Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial
Background The use of dobutamine or milrinone for inotropic support in patients with heart failure awaiting cardiac transplantation is largely arbitrary and based on institutional preference. The costs and effectiveness of these drugs have yet to be compared in a prospective, randomized study. Metho...
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| Veröffentlicht in: | The American heart journal 2003-02, Vol.145 (2), p.324-329 |
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| creator | Aranda, Juan M. Schofield, Richard S. Pauly, Daniel F. Cleeton, Timothy S. Walker, Tracy C. Monroe, V.Steven Leach, Dana Lopez, Larry M. Hill, James A. |
| description | Background The use of dobutamine or milrinone for inotropic support in patients with heart failure awaiting cardiac transplantation is largely arbitrary and based on institutional preference. The costs and effectiveness of these drugs have yet to be compared in a prospective, randomized study. Methods We compared clinical outcomes and costs associated with the use of dobutamine or milrinone in 36 hospitalized patients awaiting cardiac transplantation. Patients were randomly assigned to receive either dobutamine or milrinone at the time of initial hospitalization and were followed until death, transplantation, or placement of mechanical cardiac support (intra-aortic balloon pump or left ventricular assist device). Results Seventeen patients were randomly assigned to receive dobutamine (mean dose 4.1 ± 1.4 μg/kg/min) and 19 patients received milrinone (mean dose 0.39 ± 1.0 μg/kg/min). Therapy lasted 50 ± 46 days for those in the dobutamine group and 63 ± 45 days in the milrinone group. We did not detect differences between the 2 groups in right heart hemodynamics, death, need for additional vasodilator/inotropic therapy, or need for mechanical cardiac support before transplantation. Ventricular arrhythmias requiring increased antiarrhythmic therapy occurred frequently in both groups. Total acquisition cost of milrinone was significantly higher than that of dobutamine ($16,270 ± 1334 vs $380 ± 533 P |
| doi_str_mv | 10.1067/mhj.2003.50 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73029519</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870302947599</els_id><sourcerecordid>73029519</sourcerecordid><originalsourceid>FETCH-LOGICAL-c359t-2e495d43bb8942ebc83266322deb3dd02e5780c840d5e6117f3331615cfbb7f33</originalsourceid><addsrcrecordid>eNptkUuLFDEUhYMoTju6ci8BwY1Wm0elHrMbGl8w4EbXIZXcsm9TlZRJqmX8Df5o03aDIK7CTb4czj2HkOecbTlr2rfz_rAVjMmtYg_IhrO-rZq2rh-SDWNMVF3L5BV5ktKhjI3omsfkigvVq07xDfm1C_NiIqbgaRipC8OazYwe6BFiWhOdcYroQ7nIe4hmuafo6T6kBbOZ8Cc4upiM4HOi5ofBjP4btSY6NJbmaHxaJuNzQYK_obd0ieUr2IxHeEPLswvzH5Ec0UxPyaPRTAmeXc5r8vX9uy-7j9Xd5w-fdrd3lZWqz5WAuleulsPQ9bWAwXZSNI0UwsEgnWMCVNsx29XMKWg4b0cpJW-4suMwnIZr8uqsW9x8XyFlPWOyMBWnENakW8lEr3hfwJf_gIewRl-8ad7Uquddy09yr8-ULculCKNeIs4m3mvO9KkiXSrSp4q0YoV-cdFchxncX_bSSQHUGYASwREh6mRLwBYcxpKcdgH_K_wb0G2hkA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1645918713</pqid></control><display><type>article</type><title>Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Aranda, Juan M. ; Schofield, Richard S. ; Pauly, Daniel F. ; Cleeton, Timothy S. ; Walker, Tracy C. ; Monroe, V.Steven ; Leach, Dana ; Lopez, Larry M. ; Hill, James A.</creator><creatorcontrib>Aranda, Juan M. ; Schofield, Richard S. ; Pauly, Daniel F. ; Cleeton, Timothy S. ; Walker, Tracy C. ; Monroe, V.Steven ; Leach, Dana ; Lopez, Larry M. ; Hill, James A.