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Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality.

Publication ,  Journal Article
Thomas, KL; Al-Khatib, SM; Lokhnygina, Y; Solomon, SD; Kober, L; McMurray, JJV; Califf, RM; Velazquez, EJ
Published in: Am Heart J
January 2008

BACKGROUND: We sought to assess the association of amiodarone use with mortality during consecutive periods in patients with post-acute myocardial infarction with left ventricular systolic dysfunction and/or HF treated with a contemporary medical regimen. METHODS: This study used data from VALIANT, a randomized comparison of valsartan, captopril, or both in patients with acute myocardial infarction with HF and/or left ventricular systolic dysfunction. We compared baseline characteristics of 825 patients treated with amiodarone at randomization with 13,875 patients not treated with amiodarone. Using Cox models, we examined the association of amiodarone use with subsequent mortality during consecutive periods after randomization (days 1-16, 17-45, 46-198, and 199-1096). RESULTS: Patients treated with amiodarone were older, had higher Killip class, and were more likely to have a history of diabetes mellitus and hypertension. Adjusting for baseline predictors of mortality, we found that amiodarone use was associated with a significant increase in mortality during 3 of the 4 periods: hazard ratio 1.5, 95% CI (1.1-2.0), P = .02, for days 1 to 16; 2.1 (1.5-2.9), P < .001, for days 17 to 45; 1.1 (0.83-1.46), P = .51, for days 46 to 198; and 1.4 (1.2-1.6), P < .001, for days 199 to 1096. CONCLUSION: In this study, amiodarone use was associated with excess early and late all-cause and cardiovascular mortality. These observational findings are in contrast to earlier randomized trials of amiodarone and need to be validated prospectively.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

January 2008

Volume

155

Issue

1

Start / End Page

87 / 93

Location

United States

Related Subject Headings

  • Ventricular Dysfunction
  • Valsartan
  • Valine
  • Treatment Outcome
  • Tetrazoles
  • Survival Analysis
  • Severity of Illness Index
  • Risk Assessment
  • Reference Values
  • Proportional Hazards Models
 

Citation

APA
Chicago
ICMJE
MLA
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Thomas, K. L., Al-Khatib, S. M., Lokhnygina, Y., Solomon, S. D., Kober, L., McMurray, J. J. V., … Velazquez, E. J. (2008). Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality. Am Heart J, 155(1), 87–93. https://doi.org/10.1016/j.ahj.2007.09.010
Thomas, Kevin L., Sana M. Al-Khatib, Yuliya Lokhnygina, Scott D. Solomon, Lars Kober, John J. V. McMurray, Robert M. Califf, and Eric J. Velazquez. “Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality.Am Heart J 155, no. 1 (January 2008): 87–93. https://doi.org/10.1016/j.ahj.2007.09.010.
Thomas KL, Al-Khatib SM, Lokhnygina Y, Solomon SD, Kober L, McMurray JJV, et al. Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality. Am Heart J. 2008 Jan;155(1):87–93.
Thomas, Kevin L., et al. “Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality.Am Heart J, vol. 155, no. 1, Jan. 2008, pp. 87–93. Pubmed, doi:10.1016/j.ahj.2007.09.010.
Thomas KL, Al-Khatib SM, Lokhnygina Y, Solomon SD, Kober L, McMurray JJV, Califf RM, Velazquez EJ. Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality. Am Heart J. 2008 Jan;155(1):87–93.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

January 2008

Volume

155

Issue

1

Start / End Page

87 / 93

Location

United States

Related Subject Headings

  • Ventricular Dysfunction
  • Valsartan
  • Valine
  • Treatment Outcome
  • Tetrazoles
  • Survival Analysis
  • Severity of Illness Index
  • Risk Assessment
  • Reference Values
  • Proportional Hazards Models