High-Output Heart Failure Associated with Anagrelide Therapy for Essential Thrombocytosis
Authors: Peter J. Engel, Heide Johnson, Robert P. Baughman, Arthur I. Richards
Journal: Annals of Internal Medicine (2005)

Letters16 August 2005High-Output Heart Failure Associated with Anagrelide Therapy for Essential ThrombocytosisPeter J. Engel, MD, Heide Johnson, RN, Robert P. Baughman, MD, and Arthur I. Richards, MDPeter J. Engel, MDFrom The Ohio Heart Health Center and The Lindner Center for Research and Education, Cincinnati, OH 45219; University of Cincinnati Medical Center, Cincinnati, OH 45267; and Oncology Hematology Care, Inc., Cincinnati, OH 45219., Heide Johnson, RNFrom The Ohio Heart Health Center and The Lindner Center for Research and Education, Cincinnati, OH 45219; University of Cincinnati Medical Center, Cincinnati, OH 45267; and Oncology Hematology Care, Inc., Cincinnati, OH 45219., Robert P. Baughman, MDFrom The Ohio Heart Health Center and The Lindner Center for Research and Education, Cincinnati, OH 45219; University of Cincinnati Medical Center, Cincinnati, OH 45267; and Oncology Hematology Care, Inc., Cincinnati, OH 45219., and Arthur I. Richards, MDFrom The Ohio Heart Health Center and The Lindner Center for Research and Education, Cincinnati, OH 45219; University of Cincinnati Medical Center, Cincinnati, OH 45267; and Oncology Hematology Care, Inc., Cincinnati, OH 45219.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-4-200508160-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Congestive heart failure (CHF) is usually associated with disorders causing low cardiac output; disorders associated with high cardiac output rarely cause CHF (1, 2). Medications have not previously been thought to cause high-output heart failure. New-onset CHF and cardiovascular death have rarely been associated with therapy with anagrelide (3-5), a novel treatment for essential thrombocytosis. The mechanism of cardiac dysfunction related to anagrelide has not previously been reported.Objective: To report a case of high-output heart failure associated with anagrelide use in a patient with essential thrombocytosis.Case Report: A 34-year-old man was referred for evaluation ...References1. Braunwald E, Zipes D, Libby P. Heart Disease—A Textbook of Cardiovascular Medicine. Philadelphia: WB Saunders; 2001. Google Scholar2. Anand IS, Florea VG. High output cardiac failure. Curr Treat Options Cardiovasc Med. 2001;3:151-159. [PMID: 11242561] CrossrefMedlineGoogle Scholar3. Silverstein MN, Petitt RM, Solberg LA, Fleming JS, Knight RC, Schacter LP. Anagrelide: a new drug for treating thrombocytosis. N Engl J Med. 1988;318:1292-4. [PMID: 3362187] CrossrefMedlineGoogle Scholar4. Anagrelide, a therapy for thrombocythemic states: experience in 577 patients. Anagrelide Study Group. Am J Med. 1992;92:69-76. [PMID: 1731512] CrossrefMedlineGoogle Scholar5. Petitt RM, Silverstein MN, Petrone ME. Anagrelide for control of thrombocythemia in polycythemia and other myeloproliferative disorders. Semin Hematol. 1997;34:51-4. [PMID: 9025162] MedlineGoogle Scholar6. Packer M, Carver JR, Rodeheffer RJ, Ivanhoe RJ, DiBianco R, Zeldis SM, et al. Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE Study Research Group. N Engl J Med. 1991;325:1468-75. [PMID: 1944425] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Peter J. Engel, MD; Heide Johnson, RN; Robert P. Baughman, MD; Arthur I. Richards, MDAffiliations: From The Ohio Heart Health Center and The Lindner Center for Research and Education, Cincinnati, OH 45219; University of Cincinnati Medical Center, Cincinnati, OH 45267; and Oncology Hematology Care, Inc., Cincinnati, OH 45219.Disclosures: None disclosed. 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