The Effects of Glucocorticoids on Mortality and Renal Function in Patients With Acute Decompensated Heart Failure
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Purpose
Evidence showed that glucocorticoids could induce potent diuretic actions and improve renal functions in patients with decompensated congestive heart failure. Thus we design this study to determine the efficacy of glucocorticoids on cardiovascular mortality in the 30 days following randomization.
| Condition | Intervention | Phase |
|---|---|---|
|
Heart Failure |
Drug: glucocorticoid Drug: standard care |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | The Effects of Glucocorticoids on Mortality and Renal Function in Patients With Acute Decompensated Heart Failure |
- Cardiovascular mortality in the 30 days following randomization. [ Time Frame: 30 days following randomization ] [ Designated as safety issue: No ]
- Renal function [ Time Frame: on day 7 ] [ Designated as safety issue: Yes ]
- physician assessed global clinical status [ Time Frame: on day 3 and day 7 ] [ Designated as safety issue: No ]
- patient assessed dyspnea [ Time Frame: on day 3 and day 7. ] [ Designated as safety issue: No ]
| Enrollment: | 102 |
| Study Start Date: | January 2009 |
| Study Completion Date: | January 2012 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: glucocorticoid |
Drug: glucocorticoid
One dose of Dexamethasone (20mg/day) followed by prednisone 1mg/kg/day with a maximum dose of 60mg/day.
Other Name: Dexamethasone Sodium Phosphate; prednisone acetate tablets
|
| Active Comparator: Standard care |
Drug: standard care
The patients will be given standard care such as diuretics, inotropic and/or vasodilator in acute decompensated congestive heart failure management.
Other Name: Furosemide; torsemide; nitroglycerin; dopamine; Dobutamine
|
Detailed Description:
Newly emerging clinical evidence showed glucocorticoids, when added to best conventional therapy, could produce potent diuretic effects, and improve renal functions in patients with decompensated congestive heart failure. It holds ture even in the patients who failed to respond to high dose of furosemide (>200mg/day). The present study is to confirm the clinical efficacy of glucocorticoids on cardiovascular mortality in patients with decompensated congestive heart failure who are on best conventional therapy.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients with dyspnea at rest due to acutely decompensated CHF requiring hospitalization and intravenous therapy. The cardiac etiology for acutely decompensated CHF was established by echocardiogram and/or a chest x-ray film and 2 of the following:
- >2-pillow orthopnea before study entry
- Jugular venous distention and/or abdominal discomfort due to mesenteric congestion.
Patients may have had acute decompensation of chronic heart failure, gradual worsening of chronic heart failure, or new onset of acutely decompensated CHF. Patients who were receiving intravenous therapy i.e. Inotropic and/or vasodilator but who otherwise met entry criteria were also permitted into the study. Patients with signs of cardiac shock were also permitted into the study.
Exclusion Criteria:
- Patient refusal
- Any signs of infection
- any condition that would contraindicate a glucocorticoids use
- Poor controlled hypertension
- Poor controlled diabetes mellitus
- Active myocarditis
- Malignancy or other terminal illness
Contacts and Locations| China, Hebei | |
| The First Hospital of Hebei Medical University | |
| Shijiazhuang, Hebei, China, 050031 | |
| Principal Investigator: | Kunshen Liu, MD | Hebei Medical University First Hospital |
More Information
No publications provided
| Responsible Party: | Kun-shen Liu M.D., Professor, Hebei Medical University |
| ClinicalTrials.gov Identifier: | NCT00953303 History of Changes |
| Other Study ID Numbers: | hebmu 08-12B |
| Study First Received: | August 3, 2009 |
| Last Updated: | February 19, 2012 |
| Health Authority: | China: Food and Drug Administration |
Keywords provided by Hebei Medical University:
|
heart failure prednisone cardiovascular mortality renal function |
Additional relevant MeSH terms:
|
Heart Failure Heart Diseases Cardiovascular Diseases Dexamethasone acetate Dexamethasone Prednisone Dexamethasone 21-phosphate Glucocorticoids Sodium phosphate BB 1101 Nitroglycerin Anti-Inflammatory Agents Therapeutic Uses Pharmacologic Actions Antiemetics |
Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Central Nervous System Agents Gastrointestinal Agents Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Vasodilator Agents Cardiovascular Agents Cathartics |
ClinicalTrials.gov processed this record on May 22, 2013