S N Levinoff Roth1, G Moe. 1. Department of Medicine, Scarborough General Hospital, Ontario.
Abstract
OBJECTIVE: To describe the experience of 41 New York Heart Association (NYHA) class III and IV heart failure patients treated with intermittent intravenous amrinone infusions in addition to conventional therapy. BACKGROUND: Congestive heart failure is a condition often requiring repeated admission to hospital. Accordingly, a treatment modality which can reduce the number of admissions is desirable and potentially cost-effective. DESIGN: Retrospective analysis of data from hospital and office charts. SETTING: Community hospital with 640 active beds. INTERVENTION: The initial amrinone infusion was administered in the hospital under electrocardiographic monitoring; subsequent infusions were given in an out-patient unit. A bolus injection of 0.75 mg/kg followed by an infusion of 5 to 10 micrograms/kg/min for 8 to 12 h was administered every two to six weeks as clinically indicated. RESULTS: Results are reported for the first 51 months. Sixty-six per cent of the patients improved their NYHA class, 34% remained unchanged or deteriorated. Survival paralleled that of other studies involving similar patients not receiving nonglycoside positive inotropes. The number of days spent in the hospital in the six months after starting on amrinone compared with the six months before treatment was reduced to 50% (P < 0.05), and the number of hospital admissions in the six months after starting amrinone compared with the six months before decreased to 56% (P < 0.05). CONCLUSIONS: Intermittent intravenous amrinone infusions can be given in an out-patient setting in patients with NYHA class III to IV heart failure. This program is cost-effective, reducing hospital admissions and in-patient hospital days.
OBJECTIVE: To describe the experience of 41 New York Heart Association (NYHA) class III and IV heart failurepatients treated with intermittent intravenous amrinone infusions in addition to conventional therapy. BACKGROUND:Congestive heart failure is a condition often requiring repeated admission to hospital. Accordingly, a treatment modality which can reduce the number of admissions is desirable and potentially cost-effective. DESIGN: Retrospective analysis of data from hospital and office charts. SETTING: Community hospital with 640 active beds. INTERVENTION: The initial amrinone infusion was administered in the hospital under electrocardiographic monitoring; subsequent infusions were given in an out-patient unit. A bolus injection of 0.75 mg/kg followed by an infusion of 5 to 10 micrograms/kg/min for 8 to 12 h was administered every two to six weeks as clinically indicated. RESULTS: Results are reported for the first 51 months. Sixty-six per cent of the patients improved their NYHA class, 34% remained unchanged or deteriorated. Survival paralleled that of other studies involving similar patients not receiving nonglycoside positive inotropes. The number of days spent in the hospital in the six months after starting on amrinone compared with the six months before treatment was reduced to 50% (P < 0.05), and the number of hospital admissions in the six months after starting amrinone compared with the six months before decreased to 56% (P < 0.05). CONCLUSIONS: Intermittent intravenous amrinone infusions can be given in an out-patient setting in patients with NYHA class III to IV heart failure. This program is cost-effective, reducing hospital admissions and in-patient hospital days.