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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ERelaxin, a naturally occurring vasodilator, improves symptoms and lessens the risk of cardiovascular death and heart failure rehospitalization in patients hospitalized with acute heart failure, according to findings from the Preliminary Study of Relaxin in Acute Heart Failure [Pre-RELAX-AHF; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00520806\u0026amp;atom=%2Fspmdc%2F9%2F2%2F12.atom\u0022\u003ENCT00520806\u003C\/a\u003E].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart Failure\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ERelaxin, a naturally occurring vasodilator, improves symptoms and lessens the risk of cardiovascular death and heart failure rehospitalization in patients hospitalized with acute heart failure, according to findings from the Preliminary Study of Relaxin in Acute Heart Failure (Pre-RELAX-AHF; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00520806\u0026amp;atom=%2Fspmdc%2F9%2F2%2F12.atom\u0022\u003ENCT00520806\u003C\/a\u003E).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ERelaxin is a peptide hormone that increases in serum concentration in pregnant women to facilitate the hemodynamic adjustments of pregnancy, including increased cardiac output and decreased vascular resistance. The phase 2 Pre-RELAX-AHF trial was designed to evaluate the effects of relaxin in patients with similar physiologic changes due to heart failure. John R. Teerlink, MD, University of California San Francisco, CA, presented results from Pre-RELAX-AHF, which were simultaneously published online in \u003Cem\u003EThe Lancet.\u003C\/em\u003E\n      \u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe trial enrolled 234 patients with acute heart failure characterized by dyspnea and congestion on chest X-ray, normal or elevated systolic blood pressure (\u0026gt;125 mm Hg), impaired renal function (CrCl 30\u201375 mL\/min) and elevated brain natriuretic peptide (BNP). After receiving intravenous furosemide and within 16 hours of presentation, patients were randomly assigned to treatment with intravenous placebo (n=62) or relaxin 10 \u03bcg\/kg (n=40), 30 \u03bcg\/kg (n=43), 100 \u03bcg\/kg (n=39), or 250 \u03bcg\/kg (n=50) for 48 hours. Pre-RELAX-AHF had no prespecified primary endpoint and assessed clinical outcomes such as relief of dyspnea, inhospital worsening of heart failure, renal impairment and hospital stay, among others.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ERelaxin showed a preferential vasodilatory effect, providing a greater blood pressure reduction compared with placebo among patients with baseline systolic blood pressure \u0026gt;140 mm Hg (p=0.04), but not in those with systolic blood pressure \u2264140 mm Hg (p=0.73).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EPatients in the 30 \u03bcg\/kg dosing group appeared to benefit the most from relaxin treatment. Compared with placebo, patients in the 30 \u03bcg\/kg group reported a moderate or marked improvement in dyspnea (Likert scale) at 6, 12, and 24 hours (p=0.044), which was sustained through Day 14 (p=0.053). Relaxin 30 \u03bcg\/kg also numerically reduced the mean length of hospital stay by nearly 2 days (12.0 vs 10.2 days; p=0.18).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ERelaxin improved clinical outcomes following hospital discharge as well. Compared with placebo, relaxin 30 \u03bcg\/kg reduced the risk of cardiovascular death or rehospitalization due to heart failure or renal failure by 87% at 60 days (HR, 0.13; p=0.053). No patients died because of cardiovascular causes in the Relaxin 30 \u03bcg\/kg group at 180 days (p\u0026lt;0.05).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ERelaxin had a favorable safety profile, with a similar proportion of patients reporting any adverse event in the placebo and relaxin groups. Compared with placebo, relaxin 30 \u03bcg\/kg was associated with a nonsignificant increase in the incidence of bronchitis (0 vs 2.4%), stroke (1.6% vs 4.8%), renal failure (1.6% vs 2.4%), and hypotension (9.8% vs 11.9%). No cases of severe hypotension were reported in the placebo or relaxin 30 \u03bcg\/kg groups, though 2 cases (4.1%) were reported in the relaxin 250 \u03bcg\/kg group. Relaxin 250 \u03bcg\/kg, but not 30 \u03bcg\/kg, was associated with a nonsignifcant doubling in the incidence of worsening renal dysfunction (\u22650.3 mg\/dL increase in serum creatinine) compared with placebo (15% vs 7%, p=0.19).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EBased on these findings, Dr. Teerlink and colleagues have chosen the 30 \u03bcg\/kg dose for evaluation in the upcoming international phase 3 trial of relaxin in acute heart failure (RELAX-AHF-1).\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2009 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/9\/2\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmkf1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}