Tags

Type your tag names separated by a space and hit enter

Cross-sectional study of heart failure therapy with angiotensin converting enzyme inhibitors and digoxin.
Saudi Med J. 2004 Aug; 25(8):1060-5.SM

Abstract

OBJECTIVE

The aim of the present study is to show a better short-term (2 weeks) clinical improvement in patients with heart failure (HF) who are receiving angiotensin converting enzyme inhibitors (ACEIs) (with or without digoxin) when compared to the standard therapy excluding ACEIs.

METHODS

The study was conducted in Al-Gamhuria Teaching Hospital, Aden, Yemen, from January to July 2003. In this study, 78 patients with HF were enrolled into 3 therapeutic groups (ACEIs alone, ACEI and digoxin and digoxin alone) and their responses within 2 weeks were recorded. Exclusion criteria were as follows: thyroid disorders, gastrointestinal disturbances (diarrhea, malabsorption), electrolyte unbalanced (unless corrected) and insufficient data. Serum creatinine was measured at the beginning and after 10 days. In addition, the patients' body weight and age were recorded. Criteria for a complete improvement within 2 weeks were the occurrence of the following: 1) The relief of pulmonary congestion, 2) Decrement in heart rate to less than 74 +/- 5, 3) Disappearance of the lower limb edema, and 5) Recorded positive electroencephalogram change. Partial amelioration was recognized if only 2 or 3 of the preceding criteria were observed.

RESULTS

Nine patients received digoxin alone, while 40 patients were treated with ACEIs and digoxin. Treatment with ACEIs without digoxin was observed in 29 patients. The discrepancy between the number of patients was necessitated by the need of patients with HF. This last category of treatment regimen produced better clinical improvement (complete with 10.1%, partial with 24.3%) compared to the digoxin group without ACEI (complete 2.5% or partial 5.1%). Nevertheless, the addition of digoxin to an ACEI increased this ratio (17.8% for complete and 28.2% for partial improvement). A 49.3% increase in serum creatinine was observed after 10 days in 25 HF patients, who were randomly selected and followed up (the baseline concentration was 99.75 +/- 9.9 umol/L, while the level after 10 days was 148.97 +/- 19.8 umol/L, p=0.005).

CONCLUSION

We confirmed that short-term use of ACEI regimens has a superior effect on the therapy of HF (34.4% complete and partial response) as compared to the therapy of not using ACEI (7.6% had a complete and partial response). The combination of ACEI and digoxin has resulted in the best outcome (46% had a complete and partial response). However, we also noticed a significant rise in serum creatinine by 49% concomitant with the use of ACEI (the baseline concentration was 99.75 +/- 9.9 um/L, while the level after 10 days was 148.97 +/- 19.8 umol/L, p=0.005).

Authors+Show Affiliations

Department of Pharmacology and Pharmaceutics, Faculty of Medicine, University of Aden, PO Box 6164, Yemen. s_warfa22ye2002@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15322598

Citation

Mahmood, Samira A., et al. "Cross-sectional Study of Heart Failure Therapy With Angiotensin Converting Enzyme Inhibitors and Digoxin." Saudi Medical Journal, vol. 25, no. 8, 2004, pp. 1060-5.
Mahmood SA, Hussein GM, Hamza EA. Cross-sectional study of heart failure therapy with angiotensin converting enzyme inhibitors and digoxin. Saudi Med J. 2004;25(8):1060-5.
Mahmood, S. A., Hussein, G. M., & Hamza, E. A. (2004). Cross-sectional study of heart failure therapy with angiotensin converting enzyme inhibitors and digoxin. Saudi Medical Journal, 25(8), 1060-5.
Mahmood SA, Hussein GM, Hamza EA. Cross-sectional Study of Heart Failure Therapy With Angiotensin Converting Enzyme Inhibitors and Digoxin. Saudi Med J. 2004;25(8):1060-5. PubMed PMID: 15322598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cross-sectional study of heart failure therapy with angiotensin converting enzyme inhibitors and digoxin. AU - Mahmood,Samira A, AU - Hussein,Ganna M, AU - Hamza,Enayat A, PY - 2004/8/24/pubmed PY - 2004/10/27/medline PY - 2004/8/24/entrez SP - 1060 EP - 5 JF - Saudi medical journal JO - Saudi Med J VL - 25 IS - 8 N2 - OBJECTIVE: The aim of the present study is to show a better short-term (2 weeks) clinical improvement in patients with heart failure (HF) who are receiving angiotensin converting enzyme inhibitors (ACEIs) (with or without digoxin) when compared to the standard therapy excluding ACEIs. METHODS: The study was conducted in Al-Gamhuria Teaching Hospital, Aden, Yemen, from January to July 2003. In this study, 78 patients with HF were enrolled into 3 therapeutic groups (ACEIs alone, ACEI and digoxin and digoxin alone) and their responses within 2 weeks were recorded. Exclusion criteria were as follows: thyroid disorders, gastrointestinal disturbances (diarrhea, malabsorption), electrolyte unbalanced (unless corrected) and insufficient data. Serum creatinine was measured at the beginning and after 10 days. In addition, the patients' body weight and age were recorded. Criteria for a complete improvement within 2 weeks were the occurrence of the following: 1) The relief of pulmonary congestion, 2) Decrement in heart rate to less than 74 +/- 5, 3) Disappearance of the lower limb edema, and 5) Recorded positive electroencephalogram change. Partial amelioration was recognized if only 2 or 3 of the preceding criteria were observed. RESULTS: Nine patients received digoxin alone, while 40 patients were treated with ACEIs and digoxin. Treatment with ACEIs without digoxin was observed in 29 patients. The discrepancy between the number of patients was necessitated by the need of patients with HF. This last category of treatment regimen produced better clinical improvement (complete with 10.1%, partial with 24.3%) compared to the digoxin group without ACEI (complete 2.5% or partial 5.1%). Nevertheless, the addition of digoxin to an ACEI increased this ratio (17.8% for complete and 28.2% for partial improvement). A 49.3% increase in serum creatinine was observed after 10 days in 25 HF patients, who were randomly selected and followed up (the baseline concentration was 99.75 +/- 9.9 umol/L, while the level after 10 days was 148.97 +/- 19.8 umol/L, p=0.005). CONCLUSION: We confirmed that short-term use of ACEI regimens has a superior effect on the therapy of HF (34.4% complete and partial response) as compared to the therapy of not using ACEI (7.6% had a complete and partial response). The combination of ACEI and digoxin has resulted in the best outcome (46% had a complete and partial response). However, we also noticed a significant rise in serum creatinine by 49% concomitant with the use of ACEI (the baseline concentration was 99.75 +/- 9.9 um/L, while the level after 10 days was 148.97 +/- 19.8 umol/L, p=0.005). SN - 0379-5284 UR - https://www.unboundmedicine.com/medline/citation/15322598/Cross_sectional_study_of_heart_failure_therapy_with_angiotensin_converting_enzyme_inhibitors_and_digoxin_ L2 - https://medlineplus.gov/heartfailure.html DB - PRIME DP - Unbound Medicine ER -