PMID- 7526050
OWN - NLM
STAT- MEDLINE
DCOM- 19941220
LR  - 20131121
IS  - 0160-2446 (Print)
IS  - 0160-2446 (Linking)
VI  - 24
IP  - 2
DP  - 1994 Aug
TI  - Safety of concomitant potassium-sparing diuretics in angiotensin-converting 
      enzyme inhibitor therapy in severe congestive heart failure. Xamoterol in Severe 
      Heart Failure Study Group.
PG  - 194-8
AB  - The safety of concomitant use of angiotensin-converting enzyme (ACE) inhibitors 
      and potassium-sparing diuretics (PSD) in severe heart failure remains a 
      controversial issue. The database of the recently reported double-blind 
      international trial, "Xamoterol in Severe Heart Failure," was investigated to 
      elucidate this question. Of 516 patients with New York Heart Association (NYHA) 
      class III-IV, despite diuretics and ACE inhibitor therapy, 352 were randomized to 
      xamoterol, a beta 1 partial agonist, and 164 were randomized to placebo. During 
      the 13-week study, 28% of all patients (xamoterol, 104; placebo, 42) received 
      potassium-sparing diuretics. All groups were comparable in hemodynamics and dose 
      of other diuretics. At study end, patients with or without PSD showed no 
      significant differences in serum K+ or creatinine, independent of xamoterol or 
      placebo therapy. Mortality rate was consistently lower: 4.6% in patients with PSD 
      and 8.5% in patients without PSD, although statistical significance was not 
      reached. As compared with baseline, K+ values of 6 patients with and 17 patients 
      without PSD had increased by > 5.0 mM at study end (p = NS); 1 patient with and 
      11 patients without PSD had a creatinine level > 180 microM (p = NS). For 3 
      patients receiving PSD, and 2 patients not receiving PSD because of renal 
      impairment, study was discontinued because of hyperpotassemia. No significant 
      differences were noted in long and short action or different dosages of ACE 
      inhibitors. PSD may be administered concomitantly with ACE inhibitors, but serum 
      K+ should be monitored as with other diuretics.
FAU - Bergler-Klein, J
AU  - Bergler-Klein J
AD  - Department of Cardiology, University of Vienna, Austria.
FAU - Sochor, H
AU  - Sochor H
FAU - Pouleur, H
AU  - Pouleur H
FAU - Pacher, R
AU  - Pacher R
FAU - Porenta, G
AU  - Porenta G
FAU - Glogar, D
AU  - Glogar D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Diuretics)
RN  - 7HE0JQL703 (Xamoterol)
RN  - RWP5GA015D (Potassium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/administration & dosage/*therapeutic use
MH  - Diuretics/administration & dosage/*adverse effects
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Potassium/*blood
MH  - Prospective Studies
MH  - Xamoterol/*therapeutic use
EDAT- 1994/08/01 00:00
MHDA- 1994/08/01 00:01
CRDT- 1994/08/01 00:00
PHST- 1994/08/01 00:00 [pubmed]
PHST- 1994/08/01 00:01 [medline]
PHST- 1994/08/01 00:00 [entrez]
PST - ppublish
SO  - J Cardiovasc Pharmacol. 1994 Aug;24(2):194-8.