</creatorcontrib><description>Background The use of dobutamine or milrinone for inotropic support in patients with heart failure awaiting cardiac transplantation is largely arbitrary and based on institutional preference. The costs and effectiveness of these drugs have yet to be compared in a prospective, randomized study. Methods We compared clinical outcomes and costs associated with the use of dobutamine or milrinone in 36 hospitalized patients awaiting cardiac transplantation. Patients were randomly assigned to receive either dobutamine or milrinone at the time of initial hospitalization and were followed until death, transplantation, or placement of mechanical cardiac support (intra-aortic balloon pump or left ventricular assist device). Results Seventeen patients were randomly assigned to receive dobutamine (mean dose 4.1 ± 1.4 μg/kg/min) and 19 patients received milrinone (mean dose 0.39 ± 1.0 μg/kg/min). Therapy lasted 50 ± 46 days for those in the dobutamine group and 63 ± 45 days in the milrinone group. We did not detect differences between the 2 groups in right heart hemodynamics, death, need for additional vasodilator/inotropic therapy, or need for mechanical cardiac support before transplantation. Ventricular arrhythmias requiring increased antiarrhythmic therapy occurred frequently in both groups. Total acquisition cost of milrinone was significantly higher than that of dobutamine ($16,270 ± 1334 vs $380 ± 533 P <.00001). Conclusions Both dobutamine and milrinone can be used successfully as pharmacologic therapy for a bridge to heart transplantation. Despite similar clinical outcomes, treatment with milrinone incurs greater cost. (Am Heart J 2003;145:324-9.)</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1067/mhj.2003.50</identifier><identifier>PMID: 12595851</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adrenergic beta-Agonists - economics ; Adrenergic beta-Agonists - therapeutic use ; Adrenergic beta-Antagonists - therapeutic use ; Blood pressure ; Cardiology ; Cardiotonic Agents - economics ; Cardiotonic Agents - therapeutic use ; Demographics ; Dobutamine - economics ; Dobutamine - therapeutic use ; Drug Costs ; Drug dosages ; Female ; Heart failure ; Heart Failure - drug therapy ; Heart rate ; Heart Transplantation ; Hospitalization ; Humans ; Intubation ; Male ; Medical waiting lists ; Middle Aged ; Milrinone - economics ; Milrinone - therapeutic use ; Prospective Studies ; Pulmonary arteries ; Statistics as Topic ; Transplants & implants ; Veins & arteries</subject><ispartof>The American heart journal, 2003-02, Vol.145 (2), p.324-329</ispartof><rights>2003</rights><rights>Copyright Elsevier Limited Feb 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-2e495d43bb8942ebc83266322deb3dd02e5780c840d5e6117f3331615cfbb7f33</citedby><cites>FETCH-LOGICAL-c359t-2e495d43bb8942ebc83266322deb3dd02e5780c840d5e6117f3331615cfbb7f33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1645918713?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978,64366,64368,64370,72220</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12595851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aranda, Juan M.</creatorcontrib><creatorcontrib>Schofield, Richard S.</creatorcontrib><creatorcontrib>Pauly, Daniel F.</creatorcontrib><creatorcontrib>Cleeton, Timothy S.</creatorcontrib><creatorcontrib>Walker, Tracy C.</creatorcontrib><creatorcontrib>Monroe, V.Steven</creatorcontrib><creatorcontrib>Leach, Dana</creatorcontrib><creatorcontrib>Lopez, Larry M.</creatorcontrib><creatorcontrib>Hill, James A.</creatorcontrib><title>Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background The use of dobutamine or milrinone for inotropic support in patients with heart failure awaiting cardiac transplantation is largely arbitrary and based on institutional preference. The costs and effectiveness of these drugs have yet to be compared in a prospective, randomized study. Methods We compared clinical outcomes and costs associated with the use of dobutamine or milrinone in 36 hospitalized patients awaiting cardiac transplantation. Patients were randomly assigned to receive either dobutamine or milrinone at the time of initial hospitalization and were followed until death, transplantation, or placement of mechanical cardiac support (intra-aortic balloon pump