Long-term use of amiodarone before heart transplantation significantly reduces early post-transplant atrial fibrillation and is not associated with increased mortality after heart transplantation

被引：27

作者：

Rivinius, Rasmus ^{[1
]}

Helmschrott, Matthias ^{[1
]}

Ruhparwar, Arjang ^{[2
]}

Schmack, Bastian ^{[2
]}

Erbel, Christian ^{[1
]}

Gleissner, Christian A. ^{[1
]}

Akhavanpoor, Mohammadreza ^{[1
]}

Frankenstein, Lutz ^{[1
]}

Darche, Fabrice F. ^{[1
]}

Schweizer, Patrick A. ^{[1
]}

Thomas, Dierk ^{[1
]}

Ehlermann, Philipp ^{[1
]}

Bruckner, Tom ^{[3
]}

Katus, Hugo A. ^{[1
]}

Doesch, Andreas O. ^{[1
]}

机构：

[1] Heidelberg Univ, Dept Cardiol Angiol & Pneumol, Heidelberg, Germany

[2] Heidelberg Univ, Univ Heidelberg Hosp, Dept Cardiac Surg, Heidelberg, Germany

[3] Heidelberg Univ, Inst Med Biometry & Informat, Heidelberg, Germany

来源：

DRUG DESIGN DEVELOPMENT AND THERAPY | 2016年 / 10卷

关键词：

amiodarone; atrial fibrillation; heart failure; heart transplantation; mortality; RISK-FACTORS; THERAPY; PHARMACOKINETICS; MALIGNANCIES; BRADYCARDIA; ARRHYTHMIAS; PREVALENCE; TACROLIMUS; OUTCOMES; DEATH;

D O I：

10.2147/DDDT.S96126

中图分类号：

R914 [药物化学];

学科分类号：

100701 ;

摘要：

Background: Amiodarone is a frequently used antiarrhythmic drug in patients with end-stage heart failure. Given its long half-life, pre-transplant use of amiodarone has been controversially discussed, with divergent results regarding morbidity and mortality after heart transplantation (HTX). Aim: The aim of this study was to investigate the effects of long-term use of amiodarone before HTX on early post-transplant atrial fibrillation (AF) and mortality after HTX. Methods: Five hundred and thirty patients (age >= 18 years) receiving HTX between June 1989 and December 2012 were included in this retrospective single-center study. Patients with long-term use of amiodarone before HTX (>= 1 year) were compared to those without long-term use (none or <1 year of amiodarone). Primary outcomes were early post-transplant AF and mortality after HTX. The Kaplan-Meier estimator using log-rank tests was applied for freedom from early post-transplant AF and survival. Results: Of the 530 patients, 74 (14.0%) received long-term amiodarone therapy, with a mean duration of 32.3 +/- 26.3 months. Mean daily dose was 223.0 +/- 75.0 mg. Indications included AF, Wolff-Parkinson-White syndrome, ventricular tachycardia, and ventricular fibrillation. Patients with long-term use of amiodarone before HTX had significantly lower rates of early post-transplant AF (P=0.0105). Further, Kaplan-Meier analysis of freedom from early post-transplant AF showed significantly lower rates of AF in this group (P=0.0123). There was no statistically significant difference between patients with and without long-term use of amiodarone prior to HTX in 1-year (P=0.8596), 2-year (P=0.8620), 5-year (P=0.2737), or overall follow-up mortality after HTX (P=0.1049). Moreover, Kaplan-Meier survival analysis showed no statistically significant difference in overall survival (P=0.1786). Conclusion: Long-term use of amiodarone in patients before HTX significantly reduces early post-transplant AF and is not associated with increased mortality after HTX.

引用

页码：677 / 686

页数：10

共 28 条

[1] Prevalence, pathophysiology, and clinical significance of post-heart transplant atrial fibrillation and atrial flutter [J].