Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock.

Adrenergic beta-Agonists / therapeutic use Aged Cardiotonic Agents / adverse effects Comorbidity Dobutamine / adverse effects Double-Blind Method Female Hospital Mortality Humans Male Middle Aged Milrinone / adverse effects Phosphodiesterase 3 Inhibitors / therapeutic use Shock, Cardiogenic / drug therapy

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
05 08 2021
Historique:
entrez: 4 8 2021
pubmed: 5 8 2021
medline: 21 8 2021
Statut: ppublish

Résumé

Cardiogenic shock is associated with substantial morbidity and mortality. Although inotropic support is a mainstay of medical therapy for cardiogenic shock, little evidence exists to guide the selection of inotropic agents in clinical practice. We randomly assigned patients with cardiogenic shock to receive milrinone or dobutamine in a double-blind fashion. The primary outcome was a composite of in-hospital death from any cause, resuscitated cardiac arrest, receipt of a cardiac transplant or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack or stroke diagnosed by a neurologist, or initiation of renal replacement therapy. Secondary outcomes included the individual components of the primary composite outcome. A total of 192 participants (96 in each group) were enrolled. The treatment groups did not differ significantly with respect to the primary outcome; a primary outcome event occurred in 47 participants (49%) in the milrinone group and in 52 participants (54%) in the dobutamine group (relative risk, 0.90; 95% confidence interval [CI], 0.69 to 1.19; P = 0.47). There were also no significant differences between the groups with respect to secondary outcomes, including in-hospital death (37% and 43% of the participants, respectively; relative risk, 0.85; 95% CI, 0.60 to 1.21), resuscitated cardiac arrest (7% and 9%; hazard ratio, 0.78; 95% CI, 0.29 to 2.07), receipt of mechanical circulatory support (12% and 15%; hazard ratio, 0.78; 95% CI, 0.36 to 1.71), or initiation of renal replacement therapy (22% and 17%; hazard ratio, 1.39; 95% CI, 0.73 to 2.67). In patients with cardiogenic shock, no significant difference between milrinone and dobutamine was found with respect to the primary composite outcome or important secondary outcomes. (Funded by the Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario; ClinicalTrials.gov number, NCT03207165.).

Sections du résumé

BACKGROUND
Cardiogenic shock is associated with substantial morbidity and mortality. Although inotropic support is a mainstay of medical therapy for cardiogenic shock, little evidence exists to guide the selection of inotropic agents in clinical practice.
METHODS
We randomly assigned patients with cardiogenic shock to receive milrinone or dobutamine in a double-blind fashion. The primary outcome was a composite of in-hospital death from any cause, resuscitated cardiac arrest, receipt of a cardiac transplant or mechanical circulatory support, nonfatal myocardial infarction, transient ischemic attack or stroke diagnosed by a neurologist, or initiation of renal replacement therapy. Secondary outcomes included the individual components of the primary composite outcome.
RESULTS
A total of 192 participants (96 in each group) were enrolled. The treatment groups did not differ significantly with respect to the primary outcome; a primary outcome event occurred in 47 participants (49%) in the milrinone group and in 52 participants (54%) in the dobutamine group (relative risk, 0.90; 95% confidence interval [CI], 0.69 to 1.19; P = 0.47). There were also no significant differences between the groups with respect to secondary outcomes, including in-hospital death (37% and 43% of the participants, respectively; relative risk, 0.85; 95% CI, 0.60 to 1.21), resuscitated cardiac arrest (7% and 9%; hazard ratio, 0.78; 95% CI, 0.29 to 2.07), receipt of mechanical circulatory support (12% and 15%; hazard ratio, 0.78; 95% CI, 0.36 to 1.71), or initiation of renal replacement therapy (22% and 17%; hazard ratio, 1.39; 95% CI, 0.73 to 2.67).
CONCLUSIONS
In patients with cardiogenic shock, no significant difference between milrinone and dobutamine was found with respect to the primary composite outcome or important secondary outcomes. (Funded by the Innovation Fund of the Alternative Funding Plan for the Academic Health Sciences Centres of Ontario; ClinicalTrials.gov number, NCT03207165.).

Identifiants

DOI: 10.1056/NEJMoa2026845 PMID: 34347952
pubmed: 34347952
doi: 10.1056/NEJMoa2026845
doi:

Substances chimiques

Adrenergic beta-Agonists 0
Cardiotonic Agents 0
Phosphodiesterase 3 Inhibitors 0
Dobutamine 3S12J47372
Milrinone JU9YAX04C7

Banques de données

ClinicalTrials.gov
['NCT03207165']

Types de publication

Comparative Study Journal Article Pragmatic Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

516-525

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2021 Massachusetts Medical Society.

Auteurs

Rebecca Mathew (R)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Pietro Di Santo (P)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Richard G Jung (RG)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Jeffrey A Marbach (JA)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Jordan Hutson (J)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Trevor Simard (T)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.
ORCID: 0000-0001-9465-8150

F Daniel Ramirez (FD)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

David T Harnett (DT)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Anas Merdad (A)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Aws Almufleh (A)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Willy Weng (W)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Omar Abdel-Razek (O)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.
ORCID: 0000-0003-4123-6004

Shannon M Fernando (SM)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.
ORCID: 0000-0003-4549-4289

Kwadwo Kyeremanteng (K)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Jordan Bernick (J)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

George A Wells (GA)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Vincent Chan (V)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Michael Froeschl (M)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Marino Labinaz (M)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Michel R Le May (MR)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Juan J Russo (JJ)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

Benjamin Hibbert (B)

From the CAPITAL Research Group, Division of Cardiology (R.M., P.D.S., R.G.J., J.A.M., T.S., F.D.R., D.T.H., O.A.-R., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Cardiovascular Research Methods Centre (J.B., G.A.W.), and the Division of Cardiac Surgery (V.C.), University of Ottawa Heart Institute, and the Faculty of Medicine (R.M., P.D.S., R.G.J., J.H., D.T.H., W.W., O.A.-R., S.M.F., K.K., M.F., M.L., M.R.L.M., J.J.R., B.H.), the Division of Critical Care, Department of Medicine (R.M., J.H., S.M.F., K.K.), the School of Epidemiology and Public Health (P.D.S.), and the Department of Cellular and Molecular Medicine (R.G.J., T.S., B.H.), University of Ottawa, Ottawa, the Division of Cardiology, University of Toronto, Toronto (A.M.), and the Division of Cardiology, University of British Columbia, Vancouver (A.A.) - all in Canada; the Division of Critical Care, Tufts Medical Center, Boston (J.A.M.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.S.); and Hôpital Cardiologique du Haut Lévêque, Centre Hospitalier Universitaire Bordeaux (F.D.R.), and LIRYC (L'Institut de Rythmologie et Modélisation Cardiaque) (F.D.R.) - both in Bordeaux-Pessac, France.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Agents neuromédiateurs › Agents adrénergiques › Agonistes adrénergiques › Agonistes bêta-adrénergiques › Milrinone as Compared with Dobutamine in the...
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