or left ventricular assist device). Results Seventeen patients were randomly assigned to receive dobutamine (mean dose 4.1 ± 1.4 μg/kg/min) and 19 patients received milrinone (mean dose 0.39 ± 1.0 μg/kg/min). Therapy lasted 50 ± 46 days for those in the dobutamine group and 63 ± 45 days in the milrinone group. We did not detect differences between the 2 groups in right heart hemodynamics, death, need for additional vasodilator/inotropic therapy, or need for mechanical cardiac support before transplantation. Ventricular arrhythmias requiring increased antiarrhythmic therapy occurred frequently in both groups. Total acquisition cost of milrinone was significantly higher than that of dobutamine ($16,270 ± 1334 vs $380 ± 533 P <.00001). Conclusions Both dobutamine and milrinone can be used successfully as pharmacologic therapy for a bridge to heart transplantation. Despite similar clinical outcomes, treatment with milrinone incurs greater cost. (Am Heart J 2003;145:324-9.)</description><subject>Adrenergic beta-Agonists - economics</subject><subject>Adrenergic beta-Agonists - therapeutic use</subject><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Blood pressure</subject><subject>Cardiology</subject><subject>Cardiotonic Agents - economics</subject><subject>Cardiotonic Agents - therapeutic use</subject><subject>Demographics</subject><subject>Dobutamine - economics</subject><subject>Dobutamine - therapeutic use</subject><subject>Drug Costs</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart rate</subject><subject>Heart Transplantation</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Intubation</subject><subject>Male</subject><subject>Medical waiting lists</subject><subject>Middle Aged</subject><subject>Milrinone - economics</subject><subject>Milrinone - therapeutic use</subject><subject>Prospective Studies</subject><subject>Pulmonary arteries</subject><subject>Statistics as Topic</subject><subject>Transplants & implants</subject><subject>Veins & arteries</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkUuLFDEUhYMoTju6ci8BwY1Wm0elHrMbGl8w4EbXIZXcsm9TlZRJqmX8Df5o03aDIK7CTb4czj2HkOecbTlr2rfz_rAVjMmtYg_IhrO-rZq2rh-SDWNMVF3L5BV5ktKhjI3omsfkigvVq07xDfm1C_NiIqbgaRipC8OazYwe6BFiWhOdcYroQ7nIe4hmuafo6T6kBbOZ8Cc4upiM4HOi5ofBjP4btSY6NJbmaHxaJuNzQYK_obd0ieUr2IxHeEPLswvzH5Ec0UxPyaPRTAmeXc5r8vX9uy-7j9Xd5w-fdrd3lZWqz5WAuleulsPQ9bWAwXZSNI0UwsEgnWMCVNsx29XMKWg4b0cpJW-4suMwnIZr8uqsW9x8XyFlPWOyMBWnENakW8lEr3hfwJf_gIewRl-8ad7Uquddy09yr8-ULculCKNeIs4m3mvO9KkiXSrSp4q0YoV-cdFchxncX_bSSQHUGYASwREh6mRLwBYcxpKcdgH_K_wb0G2hkA</recordid><startdate>200302</startdate><enddate>200302</enddate><creator>Aranda, Juan M.</creator><creator>Schofield, Richard S.</creator><creator>Pauly, Daniel F.</creator><creator>Cleeton, Timothy S.</creator><creator>Walker, Tracy C.</creator><creator>Monroe, V.Steven</creator><creator>Leach, Dana</creator><creator>Lopez, Larry M.</creator><creator>Hill, James A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>200302</creationdate><title>Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial</title><author>Aranda, Juan M. ; Schofield, Richard S. ; Pauly, Daniel F. ; Cleeton, Timothy S. ; Walker, Tracy C. ; Monroe, V.Steven ; Leach, Dana ; Lopez, Larry M. ; Hill, James A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-2e495d43bb8942ebc83266322deb3dd02e5780c840d5e6117f3331615cfbb7f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adrenergic beta-Agonists - economics</topic><topic>Adrenergic beta-Agonists - therapeutic use</topic><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Blood pressure</topic><topic>Cardiology</topic><topic>Cardiotonic Agents - economics</topic><topic>Cardiotonic Agents - therapeutic use</topic><topic>Demographics</topic><topic>Dobutamine - economics</topic><topic>Dobutamine - therapeutic use</topic><topic>Drug Costs</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart rate</topic><topic>Heart Transplantation</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Intubation</topic><topic>Male</topic><topic>Medical waiting lists</topic><topic>Middle Aged</topic><topic>Milrinone - economics</topic><topic>Milrinone - therapeutic use</topic><topic>Prospective Studies</topic><topic>Pulmonary arteries</topic><topic>Statistics as Topic</topic><topic>Transplants & implants</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aranda, Juan M.