Trial alert

The editor is impressed by the vast number of clinical trials presently being undertaken or reported, so many that trial hunting and statistical troubleshooting, as well as retrospective data dredging, have all become important occupations. To help our hardpressed readers to keep up with the avalanche of trial results, this journal will from time to time alert readers to important results published elsewhere. Contributions to this column are welcome and should be sent to the editor. Milrinone Unfavorable in Congestive Heart Failure DiBianco et al. [1} show that milrinone (10 mg, four times daily) compares unfavorably with digoxin when added to diuretic therapy in patients with congestive heart failure. The clinical conditions of 20% of the patients deteriorated within 2 weeks of starting milrinone but only in 3% of those taking digoxin (p < 0.05}. Increased ventricular arrhythmias occurred more frequently in those receiving milrinone than in those who did not (p < 0.03). Supraventricular arrhythmias and. sinus tachycardia were also more common in the milrinone group. A criticism of the trial is that the randomization procedure allocated some severely ill patients with lower ejection fractions to the milrinone group, which may explain why milrinone apparently increased mortality.