Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm.
Adrenergic beta-Antagonists
/ therapeutic use
Adult
Aged
Aged, 80 and over
Amiodarone
/ therapeutic use
Angiotensin II Type 1 Receptor Blockers
/ therapeutic use
Angiotensin-Converting Enzyme Inhibitors
/ therapeutic use
Anti-Arrhythmia Agents
/ adverse effects
Arrhythmias, Cardiac
/ diagnosis
Cardiac Resynchronization Therapy Devices
Defibrillators, Implantable
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Male
Middle Aged
Patient Readmission
Recurrence
Registries
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Young Adult
Amiodarone
Angiotensin-converting enzyme inhibitor
Beta-blocker
Electrical storm
Implantable cardioverter-defibrillator
Mortality
Statin
Journal
Pharmacology
ISSN: 1423-0313
Titre abrégé: Pharmacology
Pays: Switzerland
ID NLM: 0152016
Informations de publication
Date de publication:
2019
2019
Historique:
received:
27
09
2018
accepted:
07
11
2018
pubmed:
30
1
2019
medline:
15
3
2019
entrez:
30
1
2019
Statut:
ppublish
Résumé
The study sought to assess the long-term prognostic impact of different pharmacotherapies, including angiotensin-converting enzyme inhibitor-inhibitor/angiotensin receptor blocker (ACEi/ARB), statins, and amiodarone in patients with electrical storm (ES). Data regarding the outcome of patients with ES is limited. Consecutive patients with ES from 2002 to 2016 were included. Patients on ACEi/ARB were compared to patients without ACEi/ARB, respectively, for statin and amiodarone therapy. The primary prognostic endpoint was all-cause mortality at 4 years. Secondary endpoints comprised ES recurrences, rehospitalization, and major adverse cardiac events (MACE) at 4 years. Kaplan-Meier survival curves and multivariable Cox regression analyses were applied. A total of 84 consecutive patients surviving episodes of ES was included. Beta-blocker was given in 95%, ACEi/ARB in 80%, statin in 60%, and amiodarone in 54%. ACEi/ARB patients were associated with improved all-cause mortality at 4 years (mortality rate 34 vs. 65%, log rank p = 0.018; HR 0.428; 95% CI 0.208-0.881; p = 0.021), as well as improved freedom from MACE. In contrast, statin and amiodarone therapy had no impact on long-term outcomes in ES patients. ACEi/ARB therapy is associated with improved survival and MACE in patients with ES, whereas statins and amiodarone therapy had no impact on long-term prognostic endpoints.
Sections du résumé
OBJECTIVE
OBJECTIVE
The study sought to assess the long-term prognostic impact of different pharmacotherapies, including angiotensin-converting enzyme inhibitor-inhibitor/angiotensin receptor blocker (ACEi/ARB), statins, and amiodarone in patients with electrical storm (ES).
BACKGROUND
BACKGROUND
Data regarding the outcome of patients with ES is limited.
METHODS
METHODS
Consecutive patients with ES from 2002 to 2016 were included. Patients on ACEi/ARB were compared to patients without ACEi/ARB, respectively, for statin and amiodarone therapy. The primary prognostic endpoint was all-cause mortality at 4 years. Secondary endpoints comprised ES recurrences, rehospitalization, and major adverse cardiac events (MACE) at 4 years. Kaplan-Meier survival curves and multivariable Cox regression analyses were applied.
RESULTS
RESULTS
A total of 84 consecutive patients surviving episodes of ES was included. Beta-blocker was given in 95%, ACEi/ARB in 80%, statin in 60%, and amiodarone in 54%. ACEi/ARB patients were associated with improved all-cause mortality at 4 years (mortality rate 34 vs. 65%, log rank p = 0.018; HR 0.428; 95% CI 0.208-0.881; p = 0.021), as well as improved freedom from MACE. In contrast, statin and amiodarone therapy had no impact on long-term outcomes in ES patients.
CONCLUSION
CONCLUSIONS
ACEi/ARB therapy is associated with improved survival and MACE in patients with ES, whereas statins and amiodarone therapy had no impact on long-term prognostic endpoints.
Identifiants
pubmed: 30695778
pii: 000496228
doi: 10.1159/000496228
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Angiotensin II Type 1 Receptor Blockers
0
Angiotensin-Converting Enzyme Inhibitors
0
Anti-Arrhythmia Agents
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Amiodarone
N3RQ532IUT
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
179-188Informations de copyright
© 2019 S. Karger AG, Basel.