© 2008 European Society of Cardiology
Overview of emerging pharmacologic agents for acute heart failure syndromes
a Department of Cardiovascular Sciences, European Hospital Rome, Italy
b Department of Anesthesiology and Critical Care Medicine, Lariboisiere Hospital University Paris 7 Diderot, France
c Department of Cardiology, Athens University Athens, Greece
d Heart Failure Unit, Attikon University Hospital Athens, Greece
e Division of Cardiology, Medizinische Universitätsklinik Homburg/Saar, Germany
f Department of Cardiology, University Medical Center Groningen, The Netherlands
g Division of Cardiology, University Central Hospital Helsinki, Finland
h Inserm, Clinical Investigation Center, University Henri Poincaré Nancy, France
i Department of Intensive Care, St George Hospital London, UK
j Department of Cardiovascular Surgery, Heart Center NRW, Ruhr University Bochum Bad Oeynhausen, Germany
k Division of Cardiology, University of Bergen, Stavanger University Hospital Stavanger, Norway
l Division of Cardiology, Northwestern University Chicago, IL, USA
* Corresponding author. Department of Cardiology, Heart Failure Unit Athens University Hospital Attikon, Athens, 12461, Greece. Tel.: +30 6944 479926; fax: +30 210 5832195. E-mail address: geros{at}otenet.gr (G. Filippatos).
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Abstract |
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Background: Several therapies commonly used for the treatment of acute heart failure syndromes (AHFS) present some well-known limitations and have been associated with an early increase in the risk of death. There is, therefore, an unmet need for new pharmacologic agents for the early management of AHFS that may improve both short- and long-term outcomes.
Aim: To review the recent evidence on emerging pharmacologic therapies in AHFS.
Methods: A systematic search of peer-reviewed publications was performed on MEDLINE, EMBASE and Clinical Trials.gov from January 1990 to August 2007. The results of unpublished or ongoing trials were obtained from presentations at national and international meetings and pharmaceutical industry releases. Bibliographies from these references were also reviewed, as were additional articles identified by content experts.
Results: Cumulative data from large studies and randomised trials suggest that therapies with innovative mechanisms of action may safely and effectively reduce pulmonary congestion or improve cardiac performance in AHFS patients.
Conclusion: Some investigational agents for the management of AHFS are able to improve haemodynamics and/or clinical status. In spite of these promising findings, no new agent has demonstrated a clear benefit in terms of long-term clinical outcomes compared to placebo or conventional therapies.
Key Words: Acute heart failure • New medical treatment
Received October 4, 2007; Revised November 15, 2007; Accepted January 2, 2008
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