In Acute Heart Failure Serelaxin Does Not Lower Cardiovascular Death

An infusion of serelaxin does not result in a lower incidence of death from cardiovascular causes or worsening of heart failure among patients hospitalized for acute heart failure; according to a study publish in the Aug issue of the New England Journal of Medicine. Marco Metra, M.D., from the University of Brescia in Italy, and colleagues conduct a multicenter trial involving 6,545 patients who were hospitalize for acute heart failure.

Serelaxin is a recombinant form of human relaxin-2; a vasodilator hormone that contributes to cardiovascular and renal adaptations during pregnancy. Previous studies have suggest that treatment with serelaxin; which may result in relief of symptoms and in better outcomes in patients with acute heart failure. In addition to standard care, participants were randomly assign to receive a 48-hour intravenous infusion of serelaxin or placebo.

Congestion on chest radiography

In this multicenter, double-blind, placebo control, event-driven trial; they enroll patients who were hospitalize for acute heart failure and had dyspnea, vascular congestion on chest radiography; increase plasma concentrations of natriuretic peptides; mild-to-moderate renal insufficiency; also a systolic blood pressure of at least 125 mm Hg, and they randomly assign them within 16 hours after presentation to receive either a 48-hour intravenous infusion of serelaxin (30 μg per kilogram of body weight per day) or placebo, in addition to standard care.

The two primary end points were death from cardiovascular; causes at 180 days and worsening heart failure at 5 days. The researchers found that death from cardiovascular causes occur in 8.7 and 8.9% of patients in the serelaxin and placebo groups, respectively, at day 180 (hazard ratio, 0.98; 95% confidence interval, 0.83 to 1.15; P = 0.77). Worsening heart failure occur in 6.9 and 7.7 percent of the serelaxin and placebo groups, respectively, at day 5 (hazard ratio, 0.89; 95 percent confidence interval, 0.75 to 1.07; P = 0.19).

Death from cardiovascular causes

The groups did not differ significantly in terms of incidence of death from any cause at 180 days; so incidence of death from cardiovascular causes or rehospitalization for heart failure or renal failure at 180 days; or length of the index hospital stay. So focus on intensive outpatient care (rather than an obsession with inpatient therapy) is need to reduce the burden of heart failure; write the authors of an accompanying editorial.

This study was partially fund by Novartis Pharma; so the manufacturer of serelaxin. Hence this trial involving patients who were hospitalize for acute heart failure; so an infusion of serelaxin did not result in a lower incidence of death; hence from cardiovascular causes at 180 days or worsening heart failure at 5 days than placebo.