Tags

Type your tag names separated by a space and hit enter

Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure: influence of prerandomization variables on the reduction of mortality by treatment with hydralazine and isosorbide dinitrate.
Circulation. 1987 May; 75(5 Pt 2):IV49-54.Circ

Abstract

The Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure was designed to determine whether vasodilator drugs could alter the survival of patients with chronic congestive heart failure treated with digoxin and diuretics. Among the 642 patients entered into the study, 273 were randomly assigned to placebo, 186 were randomly assigned to the combination of hydralazine and isosorbide dinitrate, and 183 patients were randomly assigned to prazosin; all patients were followed for periods ranging from 6 months to 5.7 years. Treatment with hydralazine-nitrate produced a 28% reduction in mortality compared with that in patients receiving placebo (95% confidence interval, 3% to 46%), whereas prazosin exerted no apparent beneficial effect. Data were further examined to determine if any baseline variables had an impact on the response to treatment. Mortality in the placebo group was higher in those with coronary artery disease, with a history of antiarrhythmic drug use, and with values lower than the median for ejection fraction and exercise tolerance. A reduction in mortality with hydralazine-isosorbide dinitrate was observed in all of the above pairs of subgroups as well as in those above and below 60 years of age and those with and without a history of hypertension or excess alcohol ingestion. The benefit of hydralazine and isosorbide dinitrate was particularly prominent in younger patients with a lower ejection fraction and those with a history of hypertension and without an alcoholic history.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

3552302

Citation

Cohn, J N., et al. "Veterans Administration Cooperative Study On Vasodilator Therapy of Heart Failure: Influence of Prerandomization Variables On the Reduction of Mortality By Treatment With Hydralazine and Isosorbide Dinitrate." Circulation, vol. 75, no. 5 Pt 2, 1987, pp. IV49-54.
Cohn JN, Archibald DG, Francis GS, et al. Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure: influence of prerandomization variables on the reduction of mortality by treatment with hydralazine and isosorbide dinitrate. Circulation. 1987;75(5 Pt 2):IV49-54.
Cohn, J. N., Archibald, D. G., Francis, G. S., Ziesche, S., Franciosa, J. A., Harston, W. E., Tristani, F. E., Dunkman, W. B., Jacobs, W., & Flohr, K. H. (1987). Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure: influence of prerandomization variables on the reduction of mortality by treatment with hydralazine and isosorbide dinitrate. Circulation, 75(5 Pt 2), IV49-54.
Cohn JN, et al. Veterans Administration Cooperative Study On Vasodilator Therapy of Heart Failure: Influence of Prerandomization Variables On the Reduction of Mortality By Treatment With Hydralazine and Isosorbide Dinitrate. Circulation. 1987;75(5 Pt 2):IV49-54. PubMed PMID: 3552302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure: influence of prerandomization variables on the reduction of mortality by treatment with hydralazine and isosorbide dinitrate. A1 - Cohn,J N, AU - Archibald,D G, AU - Francis,G S, AU - Ziesche,S, AU - Franciosa,J A, AU - Harston,W E, AU - Tristani,F E, AU - Dunkman,W B, AU - Jacobs,W, AU - Flohr,K H, PY - 1987/5/1/pubmed PY - 1987/5/1/medline PY - 1987/5/1/entrez SP - IV49 EP - 54 JF - Circulation JO - Circulation VL - 75 IS - 5 Pt 2 N2 - The Veterans Administration Cooperative Study on Vasodilator Therapy of Heart Failure was designed to determine whether vasodilator drugs could alter the survival of patients with chronic congestive heart failure treated with digoxin and diuretics. Among the 642 patients entered into the study, 273 were randomly assigned to placebo, 186 were randomly assigned to the combination of hydralazine and isosorbide dinitrate, and 183 patients were randomly assigned to prazosin; all patients were followed for periods ranging from 6 months to 5.7 years. Treatment with hydralazine-nitrate produced a 28% reduction in mortality compared with that in patients receiving placebo (95% confidence interval, 3% to 46%), whereas prazosin exerted no apparent beneficial effect. Data were further examined to determine if any baseline variables had an impact on the response to treatment. Mortality in the placebo group was higher in those with coronary artery disease, with a history of antiarrhythmic drug use, and with values lower than the median for ejection fraction and exercise tolerance. A reduction in mortality with hydralazine-isosorbide dinitrate was observed in all of the above pairs of subgroups as well as in those above and below 60 years of age and those with and without a history of hypertension or excess alcohol ingestion. The benefit of hydralazine and isosorbide dinitrate was particularly prominent in younger patients with a lower ejection fraction and those with a history of hypertension and without an alcoholic history.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0009-7322 UR - https://www.unboundmedicine.com/medline/citation/3552302/Veterans_Administration_Cooperative_Study_on_Vasodilator_Therapy_of_Heart_Failure:_influence_of_prerandomization_variables_on_the_reduction_of_mortality_by_treatment_with_hydralazine_and_isosorbide_dinitrate_ L2 - https://medlineplus.gov/heartfailure.html DB - PRIME DP - Unbound Medicine ER -