PMID: 11911756Mar 28, 2002Paper

Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial

JAMA : the Journal of the American Medical Association
Michael S CuffeOutcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigato

Abstract

Little randomized evidence is available to guide the in-hospital management of patients with an acute exacerbation of chronic heart failure. Although intravenous inotropic therapy usually produces beneficial hemodynamic effects and is labeled for use in the care of such patients, the effect of such therapy on intermediate-term clinical outcomes is uncertain. To prospectively test whether a strategy that includes short-term use of milrinone in addition to standard therapy can improve clinical outcomes of patients hospitalized with an exacerbation of chronic heart failure. Prospective, randomized, double-blind, placebo-controlled trial conducted from July 1997 through November 1999. Seventy-eight community and tertiary care hospitals in the United States. A total of 951 patients admitted with an exacerbation of systolic heart failure not requiring intravenous inotropic support (mean age, 65 years; 92% with baseline New York Heart Association class III or IV; mean left ventricular ejection fraction, 23%). Patients were randomly assigned to receive a 48-hour infusion of either milrinone, 0.5 microg/kg per minute initially (n = 477), or saline placebo (n = 472). Cumulative days of hospitalization for cardiovascular cause within 60 d...Continue Reading

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