Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm.

Abstract

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:

Data regarding the outcome of patients with ES is limited.

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:

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:

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.

• Authors: Tobias Schupp, Michael Behnes, Dominik Ellguth, Julian Müller, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Niko Engelke, Seung-Hyun Kim, Christoph Nienaber, Muharrem Akin, Kambis Mashayekhi, Thomas Bertsch, Martin Borggrefe, Ibrahim Akin
• Journal: Pharmacology (Pharmacology) Vol. 103 Issue 3-4 Pg. 179-188 ( 2019) ISSN: 1423-0313 [Electronic] Switzerland
• PMID: 30695778 (Publication Type: Comparative Study, Journal Article, Observational Study)
• Copyright: © 2019 S. Karger AG, Basel.

Chemical References

• Adrenergic beta-Antagonists
• Angiotensin II Type 1 Receptor Blockers
• Angiotensin-Converting Enzyme Inhibitors
• Anti-Arrhythmia Agents
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Amiodarone

Topics

• 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, therapeutic use)
• Arrhythmias, Cardiac (diagnosis, drug therapy, mortality, physiopathology)
• 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