Peer-reviewed veterinary case report
Adding ramipril to heart meds does not improve survival in dogs
By Wess, Gerhard et al.·Published in Journal of veterinary internal medicine·2020·Clinic of Small Animal Medicine, Germany·View original on PubMed →
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Original publication title: Efficacy of adding ramipril (VAsotop) to the combination of furosemide (Lasix) and pimobendan (VEtmedin) in dogs with mitral valve degeneration: The VALVE trial.
- Species:
- dog
Plain-English summary
A group of dogs with congestive heart failure caused by mitral valve disease were treated with either a combination of two medications (furosemide and pimobendan) or a triple therapy that added ramipril. The study found that adding ramipril did not improve survival time compared to the two-medication treatment. Both groups of dogs experienced similar outcomes, with most reaching the primary endpoint of cardiac death or treatment failure within about 214 days. This suggests that for dogs with this specific heart condition, the simpler treatment may be just as effective.
People also search for: dog congestive heart failure treatment · mitral valve disease in dogs · ramipril for dogs heart problems
Abstract
BACKGROUND: Triple therapy (TT) consisting of furosemide, pimobendan, and an angiotensin-converting enzyme inhibitor (ACEI) frequently is recommended for the treatment of congestive heart failure (CHF) attributable to myxomatous mitral valve disease (MMVD). However, the effect of adding an ACEI to the combination of pimobendan and furosemide (dual therapy [DT]) so far has not been evaluated prospectively. HYPOTHESIS: Triple therapy will extend survival time compared to DT in dogs with CHF secondary to MMVD. ANIMALS: Client-owned dogs presented with the first episode of CHF caused by MMVD. METHODS: Prospective, single-blinded, randomized multicenter study. One-hundred and fifty-eight dogs were recruited and prospectively randomized to receive either DT (furosemide and pimobendan) or TT (furosemide, pimobendan, and ramipril). The primary endpoint was a composite of cardiac death, euthanasia for heart failure, or treatment failure. RESULTS: Seventy-seven dogs were randomized to receive DT and 79 to receive TT. Two dogs were excluded from analysis. The primary endpoint was reached by 136 dogs (87%; 66 dogs, DT; 70 dogs, TT). Median time to reach the primary endpoint for all dogs in the study was 214 days (95% confidence interval [CI], 168-259 days). Median time to reach the primary endpoint was not significantly different between the DT group (227 days; interquartile range [IQR], 103-636 days) compared with TT group (186 days; IQR, 72-453 days; P = .42). CONCLUSIONS AND CLINICAL IMPORTANCE: Addition of the ACEI ramipril to pimobendan and furosemide did not have any beneficial effect on survival time in dogs with CHF secondary to MMVD.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32945575/