</creatorcontrib><creatorcontrib>Schofield, Richard S.</creatorcontrib><creatorcontrib>Pauly, Daniel F.</creatorcontrib><creatorcontrib>Cleeton, Timothy S.</creatorcontrib><creatorcontrib>Walker, Tracy C.</creatorcontrib><creatorcontrib>Monroe, V.Steven</creatorcontrib><creatorcontrib>Leach, Dana</creatorcontrib><creatorcontrib>Lopez, Larry M.</creatorcontrib><creatorcontrib>Hill, James A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aranda, Juan M.</au><au>Schofield, Richard S.</au><au>Pauly, Daniel F.</au><au>Cleeton, Timothy S.</au><au>Walker, Tracy C.</au><au>Monroe, V.Steven</au><au>Leach, Dana</au><au>Lopez, Larry M.</au><au>Hill, James A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2003-02</date><risdate>2003</risdate><volume>145</volume><issue>2</issue><spage>324</spage><epage>329</epage><pages>324-329</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background The use of dobutamine or milrinone for inotropic support in patients with heart failure awaiting cardiac transplantation is largely arbitrary and based on institutional preference. The costs and effectiveness of these drugs have yet to be compared in a prospective, randomized study. Methods We compared clinical outcomes and costs associated with the use of dobutamine or milrinone in 36 hospitalized patients awaiting cardiac transplantation. Patients were randomly assigned to receive either dobutamine or milrinone at the time of initial hospitalization and were followed until death, transplantation, or placement of mechanical cardiac support (intra-aortic balloon pump or left ventricular assist device). Results Seventeen patients were randomly assigned to receive dobutamine (mean dose 4.1 ± 1.4 μg/kg/min) and 19 patients received milrinone (mean dose 0.39 ± 1.0 μg/kg/min). Therapy lasted 50 ± 46 days for those in the dobutamine group and 63 ± 45 days in the milrinone group. We did not detect differences between the 2 groups in right heart hemodynamics, death, need for additional vasodilator/inotropic therapy, or need for mechanical cardiac support before transplantation. Ventricular arrhythmias requiring increased antiarrhythmic therapy occurred frequently in both groups. Total acquisition cost of milrinone was significantly higher than that of dobutamine ($16,270 ± 1334 vs $380 ± 533 P <.00001). Conclusions Both dobutamine and milrinone can be used successfully as pharmacologic therapy for a bridge to heart transplantation. Despite similar clinical outcomes, treatment with milrinone incurs greater cost. (Am Heart J 2003;145:324-9.)</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>12595851</pmid><doi>10.1067/mhj.2003.50</doi><tpages>6</tpages></addata></record> |
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| subjects | Adrenergic beta-Agonists - economics Adrenergic beta-Agonists - therapeutic use Adrenergic beta-Antagonists - therapeutic use Blood pressure Cardiology Cardiotonic Agents - economics Cardiotonic Agents - therapeutic use Demographics Dobutamine - economics Dobutamine - therapeutic use Drug Costs Drug dosages Female Heart failure Heart Failure - drug therapy Heart rate Heart Transplantation Hospitalization Humans Intubation Male Medical waiting lists Middle Aged Milrinone - economics Milrinone - therapeutic use Prospective Studies Pulmonary arteries Statistics as Topic Transplants & implants Veins & arteries |
| title | Comparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial |
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