July 21, 2012European Journal of Heart FailureOpen Access

Why do Drugs for Acute Heart Failure Fail?

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Why the study?

Does intravenous cinaciguat improve dyspnoea and haemodynamics in patients hospitalized with acute decompensated heart failure?

Structured PICO

Does intravenous cinaciguat improve dyspnoea and haemodynamics in patients hospitalized with acute decompensated heart failure?

Population

Patients hospitalized with acute decompensated heart failure and a left ventricular ejection fraction of <40%, with systolic blood pressure >120 mmHg (COMPOSE programme: COMPOSE 1 n=12, COMPOSE 2 n=4, COMPOSE EARLY n=62)

Intervention

Intravenous cinaciguat (<200 µg/h) as add-on to standard therapy, started within 12 h of admission

Comparator

Placebo

Outcome

Reduction in pulmonary capillary wedge pressure (COMPOSE 1) and improvement in dyspnoea (COMPOSE EARLY)patient reported

Limitations

Early termination due to excess non-fatal hypotension
Recruitment difficulties
Very small sample sizes (n=12 in COMPOSE 1, n=4 in COMPOSE 2)

Discussion

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Implication

Intravenous cinaciguat failed to improve dyspnoea in acute heart failure despite reducing wedge pressure, and its development was halted due to excessive hypotension.

Cite This Study

Voors et al. (2012) studied this question.

synapsesocial.com/papers/6a982060ed0046652d36767b https://doi.org/10.1093/eurjhf/hfs122

Topics

Heart failure HFrEF treatment

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Implication

Intravenous cinaciguat failed to improve dyspnoea in acute heart failure despite reducing wedge pressure, and its development was halted due to excessive hypotension.

Why do Drugs for Acute Heart Failure Fail?

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Why do Drugs for Acute Heart Failure Fail?

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider