Drug can cut heart deaths by third

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The Independent Online
A DRUG discovered 40 years ago has been found to cut death rates from heart failure by nearly a third in a clinical trial. The trial was stopped to allow patients on placebo pills to benefit from the treatment.

An international study of spironolactone - developed originally to treat water retention - revealed it can reduce by 35 per cent the risk of a patient needing hospital care, and cut the chance of premature death by 30 per cent, the researchers say. Heart failure, caused by the inability of the heart to pump blood efficiently, is estimated to affect 2 per cent of the population and is the single biggest cause of admissions to hospital in Britain.

The American-led two-year study, involving 1,663 patients in 15 countries, was terminated because it was unethical to continue giving placebo sugar- pills to half the volunteers, knowing the others in the trial were benefiting from the drug.

Over two years, there were 386 deaths in the placebo group of 841 patients - a death rate of 46 per cent - compared with 284 deaths in the spironolactone group of 822, a death rate of 35 per cent.

Bertram Pitt, a scientist at the University of Michigan who led the research, said: "This is going to have a major health impact around the world. The drug is already available, it's cheap, it will keep a lot of people alive and it'll make a lot of people feel better."

The British Heart Foundation, which was told of the trial's early termination only yesterday, said the results could prove to be "very important" for the way doctors treat heart failure, an incurable condition causing breathlessness, severe tiredness and swelling of the feet and ankles.

"Clearly it is important that the research results are subject to proper scrutiny before patients should expect to have access to this drug," said a foundation spokesman. "But if the effects of this treatment are as great as suggested by this study, the potential benefits in terms of lives saved and quality of life improvement could be huge."

The New England Journal of Medicine which was due to publish the results of the study in September, released them early because of benefits to other heart failure patients. Only a handful of medical discoveries each year are important enough to merit such treatment, said the journal's editor, Jerome Kassirer.

Karl Weber, a medical researcher at the University of Missouri Health Sciences Center in Columbia, said chronic heart failure occurs most commonly after a heart attack, or from long-standing high blood pressure, and many patients stand to benefit from the drug.

"This observation is an important therapeutic advance and suggests the standard of care for the treatment of patients with moderate or severe symptomatic heart failure should be broadened to include spironolactone," says Dr Weber in an editorial in the Journal.