Can drug effects on mortality in heart failure be predicted by any surrogate measure?

European Heart Journal
K M Yee, A D Struthers

Abstract

Clearly at present, the one perfect surrogate marker for mortality remains elusive. Chronic heart failure is a complex syndrome: as such it may perhaps be too simplistic to expect any single parameter to be universally predictive of drug effects on mortality, especially when each drug works by different mechanisms. Nevertheless, neurohormonal antagonists, such as ACE inhibitors and beta-blockers, seem to benefit both mortality and all surrogate markers of mortality. Equally, inotropic drugs and Class I antiarrhythmics appear to worsen both mortality and many surrogates. This is encouraging. However, significant discrepancies exist, particularly for digoxin, ibopamine and hydralazine-nitrates, although it is only with the latter two that diametrically opposite effects occurred, whereby favourable surrogate effects turned into unfavourable mortality effects (or vice versa). It appears appropriate to have guarded optimism about the potential use of these surrogates to predict drug effects in chronic heart failure. Given our current understanding, none of the parameters discussed above is perfect when used alone. Perhaps a battery of surrogates would be more appropriate rather than there being any single surrogate. The most promisi...Continue Reading

Citations

Aug 3, 2005·Current Hypertension Reports·Guido Grassi
Jun 16, 2000·Journal of Immunological Methods·H M DavisD E Griswold
May 3, 2002·Journal of the American College of Cardiology·Inder S AnandLloyd Fisher
Nov 3, 2007·Seminars in Fetal & Neonatal Medicine·Keith J Barrington
Apr 6, 1999·The American Journal of Cardiology·K S SpargiasS G Ball
Oct 9, 2014·Annual Review of Pharmacology and Toxicology·A F CohenG J Groeneveld
Feb 28, 2001·Diabetes, Obesity & Metabolism·P G McNallyH Thurston
Dec 23, 1998·British Journal of Clinical Pharmacology·K M Yee, A D Struthers
Mar 16, 2002·The Annals of Pharmacotherapy·Craig R LeeJ Herbert Patterson

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