Efficacy of Pimobendan in the Prevention of Congestive Heart Failure or Sudden Death in Doberman Pinschers with Preclinical Dilated Cardiomyopathy (The <scp>PROTECT</scp> Study)

<jats:sec><jats:title>Background</jats:title><jats:p>The benefit of pimobendan in delaying the progression of preclinical dilated cardiomyopathy (<jats:styled-content style="fixed-case">DCM</jats:styled-content>) in Dobermans is not reported.</jats:p></jats:sec><jats:sec><jats:title>Hypothesis</jats:title><jats:p>That chronic oral administration of pimobendan to Dobermans with preclinical <jats:styled-content style="fixed-case">DCM</jats:styled-content> will delay the onset of <jats:styled-content style="fixed-case">CHF</jats:styled-content> or sudden death and improve survival.</jats:p></jats:sec><jats:sec><jats:title>Animals</jats:title><jats:p>Seventy‐six client‐owned Dobermans recruited at 10 centers in the <jats:styled-content style="fixed-case">UK</jats:styled-content> and North America.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The trial was a randomized, blinded, placebo‐controlled, parallel group multicenter study. Dogs were allocated in a 1:1 ratio to receive pimobendan (Vetmedin capsules) or visually identical placebo.</jats:p><jats:p>The composite primary endpoint was prospectively defined as either onset of <jats:styled-content style="fixed-case">CHF</jats:styled-content> or sudden death. Time to death from all causes was a secondary endpoint.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The proportion of dogs reaching the primary endpoint was not significantly different between groups (<jats:italic>P</jats:italic> = .1). The median time to the primary endpoint (onset of <jats:styled-content style="fixed-case">CHF</jats:styled-content> or sudden death) was significantly longer in the pimobendan (718 days, <jats:styled-content style="fixed-case">IQR</jats:styled-content> 441–1152 days) versus the placebo group (441 days, <jats:styled-content style="fixed-case">IQR</jats:styled-content> 151–641 days) (log‐rank <jats:italic>P</jats:italic> = 0.0088). The median survival time was significantly longer in the pimobendan (623 days, <jats:styled-content style="fixed-case">IQR</jats:styled-content> 491–1531 days) versus the placebo group (466 days, <jats:styled-content style="fixed-case">IQR</jats:styled-content> 236–710 days) (log‐rank <jats:italic>P</jats:italic> = .034).</jats:p></jats:sec><jats:sec><jats:title>Conclusion and Clinical Importance</jats:title><jats:p>The administration of pimobendan to Dobermans with preclinical <jats:styled-content style="fixed-case">DCM</jats:styled-content> prolongs the time to the onset of clinical signs and extends survival. Treatment of dogs in the preclinical phase of this common cardiovascular disorder with pimobendan can lead to improved outcome.</jats:p></jats:sec>