Mortality in two recent reports of clinical trials on patients with congestive heart failure compared with mortality in three previous clinical trials.
BACKGROUND
Several clinical trials of drug treatment of patients with congestive heart failure (CHF) have previously been reported as Mortality Abstracts in the Journal of Insurance Medicine. Results are presented here for two similar clinical trials reported in September 1999 and compared with the previous results.


RESULTS
In a recent international multicenter clinical trial, excess mortality in terms of excess death rates (EDRs) was reduced from 195 per 1000 per year in the placebo group to 139 in the group treated with Spironolactone. There was no significant reduction in the Danish multicenter study of Dofetilide to convert the atrial fibrillation (AF) to a normal rhythm in the 25% of the CHF patients who had AF (EDR was 224 in the placebo group and 216 in the Dofetilide group). In both of these studies, there were more patients with severe CHF than in the previous studies and the EDR values were higher. Results from the Danish study by severity according to the New York Heart Association (NYHA) classification show a progressive increase in EDR from 173 in class 2 to 237 in class 3 to 392 in class 4.


CONCLUSIONS
Excess mortality in symptomatic CHF is far outside the issue limits for individual life insurance, but these results are of potential utility for the underwriting of such cases for structured settlement annuities.
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D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003718:Denmark / Q000453:epidemiology; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D010627:Phenethylamines / Q000627:therapeutic use; D010919:Placebos; D013148:Spironolactone / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D014481:United States
D000889:Anti-Arrhythmia Agents; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D010627:Phenethylamines; D010919:Placebos; D013449:Sulfonamides; D013148:Spironolactone; C063533:dofetilide