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Perhexiline improves symptomatic status in elderly patients with severe aortic stenosis
S A Unger1, M A Robinson, J D Horowitz
1Cardiology Unit, Queen Elizabeth Hospital, North Western Adelaide Health Service, University of Adelaide, SA.
Australian and New Zealand Journal of Medicine
|February 1, 1997
Summary
Perhexiline improved symptoms in elderly patients with severe aortic stenosis who were not surgical candidates. This novel anti-ischaemic agent demonstrated a marked clinical improvement and good tolerability in this patient group.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Severe symptomatic aortic stenosis (AS) carries a poor prognosis without valve replacement.
- Elderly patients with AS face high risks from cardiothoracic surgery.
- Medical treatment options for AS symptoms and outcomes have been limited.
Purpose of the Study:
- To evaluate the efficacy of perhexiline, an anti-ischaemic agent, in improving symptomatic status in elderly patients with severe AS.
- To assess the safety and tolerability of perhexiline in this population.
Main Methods:
- Elderly patients with symptomatic severe AS unsuitable for surgery received perhexiline.
- Drug dosage was adjusted based on plasma concentrations.
- NYHA functional class was assessed before and three months after treatment initiation.
Main Results:
- 13 out of 15 patients showed improved symptoms within three months of perhexiline therapy (p < 0.01).
- Five patients became asymptomatic.
- Twelve-month survival was 80%, with good tolerability and no treatment withdrawals.
Conclusions:
- Perhexiline therapy significantly improved the clinical status of elderly patients with severe AS.
- The drug was well-tolerated, offering a potential medical treatment option for this high-risk group.