Short term effects of milrinone on biomarkers of necrosis, apoptosis, and inflammation in patients with severe heart failure
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Key result
Milrinone in severe HF is linked to reduced inflammatory and apoptotic biomarkers without increasing troponin.
- MD 0.0086
- P=0.44
- n=10
Why the study?
Does milrinone infusion alter biomarkers of necrosis, apoptosis, and inflammation in patients with severe heart failure?
Population
10 patients with severe heart failure and reduced cardiac output
Comparison
Milrinone infusion for 24 hours vs Baseline (pre-infusion values)
Design
Cohort
Follow-up
24 hours
Authors
Discussion
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Implication
Supports biomarker safety signals for short-term milrinone in severe HF; hypothesis-generating and leaves open outcome impact without RCTs.
Study Design
Type
Observational (n=10)
Multicenter
No
Structured PICO
Does milrinone infusion alter biomarkers of necrosis, apoptosis, and inflammation in patients with severe heart failure?
P
Population
10 patients with severe heart failure (NYHA Class IV) and reduced cardiac output (cardiac index <2.0 L/min/m2) who received intravenous milrinone, followed for 24 hours.
I
Intervention
Milrinone infusion (0.25-0.5 mcg/kg/min) for 24 hours
C
Comparator
Baseline (pre-infusion values)
O
Outcome
Changes in plasma biomarkers of myocardial necrosis, inflammation, and apoptosis (troponin, myoglobin, N-terminal-pro-BNP, interleukin-6, tumor necrosis factor-alpha, soluble Fas, and soluble Fas-ligand) at 24 hourssurrogate
Main Result
Mean Difference: 0.0086
Absolute Event Rate: 0.1345% vs 0.1259%
p-value: p=0.44
Short-term milrinone infusion in severe heart failure does not acutely exacerbate myocardial necrosis and is associated with improvements in inflammatory and apoptotic biomarkers.
Limitations
- Non-randomized and uncontrolled study design
- Small sample size (n=10)
- Observation window of 24 hours may have been too short to observe troponin changes
- Subjects were end-stage patients mostly of non-ischemic etiology, limiting generalizability to other heart failure populations
Cite This Study
Lanfear et al. (2009) conducted an observational in Severe heart failure (n=10). Milrinone vs. Baseline was evaluated on Change in Troponin I (TnI) levels from baseline to 24 hours (MD 0.0086, p=0.44). In patients with severe heart failure, a 24-hour milrinone infusion did not significantly increase troponin I levels (p=0.44) but significantly reduced inflammatory and apoptotic biomarkers.
Topics
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