable heart failure supports animal research suggesting that an obscure drug, a selective activator of cardiac myosin, can amplify contractile function without increasing myocardial oxygen demand [1]. Investigators hope that CK-1827452 (Cytokinetics), as it’s called for now, will offer the benefits of conventional inotropic agents without the effects that can ultimately harm patients taking them.
They also don’t want the myosin activator, still technically a positive inotropic agent, to carry the drug class’s stigma by being lumped with 
1-adrenergic agonists like dobutamine or phosphodiesterase-3 inhibitors like milrinone. Those drugs strengthen myocardial contractions and are used sparingly for short-term symptom relief in some high-risk populations, but at a high metabolic cost and increased arrhythmic and mortality risk.
Fish Oil Cut Heart Failure Morbidity, Death in GISSI-HF
September 27, 2008 by admin
Filed under Heart Happenings
In same study, statin showed no benefit.
Cardiology News (read full article)
Volume 6, Issue 9, Page 1 (September 2008)
MUNICH — Supplementation with a single daily low-dose fish oil capsule in patients with chronic heart failure resulted in modest but clinically meaningful reductions in mortality and cardiovascular hospitalization in a nearly 7,000-patient randomized trial presented at the annual congress of the European Society of Cardiology.
In a surprise finding, the same Italian study, known as GISSI-HF, concluded that rosuvastatin at 10 mg/day had no effect on mortality or hospital admission for cardiovascular events, suggesting that patients with chronic heart failure should not be started on statins. (See story on p. 9.)
In GISSI-HF, 6,975 patients with New York Heart Association class II-IV chronic heart failure were randomized in double-blind fashion to 1 g/day of omega-3 polyunsaturated fatty acids (n-3 PUFA) in the form of eicosapentaenoic acid and docosahexaenoic acid or to placebo. The participants were on standard background therapy with the agents of proven efficacy in heart failure.
All-cause mortality after a median 3.9 years of follow-up was 27% in the n-3 PUFA group and 29% in controls, for a significant adjusted 9% relative risk reduction in the n-3 PUFA group, reported Dr. Luigi Tavazzi, chair of the GISSI-HF steering committee and professor of cardiology at the University of Pavia (Italy).
The co-primary end point in GISSI-HF was death or cardiovascular hospitalization, which occurred in 57% of the n-3 PUFA cohort and in 59% of those on placebo, for an 8% relative risk reduction that did not reach statistical significance.
In all, 44 patients needed to be treated with n-3 PUFA for 3.9 years in order to prevent one additional death or cardiovascular hospitalization, whereas 56 patients needed to be treated in order to prevent one death. Those are fairly high numbers, but it’s a trouble-free therapy, according to Dr. Tavazzi.
