PMID- 15832667
OWN - NLM
STAT- MEDLINE
DCOM- 20050509
LR  - 20181201
IS  - 0256-9574 (Print)
VI  - 95
IP  - 3
DP  - 2005 Mar
TI  - Pentoxifylline for heart failure: a systematic review.
PG  - 171-5
AB  - BACKGROUND: Recent trials have indicated a beneficial effect of pentoxifylline on 
      measures of inflammation and markers of cardiac dysfunction in people with heart 
      failure. However, it is uncertain whether pentoxifylline should be used routinely 
      in the management of heart failure. OBJECTIVE: To determine the effectiveness of 
      pentoxifylline in heart failure. DESIGN: Systematic review of randomised 
      controlled trials. METHODS: We searched MEDLINE (1 January 1966 - 20 November 
      2004), the Cochrane Controlled Trials Register (issue 4, 2004), and reference 
      lists of related papers, for randomised controlled trials of pentoxifylline in 
      the treatment of heart failure. Prospective, randomised, double-blind controlled 
      trials were sought for inclusion in the study. The two reviewers independently 
      assessed trial quality and extracted data, which were analysed using RevMan 
      statistical software. The following outcome measures were evaluated: (i) New York 
      Heart Association (NYHA) functional class; (ii) left ventricular ejection 
      fraction (LVEF); (iii) frequency of hospitalisation; and (iv) death from all 
      causes. RESULTS: Four studies with a total of 144 participants met the inclusion 
      criteria. Statistical pooling (or meta-analysis) was not performed owing to the 
      significant clinical heterogeneity and differences in reporting of the outcomes 
      in the included studies; instead, the trials were analysed separately for the 
      outcomes of interest. The four studies tested the use of pentoxifylline versus 
      placebo in patients with heart failure of varying aetiology (idiopathic dilated 
      cardiomyopathy, 3 studies; ischaemic cardiomyopathy, 1 study). In 2 of the 
      idiopathic dilated cardiomyopathy studies, patients were classified as NYHA class 
      II or III, while the study population in another idiopathic cardiomyopathy study 
      was in NYHA class IV. The trial of patients with ischaemic cardiomyopathy 
      included patients in NYHA functional classes I - IV. The use of pentoxifylline 
      was associated with significant improvement in symptoms (i.e. NYHA functional 
      class) and cardiac function (i.e. LVEF) in 3 out of 4 studies. The beneficial 
      effect on symptoms of heart failure and cardiac function was seen in all grades 
      of severity of heart failure and in patients with ischaemic and idiopathic 
      dilated cardiomyopathy. All 4 studies showed a trend towards reduction of 
      mortality, but this effect was not statistically significant. The effect of 
      pentoxifylline on the frequency of hospitalisation has not been tested in 
      randomised controlled trials. INTERPRETATION: Pentoxifylline may have a 
      beneficial effect on NYHA functional class, ejection fraction and mortality in 
      heart failure, but published trials are too small to provide conclusive evidence. 
      There is a need for large, placebo-controlled trials of pentoxifylline in heart 
      failure, involving a diverse group of patients with regard to cause and severity 
      of heart failure.
FAU - Batchelder, Kathryn
AU  - Batchelder K
AD  - The Cardiac Clinic, Department of Medicine, Groote Schuur Hospital and University 
      of Cape Town.
FAU - Mayosi, Bongani M
AU  - Mayosi BM
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - South Africa
TA  - S Afr Med J
JT  - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
JID - 0404520
RN  - 0 (Vasodilator Agents)
RN  - SD6QCT3TSU (Pentoxifylline)
SB  - IM
MH  - Double-Blind Method
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Pentoxifylline/*therapeutic use
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic
MH  - Stroke Volume/drug effects
MH  - Treatment Outcome
MH  - Vasodilator Agents/therapeutic use
MH  - Ventricular Dysfunction, Left/drug therapy
RF  - 13
EDAT- 2005/04/19 09:00
MHDA- 2005/05/10 09:00
CRDT- 2005/04/19 09:00
PHST- 2005/04/19 09:00 [pubmed]
PHST- 2005/05/10 09:00 [medline]
PHST- 2005/04/19 09:00 [entrez]
PST - ppublish
SO  - S Afr Med J. 2005 Mar;95(3):171-5.