A study was conducted to understand the differences between milrinone and dobutamine. The study's primary outcome was a composite of in-hospital mortality due to various reasons such as resuscitated cardiac arrest, non-fatal myocardial infarction, stroke or transient ischemic attack, or mechanical circulatory support or cardiac transplant. The individual aspects of primary composite outcome were included in the secondary outcomes.

The authors of the study stated, no substantial differences were noted in the primary or secondary outcomes of the study. Moreover, there is a link between significant death and morbidity and cardiogenic shock. Inotropic support is the direct pharmacological therapy for cardiogenic shock; however, the guidelines for selecting appropriate inotropic agents are not readily available in clinical practice. Because of the above-mentioned reason, Mathew R, University of Ottawa, Canada, and her colleagues, conducted a double-blinded randomized study and administered milrinone or dobutamine randomly to the patients to understand the difference between the two drugs.

Findings:

Overall, 192 patients were enrolled, with 96 patients in each group. It was observed that the occurrence of primary outcome events was seen in 49% of participants receiving milrinone and in 54% of patients receiving dobutamine with the relative risk of 0.90. Moreover, no substantial differences were observed regarding secondary outcomes. In addition, the resuscitated cardiac arrest event occurred in 7% and 9% patients; renal replacement therapy was initiated in 22% and 17% patients; in-hospital mortality was 37% and 43%, respectively; mechanical circulatory support was received by 12% and 15% patients respectively. The study findings were published in the New England Journal of Medicine.

Conclusion:

The results observed in patients receiving milrinone were similar to the dobutamine receiving group. No significant differences were noted in the composite primary outcome or essential secondary outcomes in cardiogenic shock patients.

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Keywords

Disease Condition,Therapeutic Modality,Heart Failure,Interventional Cardiology,Pharmacotherapeutics,TINC_others,TPHT_others,Myocardial Disease and Cardiomypathies,Cardiogenic Shock

Source

https://medicaldialogues.in/cardiology-ctvs/news/milrinone-is-no-better-than-dobutamine-for-treatment-of-cardiogenic-shock-study-finds-80568

Tags

Disease Condition ,Therapeutic Modality ,Heart Failure,Myocardial Disease and Cardiomyopathies,Interventional Cardiology,Pharmacotherapeutics,Cardiogenic Shock,TINC_others,TPHT_others