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Titolo:
RANDOMIZED TRIAL OF EFFECT OF AMIODARONE ON MORTALITY IN PATIENTS WITH LEFT-VENTRICULAR DYSFUNCTION AFTER RECENT MYOCARDIAL-INFARCTION - EMIAT
Autore:
JULIAN DG; CAMM AJ; FRANGIN G; JANSE MJ; MUNOZ A; SCHWARTZ PJ; SIMON P;
Indirizzi:
ST GEORGE HOSP,SCH MED,CRANMER TERRACE LONDON SW17 0RE ENGLAND ST GEORGE HOSP,SCH MED LONDON SW17 0RE ENGLAND NETHERHALL GARDENS LONDON ENGLAND SANOFI RECH F-34082 MONTPELLIER FRANCE UNIV AMSTERDAM,ACAD MED CTR,DEPT CLIN & EXPTL CARDIOL NL-1105 AZ AMSTERDAM NETHERLANDS UNIV PAVIA,DEPT CARDIOL I-27100 PAVIA ITALY
Titolo Testata:
Lancet
fascicolo: 9053, volume: 349, anno: 1997,
pagine: 667 - 674
SICI:
0140-6736(1997)349:9053<667:RTOEOA>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTIARRHYTHMIC THERAPY; SUDDEN-DEATH; ARRHYTHMIAS; SURVIVORS; ISCHEMIA; EFFICACY; DESIGN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
D.G. Julian et al., "RANDOMIZED TRIAL OF EFFECT OF AMIODARONE ON MORTALITY IN PATIENTS WITH LEFT-VENTRICULAR DYSFUNCTION AFTER RECENT MYOCARDIAL-INFARCTION - EMIAT", Lancet, 349(9053), 1997, pp. 667-674

Abstract

Background Ventricular arrhythmias are a major cause of death after myocardial infarction, especially in patients with poor left-ventricular function. Previous attempts to identify and suppress arrhythmias with various antiarrhythmic drugs failed to reduce or actually increase mortality. Amiodarone is a powerful antiarrhythmic drug with several potentially beneficial actions, and has shown benefit in several small-scale studies. We postulated that this drug might reduce mortality in patients at high risk of death after myocardial infarction because of impaired ventricular function, irrespective of whether they had ventricular arrhythmias. Methods The European Myocardial Infarct Amiodarone Trial (EMIAT) was a randomised double-blind placebo-controlled trial toassess whether amiodarone reduced ail-cause mortality (primary endpoint) and cardiac mortality and arrhythmic death (secondary endpoints) in survivors of myocardial infarction with a left-ventricular ejection fraction (LVEF) of 40% or less. Intention-to-treat and on-treatment analyses were done. Findings EMIAT enrolled 1486 patients (743 in the amiodarone group, 743 in the placebo group). Median follow-up was 21 months. All-cause mortality (103 deaths in the amiodarone group, 102 in the placebo group) and cardiac mortality did not differ between the twogroups. However, in the amiodarone group, there was a 35% risk reduction (95% CI 0-58, p=0.05) in arrhythmic deaths. Interpretation Our findings do not support the systematic prophylactic use of amiodarone in all patients with depressed left-ventricular function after myocardialinfarction. However, the lack of proarrhythmia and the reduction in arrhythmic death support the use of amiodarone in patients for whom antiarrhythmic therapy is indicated.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 00:08:15