Long-term benefit of 1-year amiodarone treatment for persistent complex ventricular arrhythmias after myocardial infarction.

Abstract:

BACKGROUND:In the Basel Antiarrhythmic Study of Infarct Survival trial, low-dose amiodarone improved 1-year survival in patients with asymptomatic complex ventricular arrhythmias persisting 2 weeks after myocardial infarction. To assess whether this beneficial effect persisted despite discontinuation of amiodarone after 1 year, the long-term outcomes of all patients of the amiodarone-treated group (initially n = 98) and those of the control group (n = 114) were assessed. METHODS AND RESULTS:After a mean follow-up of 72 (55-125) months, information on 96% of patients (203 of 212) was obtained regarding survival or cause of death. The probability of death after 84 months according to actuarial life-table analysis (Kaplan-Meier) was 30% for the amiodarone-treated patients and 45% for control patients. For the total follow-up, mortality remained significantly lower in the amiodarone group versus the control group regarding all deaths (p = 0.03) as well as cardiac death (p = 0.047). This mortality reduction was entirely due to the first-year amiodarone effect, since there was no significant mortality difference between groups when considering survival after discontinuation of amiodarone only. CONCLUSIONS:These data suggest that the beneficial effect of amiodarone on survival in this high-risk group of patients persists for several years. In addition, the results stress the importance of early treatment after myocardial infarction, whereas the rate of sudden death and all cardiac death is low (1.6% and 4.1% per year, respectively) during late follow-up and therefore may not warrant further therapy.

journal_name

Circulation

journal_title

Circulation

authors

Pfisterer ME,Kiowski W,Brunner H,Burckhardt D,Burkart F

doi

10.1161/01.cir.87.2.309

subject

Has Abstract

pub_date

1993-02-01 00:00:00

pages

309-11

issue

2

eissn

0009-7322

issn

1524-4539

journal_volume

87

pub_type

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