Heart failure & cardiomyopathiesRandomised controlled trial
Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery
- Randomised controlled trial
- double-blind
- equivalence
- stratified randomisation
Authors' conclusion
Among patients undergoing major cardiac surgery for advanced heart failure, inhaled pulmonary-selective vasodilator treatment using iEPO was associated with similar risks for RVF development and development of other postoperative secondary outcomes compared with treatment using iNO.
Study context
- Population
- Patients undergoing orthotopic heart transplantation or LV assist device implantation for advanced HFrandomized, eligible at surgery
- Participants
- 231 patients
- Comparison
- Inhaled epoprostenol vs inhaled nitric oxide
- Inhaled epoprostenol (iEPO)n = 120
- iNOn = 111reference
- Primary endpoint
- Composite RV failure rate (after transplantation:
- Mechanical circulatory support for isolated right ventricular failure (RVF)
- After LV assist device: moderate
- Severe right HF by INTERMACS criteria)
Primary result
As reported in the abstract
Risk difference
2.5 percentage points
90% one-sided CI −6.6% to 11.6%
Events by treatment group
iEPO vs iNO
risk difference 2.5 percentage points (90% one-sided CI −6.6% to 11.6%)
Secondary outcomes
Mechanical ventilation duration, hospital and ICU length of stay, AKI incl. renal replacement therapy, death at 30 days, 90 days and 1 year
- No significant between-group differences
Original publication
Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery. Circulation. Published 4 July 2023. doi:10.1161/circulationaha.122.062464
Summarised from the published abstract; every number is checked against it