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Titolo:
Dofetilide in patients with congestive heart failure and left ventricular dysfunction
Autore:
Torp-Pedersen, C; Moller, M; Bloch-Thomsen, PE; Kober, L; Sandoe, E; Egstrup, K; Agner, E; Carlsen, J; Videbaek, J; Marchant, B; Camm, AJ;
Indirizzi:
Odense Univ Hosp, Dept Cardiol B, DK-5000 Odense, Denmark Odense Univ Hosp Odense Denmark DK-5000 rdiol B, DK-5000 Odense, Denmark Gentofte Univ Hosp, Dept Cardiol, Hellerup, Denmark Gentofte Univ Hosp Hellerup Denmark sp, Dept Cardiol, Hellerup, Denmark Haderslev Hosp, Dept Cardiol, Haderslev, Denmark Haderslev Hosp Haderslev Denmark Hosp, Dept Cardiol, Haderslev, Denmark Helsingor Hosp, Dept Cardiol, Helsingor, Denmark Helsingor Hosp Helsingor Denmark Hosp, Dept Cardiol, Helsingor, Denmark Bispebjerg Univ Hosp, Dept Cardiol, Bispebjerg, Denmark Bispebjerg Univ Hosp Bispebjerg Denmark pt Cardiol, Bispebjerg, Denmark Pfizer Cent Res, Sandwich, Kent, England Pfizer Cent Res Sandwich Kent England Cent Res, Sandwich, Kent, England St Georges Hosp, Dept Cardiol, London, England St Georges Hosp London England rges Hosp, Dept Cardiol, London, England
Titolo Testata:
NEW ENGLAND JOURNAL OF MEDICINE
fascicolo: 12, volume: 341, anno: 1999,
pagine: 857 - 865
SICI:
0028-4793(19990916)341:12<857:DIPWCH>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-DOSE AMIODARONE; MYOCARDIAL-INFARCTION; ATRIAL-FIBRILLATION; RANDOMIZED TRIAL; ANTIARRHYTHMIC DRUG; SINUS RHYTHM; D-SOTALOL; MORTALITY; THERAPY; ARRHYTHMIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Moller, M Odense Univ Hosp, Dept Cardiol B, DK-5000 Odense, Denmark OdenseUniv Hosp Odense Denmark DK-5000 K-5000 Odense, Denmark
Citazione:
C. Torp-Pedersen et al., "Dofetilide in patients with congestive heart failure and left ventricular dysfunction", N ENG J MED, 341(12), 1999, pp. 857-865

Abstract

Background Atrial fibrillation occurs frequently in patients with congestive heart failure and commonly results in clinical deterioration and hospitalization. Sinus rhythm may be maintained with antiarrhythmic drugs, but some of these drugs increase the risk of death. Methods We studied 1518 patients with symptomatic congestive heart failure and severe left ventricular dysfunction at 34 Danish hospitals. We randomly assigned 762 patients to receive dofetilide, a novel class III antiarrhythmic agent, and 756 to receive placebo in a double-blind study. Treatment was initiated in the hospital and included three days of cardiac monitoring and dose adjustment. The primary end point was death from any cause. Results During a median follow-up of 18 months, 311 patients in the dofetilide group (41 percent) and 317 patients in the placebo group (42 percent) died (hazard ratio, 0.95; 95 percent confidence interval, 0.81 to 1.11). Treatment with dofetilide significantly reduced the risk of hospitalization for worsening congestive heart failure (risk ratio, 0.75; 95 percent confidence interval, 0.63 to 0.89). Dofetilide was effective in converting atrial fibrillation to sinus rhythm. After one month, 22 of 190 patients with atrial fibrillation at base line (12 percent) had sinus rhythm restored with dofetilide, as compared with only 3 of 201 patients (1 percent) given placebo. Once sinus rhythm was restored, dofetilide was significantly more effective than placebo in maintaining sinus rhythm (hazard ratio for the recurrence of atrial fibrillation, 0.35; 95 percent confidence interval, 0.22 to 0.57; P < 0.001). There were 25 cases of torsade de pointes in the dofetilide group (3.3 percent) as compared with none in the placebo group. Conclusions In patients with congestive heart failure and reduced left ventricular function, dofetilide was effective in converting atrial fibrillation, preventing its recurrence, and reducing the risk of hospitalization forworsening heart failure. Dofetilide had no effect on mortality. (N Engl J Med 1999;341:857-65. ) (C) 1999, Massachusetts Medical Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 20:02:28