Safety of concomitant XXXX -sparing diuretics in angiotensin-converting enzyme inhibitor therapy in severe @entity712 . @entity18293 in Severe @entity712 Study Group.

@entity1 @entity8 @entity712 @entity1289 @entity18293 @entity972 @entity1011 @entity4144
The safety of concomitant use of angiotensin-converting enzyme ( @entity1289 ) inhibitors and @entity972 -sparing diuretics (PSD) in severe @entity712 remains a controversial issue. The database of the recently reported double-blind international trial, " @entity18293 in Severe @entity712 ," was investigated to elucidate this question. Of 516 @entity1 with New York Heart Association (NYHA) class III-IV, despite diuretics and @entity1289 inhibitor therapy, 352 were randomized to @entity18293 , a beta 1 partial agonist, and 164 were randomized to placebo. During the 13-week study, 28% of all @entity1 ( @entity18293 , 104; placebo, 42) received @entity972 -sparing diuretics. All groups were comparable in hemodynamics and dose of other diuretics. At study end, @entity1 with or without PSD showed no significant differences in serum K+ or @entity1011 , independent of @entity18293 or placebo therapy. Mortality rate was consistently lower: 4.6% in @entity1 with PSD and 8.5% in @entity1 without PSD, although statistical significance was not reached. As compared with baseline, K+ values of 6 @entity1 with and 17 @entity1 without PSD had increased by > 5.0 mM at study end (p = NS); 1 @entity1 with and 11 @entity1 without PSD had a @entity1011 level > 180 microM (p = NS). For 3 @entity1 receiving PSD, and 2 @entity1 not receiving PSD because of @entity8 , study was discontinued because of @entity4144 . No significant differences were noted in long and short action or different dosages of @entity1289 inhibitors. PSD may be administered concomitantly with @entity1289 inhibitors, but serum K+ should be monitored as with other diuretics.
