Multi-centre experience on the use of perhexiline in chronic heart failure and refractory angina: old drug, new hope.

Abstract

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.

• Authors: Thanh Trung Phan, Ganesh Nallur Shivu, Anirban Choudhury, Khalid Abozguia, Chris Davies, Ulasini Naidoo, Ibrar Ahmed, Zaheer Yousef, John Horowitz, Michael Frenneaux
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 11 Issue 9 Pg. 881-6 (Sep 2009) ISSN: 1879-0844 [Electronic] England
• PMID: 19656806 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Cardiovascular Agents
• Vasodilator Agents
• Perhexiline

Topics

• Aged
• Analysis of Variance
• Angina Pectoris (drug therapy)
• Cardiovascular Agents (therapeutic use)
• Confidence Intervals
• Drug Monitoring
• Female
• Health Status Indicators
• Humans
• Logistic Models
• Male
• Odds Ratio
• Perhexiline (therapeutic use)
• Proportional Hazards Models
• Prospective Studies
• Time Factors
• Treatment Failure
• Vasodilator Agents (therapeutic use)