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Br Heart J. 1994 September; 72(3): 226–230.
PMCID: PMC1025506

Treatment of severe heart failure: quantity or quality of life? A trial of enoximone. Enoximone Investigators.

Abstract

OBJECTIVES--To determine the effects of enoximone on mortality and quality of life in patients with severe end stage heart failure. DESIGN--A randomised, double blind, placebo controlled trial of the addition of enoximone to conventional treatment. Planned minimum follow up of one year. SETTING--District general hospitals and cardiological referral centres in the United Kingdom. PATIENTS--Planned 200 patients with severe, symptomatic heart failure despite treatment with diuretics and where appropriate and tolerated angiotensin converting enzyme inhibitors and digoxin. RESULTS--The study was ended early by the ethics committee after 151 patients had been recruited because of an excess mortality in the enoximone group: 27 deaths compared with 18 in the placebo group (P < 0.05). Quality of life measured with a disease specific questionnaire showed a clinically significant improvement at week 2 with a mean increase score of 0.48 in the enoximone treated patients compared with 0.14 in those receiving placebo (P = 0.0086). With the Nottingham health profile questionnaire the physical mobility score was improved after three months in the enoximone group, median 21.3 compared with 41.8 in the placebo group (P = 0.008). CONCLUSIONS--In patients with severe heart failure who remain incapacitated despite conventional treatment enoximone reduced survival but had a beneficial effect on the quality of life. Drugs that improve symptoms in severe end stage heart failure should not be discarded lightly.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cowley AJ, Rowley JM, Stainer KL, Hampton JR. Captopril therapy for heart failure. A placebo controlled study. Lancet. 1982 Oct 2;2(8301):730–732. [PubMed]
  • Uretsky BF, Jessup M, Konstam MA, Dec GW, Leier CV, Benotti J, Murali S, Herrmann HC, Sandberg JA. Multicenter trial of oral enoximone in patients with moderate to moderately severe congestive heart failure. Lack of benefit compared with placebo. Enoximone Multicenter Trial Group. Circulation. 1990 Sep;82(3):774–780. [PubMed]
  • Packer M, Carver JR, Rodeheffer RJ, Ivanhoe RJ, DiBianco R, Zeldis SM, Hendrix GH, Bommer WJ, Elkayam U, Kukin ML, et al. Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE Study Research Group. N Engl J Med. 1991 Nov 21;325(21):1468–1475. [PubMed]
  • Hunt SM, McKenna SP, McEwen J, Backett EM, Williams J, Papp E. A quantitative approach to perceived health status: a validation study. J Epidemiol Community Health. 1980 Dec;34(4):281–286. [PMC free article] [PubMed]
  • Demets DL. Group sequential procedures: calendar versus information time. Stat Med. 1989 Oct;8(10):1191–1198. [PubMed]
  • Cowley AJ, McEntegart DJ. Placebo-controlled trial of flosequinan in moderate heart failure. The possible importance of aetiology and method of analysis in the interpretation of the results of heart failure trials. Int J Cardiol. 1993 Feb;38(2):167–175. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Group