Preferred treatment for acute heart failure

Reported by Susan Aldridge, PhD, medical journalist

Vasodilator drugs are best for treating people hospitalized for acute heart failure.
In congestive heart failure, the heart can no longer pump blood efficiently around the body. In its extreme form, known as acute decompensated heart failure (ADHF), hospital admission for treatment is essential. There are four drugs used for ADHF - dobutamine and milrinone, which are inotropes, and nitroglycerin and nesiritide, which are vasodilators. Inotropes make the heart work harder, while vasodilators expand the blood vessels so the heart needs to expand less pumping effort.

In a study of over 65,000 patients, researchers at Ohio State University compared patients on each of the four drugs. They find the vasodilators have a distinct advantage in terms of reduced in-hospital mortality compared to the inotropes. Therefore, they suggest the latter be reserved for those who do not respond to vasodilators or who are so sick that they need both types of medication.

Source
Journal of the American College of Cardiology 5th July 2005