Thursday, August 23, 2007

Cardiac devices boost survival in heart failure patients

For patients with end-stage heart failure who cannot have a heart transplant, ventricular assist devices (VAD) might be a more effective treatment option than remaining on inotropic drug therapy, also known as heart pump medication, according to a new investigation.

Patients whose hearts don't pump as much blood as their bodies need will gradually develop more chronic health problems as their heart weakens. When other treatment options are no longer viable, patients are often prescribed intravenous inotropic medications to increase the strength of their heart's contractions. Patients need to wear an infusion pump that delivers the drugs directly into their system.

The DCRI's Joseph Rogers, MD, lead author of INTREPID (the Investigation of NonTRansplant-Eligible Patients who are Inotrope-Dependent), found that patients have better survival rate and a better quality of life when they receive a VAD to help their heart pump blood, instead of relying on the inotropic drugs. The report was published in the August 21 issue of the Journal of the American College of Cardiology.

However, there is still room for improvement with VADs, as 73% of the patients in the INTREPID trial who received a VAD died within one year. The trial involved 55 patients, 18 of whom did not receive a VAD and continued treatment with only the inotropic drugs.

INTREPID used “first-generation” VADs that were available between 2000 and 2003 when the trial was enrolling patients. VADs are often used to help patients while they are waiting for a heart transplant, but there wasn't much data about how successful they are as a permanent treatment option instead of transplant.