Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study-A Randomized Clinical Trial

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dc.contributor.authorBoswood, Adrianen
dc.contributor.authorHaggstrom, Jensen
dc.contributor.authorGordon, Sonya G.en
dc.contributor.authorWess, G.en
dc.contributor.authorStepien, R. L.en
dc.contributor.authorOyama, Mark A.en
dc.contributor.authorKeene, Bruce W.en
dc.contributor.authorBonagura, Johnen
dc.contributor.authorMacDonald, Kristin A.en
dc.contributor.authorPatteson, M.en
dc.contributor.authorSmith, S.en
dc.contributor.authorFox, P. R.en
dc.contributor.authorSanderson, Karenen
dc.contributor.authorWoolley, Richarden
dc.contributor.authorSzatmari, Viktoren
dc.contributor.authorMenaut, Pierreen
dc.contributor.authorChurch, Whitney M.en
dc.contributor.authorO'Sullivan, M. Lynneen
dc.contributor.authorJaudon, J-Pen
dc.contributor.authorKresken, Jan-Gerden
dc.contributor.authorRush, J.en
dc.contributor.authorBarrett, K. A.en
dc.contributor.authorRosenthal, S. L.en
dc.contributor.authorSaunders, Ashley B.en
dc.contributor.authorLjungvall, Ingriden
dc.contributor.authorDeinert, Michaelen
dc.contributor.authorBomassi, Ericen
dc.contributor.authorEstrada, Amara H.en
dc.contributor.authorFernandez Del Palacio, Maria J.en
dc.contributor.authorMoise, N. Sydneyen
dc.contributor.authorAbbott, Jonathan A.en
dc.contributor.authorFujii, Yokoen
dc.contributor.authorSpier, Alanen
dc.contributor.authorLuethy, Michael W.en
dc.contributor.authorSantilli, Roberto A.en
dc.contributor.authorUechi, Masamien
dc.contributor.authorTidholm, Annaen
dc.contributor.authorWatson, P.en
dc.date.accessioned2019-08-07T18:40:02Zen
dc.date.available2019-08-07T18:40:02Zen
dc.date.issued2016-11en
dc.description.abstractBackground: Pimobendan is effective in treatment of dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Its effect on dogs before the onset of CHF is unknown. Hypothesis/Objectives: Administration of pimobendan (0.4-0.6 mg/kg/d in divided doses) to dogs with increased heart size secondary to preclinical MMVD, not receiving other cardiovascular medications, will delay the onset of signs of CHF, cardiac-related death, or euthanasia. Animals: 360 client-owned dogs with MMVD with left atrial-to-aortic ratio >= 1.6, normalized left ventricular internal diameter in diastole >= 1.7, and vertebral heart sum >10.5. Methods: Prospective, randomized, placebo-controlled, blinded, multicenter clinical trial. Primary outcome variable was time to a composite of the onset of CHF, cardiac-related death, or euthanasia. Results: Median time to primary endpoint was 1228 days (95% CI: 856-NA) in the pimobendan group and 766 days (95% CI: 667-875) in the placebo group (P = .0038). Hazard ratio for the pimobendan group was 0.64 (95% CI: 0.47-0.87) compared with the placebo group. The benefit persisted after adjustment for other variables. Adverse events were not different between treatment groups. Dogs in the pimobendan group lived longer (median survival time was 1059 days (95% CI: 952-NA) in the pimobendan group and 902 days (95% CI: 747-1061) in the placebo group) (P = .012). Conclusions and Clinical Importance: Administration of pimobendan to dogs with MMVD and echocardiographic and radiographic evidence of cardiomegaly results in prolongation of preclinical period and is safe and well tolerated. Prolongation of preclinical period by approximately 15 months represents substantial clinical benefit.en
dc.description.notesThis project was funded by Boehringer Ingelheim Animal Health GmbH. A representative of Boehringer Ingelheim Animal Health GmbH read the final draft before submission. Philip Watson is an employee of Boehringer Ingelheim Animal Health GmbH.en
dc.description.sponsorshipBoehringer Ingelheim Animal Health GmbHen
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1111/jvim.14586en
dc.identifier.eissn1939-1676en
dc.identifier.issn0891-6640en
dc.identifier.issue6en
dc.identifier.pmid27678080en
dc.identifier.urihttp://hdl.handle.net/10919/92880en
dc.identifier.volume30en
dc.language.isoenen
dc.publisherAmerican College of Veterinary Internal Medicineen
dc.rightsCreative Commons Attribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectAsymptomaticen
dc.subjectEchocardiographyen
dc.subjectEndocardiosisen
dc.subjectHeart failureen
dc.subjectMitral regurgitationen
dc.subjectPreventionen
dc.subjectTreatmenten
dc.subjectVertebral heart sumen
dc.titleEffect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study-A Randomized Clinical Trialen
dc.title.serialJournal of Veterinary Internal Medicineen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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