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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
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: Th...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762580/ https://www.ncbi.nlm.nih.gov/pubmed/26937171 http://dx.doi.org/10.2147/DDDT.S96126 |
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author | Rivinius, Rasmus Helmschrott, Matthias Ruhparwar, Arjang Schmack, Bastian Erbel, Christian Gleissner, Christian A Akhavanpoor, Mohammadreza Frankenstein, Lutz Darche, Fabrice F Schweizer, Patrick A Thomas, Dierk Ehlermann, Philipp Bruckner, Tom Katus, Hugo A Doesch, Andreas O |
author_facet | Rivinius, Rasmus Helmschrott, Matthias Ruhparwar, Arjang Schmack, Bastian Erbel, Christian Gleissner, Christian A Akhavanpoor, Mohammadreza Frankenstein, Lutz Darche, Fabrice F Schweizer, Patrick A Thomas, Dierk Ehlermann, Philipp Bruckner, Tom Katus, Hugo A Doesch, Andreas O |
author_sort | Rivinius, Rasmus |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4762580 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-47625802016-03-02 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 Rivinius, Rasmus Helmschrott, Matthias Ruhparwar, Arjang Schmack, Bastian Erbel, Christian Gleissner, Christian A Akhavanpoor, Mohammadreza Frankenstein, Lutz Darche, Fabrice F Schweizer, Patrick A Thomas, Dierk Ehlermann, Philipp Bruckner, Tom Katus, Hugo A Doesch, Andreas O Drug Des Devel Ther Original Research 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. Dove Medical Press 2016-02-16 /pmc/articles/PMC4762580/ /pubmed/26937171 http://dx.doi.org/10.2147/DDDT.S96126 Text en © 2016 Rivinius et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Rivinius, Rasmus Helmschrott, Matthias Ruhparwar, Arjang Schmack, Bastian Erbel, Christian Gleissner, Christian A Akhavanpoor, Mohammadreza Frankenstein, Lutz Darche, Fabrice F Schweizer, Patrick A Thomas, Dierk Ehlermann, Philipp Bruckner, Tom Katus, Hugo A Doesch, Andreas O 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762580/ https://www.ncbi.nlm.nih.gov/pubmed/26937171 http://dx.doi.org/10.2147/DDDT.S96126 |
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