An amazingly simple method of filtering excess fluid from the bloodstream appears safer and far more effective than the "water pills" that have been used for decades to treat hospitalized heart failure patients, doctors reported Sunday.
The research points to a new way to treat a problem that affects 5 million Americans and sends more than 1 million to hospitals each year, gasping for breath.
It requires no drugs, seems to get them back home sooner, and uses a device that is already on the market.
"It's really pretty exciting," said Dr. Clyde Yancy, a cardiologist at UT-Southwestern Medical Center in Dallas and an American Heart Association spokesman who had no role in the study. "You could use this right now ... based on this information."
The research was discussed Sunday at an American College of Cardiology meeting in Atlanta.
Heart failure occurs when weak hearts can't pump forcefully enough and fluid backs up into the lungs. Diuretics or "water pills" remove fluid but take days to work, are tough on the kidneys and often lose effectiveness over time.
Years ago, doctors tried filtering the blood to remove excess water and salt through a tube inserted into a large vein, but this never caught on because it required a somewhat painful and difficult procedure.
A new device by Minneapolis-based CHF Solutions gave a simpler way to do this, though it still involves a tube inserted into a vein in an arm, leg or neck. The tube is connected to a machine that separates water and salt from the blood and returns the rest.
A company-sponsored study tested this in 200 people at 28 hospitals around the country. Half were given the usual pills and the others got filtration for about eight hours.
Two days later, those given filtration had lost significantly more fluid and more weight — 11 pounds versus 6.8 pounds — than those on pills, said the study's leader, Dr. Maria Rosa Costanzo of Midwest Heart specialists in Chicago.
In the next three months, they spent far fewer days in the hospital — 123 days versus 330 days — and were half as likely to wind up back in an emergency room.
The only negative: patients in the study didn't report feeling any better on one treatment than the other.
The filtration device costs hospitals $10,000 and each treatment requires an $800 filter — expenses that should be more than offset by lower hospital bills because of shorter stays, Costanzo said.
More studies are needed, Yancy said, but about 100 hospitals around the country already are using the treatment.
"We are enthusiastically offering this to our patients," said Dr. Bill Abraham at Ohio State University Medical Center, which has four devices and finds that they're often all in use.
Rose Rauck, a 46-year-old Columbus, Ohio, woman with severe heart failure, was hooked up to one on Sunday after successfully trying it a month ago.
"It took all the fluid off. I actually could breathe again," she said.
Eric Guggemos, 33, of Savage, Minn., said the treatment also worked for him.
"It gave me my life back," said Savage, who has had multiple heart problems since birth.
Also at the conference, two studies show that when a clog forms in a stent, a tiny mesh scaffold propping an artery open, it's better to slip a newer drug-oozing stent inside it than to clear the blockage and zap the artery with radiation — the only treatment currently approved for this condition.
The studies involved about 400 patients each and were led by Dr. David Holmes Jr. of Mayo Clinic in Rochester, Minn., and Dr. Gregg Stone of Columbia University in New York, and tested Cordis Corp.'s Cypher stent and Boston Scientific Corp.'s Taxus stent, respectively. Results will appear in the Journal of the American Medical Association's March 15 issue.