Long-Term Ambulatory Intravenous Milrinone Therapy in Advanced Heart Failure.


Journal

Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 29 01 2022
revised: 13 08 2022
accepted: 01 09 2022
pubmed: 14 10 2022
medline: 27 12 2022
entrez: 13 10 2022
Statut: ppublish

Résumé

The role of intravenous (IV) inotropes in the treatment of ambulatory patients with advanced heart failure (HF) remains controversial. This was a retrospective study of patients with advanced HF. Patients on home IV milrinone, who remained on it for at least 3 months, were included. We compared the data from 3 months before starting IV milrinone to 3 months after initiating therapy. A subset of patients who remained on milrinone for 6 months or longer was analysed separately. A total of 90 patients remained on continuous IV milrinone for 3 months, and 55 patients were treated for 6 months or longer. In both groups, improvements in cardiac index (1.86-2.25, p<0.001 and 1.9-2.38, p<0.0001), New York Heart Association (NYHA) class (3.32-2.76, p<0.0001 and 3.25-2.72, p=0.001), and liver function were noted. In the 6-month group, there was also a decrease in mean hospitalised days per patient (9.40 vs 4.12, p<0.001) and an improved tolerance of beta blocker therapy (83.3% vs 98.1%, p=0.006). Long-term IV use of milrinone is associated with improvement in haemodynamics, functional class, tolerance of medical therapy, and decrease in hospitalised days.

Sections du résumé

BACKGROUND BACKGROUND
The role of intravenous (IV) inotropes in the treatment of ambulatory patients with advanced heart failure (HF) remains controversial.
METHODS METHODS
This was a retrospective study of patients with advanced HF. Patients on home IV milrinone, who remained on it for at least 3 months, were included. We compared the data from 3 months before starting IV milrinone to 3 months after initiating therapy. A subset of patients who remained on milrinone for 6 months or longer was analysed separately.
RESULTS RESULTS
A total of 90 patients remained on continuous IV milrinone for 3 months, and 55 patients were treated for 6 months or longer. In both groups, improvements in cardiac index (1.86-2.25, p<0.001 and 1.9-2.38, p<0.0001), New York Heart Association (NYHA) class (3.32-2.76, p<0.0001 and 3.25-2.72, p=0.001), and liver function were noted. In the 6-month group, there was also a decrease in mean hospitalised days per patient (9.40 vs 4.12, p<0.001) and an improved tolerance of beta blocker therapy (83.3% vs 98.1%, p=0.006).
CONCLUSION CONCLUSIONS
Long-term IV use of milrinone is associated with improvement in haemodynamics, functional class, tolerance of medical therapy, and decrease in hospitalised days.

Identifiants

pubmed: 36229299
pii: S1443-9506(22)01097-6
doi: 10.1016/j.hlc.2022.09.004
pii:
doi:

Substances chimiques

Milrinone JU9YAX04C7
Cardiotonic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1630-1639

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Auteurs

Sandipan Shringi (S)

Gill Heart Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA.

Shiksha Joshi (S)

Gill Heart Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA.

John M Suffredini (JM)

Department of Internal Medicine, University of Kentucky, Lexington, KY, USA.

Ashley Schenk (A)

Gill Heart Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA.

Navin Rajagopalan (N)

Gill Heart Institute, Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, USA.

Maya Guglin (M)

Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis, IN, USA. Electronic address: mguglin@iu.edu.

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