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Calcium channel blockers are thought to be harmful for patients with severe heart failure. However, a new calcium channel blocker, amlodipine, has been reported in some studies to improve short-term outcomes in these patients. To investigate the efficacy of amlodipine for patients with severe chronic heart failure, investigators at 105 participating U.S. institutions randomized 1153 patients with severe dyspnea or fatigue and a left ventricular ejection fraction of less than 30% to amlodipine or placebo.
Overall, there was no significant difference between amlodipine and placebo in the primary endpoint of combined mortality from all causes and cardiovascular morbidity. However, subgroup analysis demonstrated a significant interaction between…