SAFETY OF CONCOMITANT POTASSIUM-SPARING DIURETICS IN ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR THERAPY IN SEVERE CONGESTIVE-HEART-FAILURE

The safety of concomitant use of angiotensin-converting enzyme (ACE) inhibitors and potassium-sparing diurectics (PSD) in severe heart failure remains a controversial issue. The database of the recently reported double-blind international trial, ''Xamoterol in Severe Heart Failure,'' was investigated to elucidate this question. Of 516 patients with New York Heart Association (NYHA) class III-IV, despite diuretics and ACE inhibitor therapy, 352 were randomized to xamoterol, a beta(1) partial agonist, and 164 were randomized to placebo. During the 13-week study, 28% of all patients (xamoterol, 104; placebo, 42) received potassium-sparing diuretics. All groups were comparable in hemodynamics and dose of other diuretics. At study end, patients with or without PSD showed no significant differences in serum K+ or creatinine, independent of xamoterol or placebo therapy.