Effect of inotrope withdrawal on morbidity and mortality in patients with chronic heart failure: results of the vesnarinone trial withdrawal substudy. Vest Withdrawal Substudy Group.
BACKGROUND
The use of inotropic agents in the therapy of patients with congestive heart failure (CHF) is controversial. One concern regarding inotropic therapy has been that drug withdrawal could be associated with a worsening of symptoms.


RESULTS
We took advantage of the discontinuation of the recent trial of vesnarinone in the therapy of CHF to assess the effects of withdrawal of the inotropic agent, vesnarinone, in patients with chronic CHF who had been randomized to receive either placebo or 30 or 60 mg of vesnarinone. Contrary to our initial hypothesis, withdrawal of vesnarinone did not impact on either morbidity or mortality over a period of 6 months.


CONCLUSIONS
Although these results suggest vesnarinone withdrawal is safe, the applicability of these results to other inotropic agents remains unclear.
Soran
O
O
Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pennsylvania, USA.
Young
J D
JD
Holubkov
R
R
Loftus
S
S
Bourge
R
R
Carson
P
P
Jaski
B
B
White
B G
BG
Feldman
A M
AM
D002316:Cardiotonic Agents / Q000009:adverse effects*; D002423:Cause of Death; D002908:Chronic Disease; D018450:Disease Progression; D005500:Follow-Up Studies; D006333:Heart Failure / Q000139:chemically induced / Q000401:mortality*; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction; D011719:Pyrazines; D011804:Quinolines / Q000009:adverse effects*; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000401:mortality*; D015996:Survival Rate
D002316:Cardiotonic Agents; D011719:Pyrazines; D011804:Quinolines; C041667:vesnarinone