Comparing the effects of milrinone and olprinone in patients with congestive heart failure

• Published in: Heart and vessels 2020-06, Vol.35 (6), p.776-785
• Main Authors: Dobashi, Shintaro, Watanabe, Ippei, Nakanishi, Rine, Hisatake, Shinji, Kiuchi, Shunsuke, Kabuki, Takayuki, Oka, Takashi, Fujii, Takahiro, Ikeda, Takanori
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiotonic Agents - adverse effects; Cardiotonic Agents - therapeutic use; Cardiovascular disease; Cardiovascular diseases; Congestive heart failure; Coronary artery disease; Death; Disease Progression; Female; Health hazards; Health services; Heart diseases; Heart failure; Heart Failure - diagnosis; Heart Failure - drug therapy; Heart Failure - mortality; Heart Failure - physiopathology; Hospitalization; Humans; Imidazoles - adverse effects; Imidazoles - therapeutic use; Inhibitors; Ischemia; Kidney diseases; Male; Medicine; Medicine & Public Health; Middle Aged; Milrinone - adverse effects; Milrinone - therapeutic use; Mortality; Multivariate analysis; Oral administration; Original Article; Patients; Phosphodiesterase; Phosphodiesterase 3 Inhibitors - adverse effects; Phosphodiesterase 3 Inhibitors - therapeutic use; Progression-Free Survival; Pyridones - adverse effects; Pyridones - therapeutic use; Recovery of Function; Retrospective Studies; Statistical models; Time Factors; Vascular Surgery
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-019-01543-6

Phosphodiesterase-3 (PDE3) inhibitors are widely used among patients with congestive heart failure (CHF). However, no studies have compared the cardiovascular outcomes between different PDE3 inhibitors in CHF management. In this report, we retrospectively compared the clinical benefits of two PDE3 inhibitors, milrinone and olprinone, to determine which better controls the progression of CHF. A total of 288 hospitalized patients who received PDE3 inhibitors [(milrinone; n  = 77 and olprinone; n  = 211, respectively)] for CHF were retrospectively enrolled. The primary endpoint was defined as having a major adverse cardiovascular and cerebrovascular event (MACCE) or cardiac death by day 60. Kaplan–Meier curves and multivariate Cox proportional models were used to compare the outcomes for patients treated with milrinone and olprinone. We found no significant differences in the baseline characteristics between the two groups. In patients treated with milrinone, a greater incidence of a MACCE or cardiac death was observed (log rank; P  = 0.005 and P  = 0.01, respectively). Milrinone-treated patients with ischemic heart disease and chronic kidney disease (CKD) at stage ≥ 4 presented with greater incidence of MACCE (log rank; P