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Multi‐centre experience on the use of perhexiline in chronic heart failure and refractory angina: old drug, new hope
Author(s) -
Phan Thanh Trung,
Shivu Ganesh Nallur,
Choudhury Anirban,
Abozguia Khalid,
Davies Chris,
Naidoo Ulasini,
Ahmed Ibrar,
Yousef Zaheer,
Horowitz John,
Frenneaux Michael
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp106
Subject(s) - medicine , heart failure , refractory (planetary science) , cardiology , angina , drug , intensive care medicine , pharmacology , myocardial infarction , physics , astrobiology
Aims The objective of this study is to report on our 5‐year collective experience on the use of perhexiline in the UK, in patients with chronic heart failure (CHF) and/or refractory angina with respect to ‘ real‐life’ drug side effects and toxicity, therapeutic drug level monitoring, 5 year mortality outcomes and predictors of response to perhexiline therapy. Methods and results Data on clinical history, perhexiline monitoring, follow‐up, and mortality were retrospectively collated from centralized perhexiline databases from two tertiary referral centres. A total of 151 patients were on perhexiline therapy at two UK tertiary referral centres. At 3–4 months, 68.8% of patients had drug level within the therapeutic range and 20.8% were above the therapeutic range. A total of 58.9% of patients reported to have felt better on the perhexiline (responders). The presence of refractory angina was an independent predictor of response to perhexiline therapy (odds ratio 2.84, 95% confidence interval 1.28–6.32, P = 0.01). Five‐year mortality was non‐significantly different between patients with refractory angina, CHF, or both (20.5, 31.0, and 38.4%, P = 0.20, respectively). Conclusion Perhexiline therapy provides symptomatic relief in the majority of patients with minimal side effects or toxicity. Careful therapeutic level monitoring for dose titration is important to prevent acute and chronic toxicity. Patients with refractory angina were more likely to be responders.