linkResearchers at Ohio State University Medical Center conducted a retrospective study of over 65,000 ADHF patients treated intravenously with either of these types of drugs.

Reporting in the July 5 Journal of the American College of Cardiology, they found that those who received the vasodilators nitroglycerin and nesiritide had lower in-hospital death rates than those who received either of two positive inotrope drugs, dobutamine and milrinone.

The findings may surprise some in the medical community, particularly those who favor the use of positive inotropes, said study lead author Dr. William T. Abraham, director of cardiovascular medicine at the Richard M. Ross Heart Hospital at Ohio State University.

"This is a significant finding from a large population of patients and will certainly aid in the development of guidelines for treating patients with acute decompensated heart failure," Abraham said in a prepared statement.

"Our study suggests that inotropes be reserved for patients who fail with vasodilators or are so severely ill that vasodilators alone are likely to be inadequate treatment," he said.