Prognostic impact of beta-blocker compared to combined amiodarone therapy secondary to ventricular tachyarrhythmias.
Adolescent
Adrenergic beta-Antagonists
/ administration & dosage
Adult
Aged
Aged, 80 and over
Amiodarone
/ administration & dosage
Anti-Arrhythmia Agents
/ administration & dosage
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Registries
Retrospective Studies
Survival Rate
/ trends
Tachycardia, Ventricular
/ diagnostic imaging
Young Adult
Amiodarone
Beta-blocker
ICD
Mortality
Ventricular fibrillation
Ventricular tachycardia
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 Feb 2019
15 Feb 2019
Historique:
received:
26
07
2018
revised:
17
10
2018
accepted:
09
11
2018
pubmed:
27
11
2018
medline:
4
9
2019
entrez:
27
11
2018
Statut:
ppublish
Résumé
The study sought to assess the prognostic impact of treatment with beta-blocker (BB) compared to combined BB plus amiodarone (BB-AMIO) on long-term survival in patients surviving ventricular tachyarrhythmias on admission. Data regarding the prognostic outcome of patients presenting with ventricular tachyarrhythmias treated with BB and BB-AMIO is limited. A large retrospective registry was used including consecutive patients surviving index episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with BB were compared to patients with BB-AMIO. The primary prognostic endpoint was long-term all-cause death at 3 years. Kaplan-Meier, multivariable Cox regression and propensity score matching analyses were applied. A total of 1354 patients was included, 85% treated with BB, 15% with BB-AMIO. Within the unmatched real-life cohort, uni- and multivariable Cox regression models revealed BB associated with improved long-term survival compared to BB-AMIO (univariable: HR = 0.550; p = 0.001, multivariable: HR = 0.712; statistical trend, p = 0.052). After propensity-score matching (n = 186 matched pairs), BB therapy was still associated with improved survival compared to BB-AMIO (mortality rate 18% versus 26%; log rank p = 0.042; HR = 0.634; 95% CI = 0.407-0.988; p = 0.044). Prognostic superiority of BB was mainly observed in patients with LVEF ≥ 35% (HR = 0.463; 95% CI = 0.215-0.997; p = 0.049) and in those without atrial fibrillation (non-AF) (HR = 0.415; 95% CI = 0.202-0.852; p = 0.017). BB therapy is associated with improved secondary long-term prognosis compared to BB-AMIO in patients surviving index episodes of ventricular tachyarrhythmias.
Sections du résumé
OBJECTIVE
OBJECTIVE
The study sought to assess the prognostic impact of treatment with beta-blocker (BB) compared to combined BB plus amiodarone (BB-AMIO) on long-term survival in patients surviving ventricular tachyarrhythmias on admission.
BACKGROUND
BACKGROUND
Data regarding the prognostic outcome of patients presenting with ventricular tachyarrhythmias treated with BB and BB-AMIO is limited.
METHODS
METHODS
A large retrospective registry was used including consecutive patients surviving index episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with BB were compared to patients with BB-AMIO. The primary prognostic endpoint was long-term all-cause death at 3 years. Kaplan-Meier, multivariable Cox regression and propensity score matching analyses were applied.
RESULTS
RESULTS
A total of 1354 patients was included, 85% treated with BB, 15% with BB-AMIO. Within the unmatched real-life cohort, uni- and multivariable Cox regression models revealed BB associated with improved long-term survival compared to BB-AMIO (univariable: HR = 0.550; p = 0.001, multivariable: HR = 0.712; statistical trend, p = 0.052). After propensity-score matching (n = 186 matched pairs), BB therapy was still associated with improved survival compared to BB-AMIO (mortality rate 18% versus 26%; log rank p = 0.042; HR = 0.634; 95% CI = 0.407-0.988; p = 0.044). Prognostic superiority of BB was mainly observed in patients with LVEF ≥ 35% (HR = 0.463; 95% CI = 0.215-0.997; p = 0.049) and in those without atrial fibrillation (non-AF) (HR = 0.415; 95% CI = 0.202-0.852; p = 0.017).
CONCLUSION
CONCLUSIONS
BB therapy is associated with improved secondary long-term prognosis compared to BB-AMIO in patients surviving index episodes of ventricular tachyarrhythmias.
Identifiants
pubmed: 30473333
pii: S0167-5273(18)34572-8
doi: 10.1016/j.ijcard.2018.11.030
pii:
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Anti-Arrhythmia Agents
0
Amiodarone
N3RQ532IUT
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
118-124Informations de copyright
Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.