Adverse mortality effect of central sympathetic inhibition with sustained-release moxonidine in patients with heart failure (MOXCON).

摘要: Background: The association between sympathetic activation and mortality in chronic heart failure the favorable effect of beta blocking drugs has raised possibility therapeutic efficacy for central inhibition with sustained-release (SR) moxonidine, an imidazoline receptor agonist. Methods: A randomized double-blind, placebo-controlled trial was initiated 425 centers 17 countries a plan to enter 4533 patients New York Heart Association class II–IV reduced ejection fraction. Moxonidine SR or matching placebo titrated target dose 1.5 mg BID. The powered detect 20% reduction mortality, which required total 724 deaths. Findings: An early increase death rate adverse events moxonidine group led premature termination because safety concerns after 1934 were entered. Final analysis revealed 54 deaths (5.5%) 32 (3.4%) during active treatment phase. Survival curves significantly (P=0.012) worse outcome group. Hospitalization failure, acute myocardial infarction also more frequent Plasma norepinephrine decreased by (−18.8% from baseline) vs. (+6.9%). Interpretation: Early limited conclusions regarding long-term effects inhibition. Nonetheless, excess morbidity suggest likelihood raise generalized failure.