A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure.
Why the study?
Does nifedipine alone or in combination with isosorbide dinitrate improve outcomes compared to isosorbide dinitrate alone in patients with chronic heart failure?
Population
28 patients with New York Heart Association Functional class II or III chronic heart failure due to left…
Comparison
Nifedipine alone or in combination with… vs Isosorbide dinitrate (ISDN) alone for 8 weeks.
Design
RCT, randomized, crossover, double-blind
Follow-up
8 weeks per therapy period
Authors
Discussion
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Implication
Nifedipine should be avoided in HFrEF due to excess hospitalizations; challenges calcium channel blocker use in systolic dysfunction.
Structured PICO
Does nifedipine alone or in combination with isosorbide dinitrate improve outcomes compared to isosorbide dinitrate alone in patients with chronic heart failure?
P
Population
28 patients with New York Heart Association Functional class II or III chronic heart failure due to left ventricular systolic dysfunction, maintained on a constant dose of digitalis and diuretics.
I
Intervention
Nifedipine alone or in combination with isosorbide dinitrate (ISDN) for 8 weeks.
C
Comparator
Isosorbide dinitrate (ISDN) alone for 8 weeks.
O
Outcome
Heart failure deterioration necessitating hospitalizations and/or additional diuretics.hard clinical
Nifedipine, alone or combined with isosorbide dinitrate, causes significant clinical deterioration and increased hospitalizations compared to isosorbide dinitrate alone in patients with heart failure with reduced ejection fraction.
Cite This Study
Elkayam et al. (1990) studied this question.