Copyright © 1998 by the European Society of Cardiology.
Identification of post acute myocardial infarction patients with potential benefit from prophylactic treatment with amiodarone
A substudy of EMIAT (The European Myocardial Infarct Amiodarone Trial)
a Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
b Department of Cardiological Sciences, St. George's Hospital Medical School, London, U.K.
c Netherhall Gardens, London, U.K.
d Sanofi Recherche, Montpellier, France
e Department of Cardiology, University of Pavia and Policlinico S. Matteo IRCCS, Pavia, Italy
accepted October 13, 1997
Aims To perform a retrospective analysis of subgroups of patients enrolled into the European Myocardial Infarct Amiodarone Trial (EMIAT) in order to identify patients who might benefit from prophylactic amiodarone treatment and patients in whom amiodarone might be harmful.
Methods Baseline characteristics of the 1486 patients enrolled in EMIAT were used to investigate the all-cause mortality effect of amiodarone (intention-to-treat) in patients with a left ventricular ejection fraction 30–40% and <30%, in patients with and without arrhythmia signs on Holter recordings, in patients with high and low baseline resting heart rate, in patients on and off beta-blocker treatment, and in a combination of these groups.
Results A univariate analysis suggested that all-cause mortality is reduced on amiodarone in patients with an ejection fraction <30%, with arrhythmia on the initial Holter, on beta-blocker treatment, and with an increased initial heart rate. A trend towards an increase of all-cause mortality was noted in patients with an ejection fraction 30–40%, without arrhythmia on Holter, off beta-blockers, and with a low baseline heart rate. A multivariate analysis suggested that the univariate observations are mutually additive.
Conclusions The study might serve as a basis for future prospective trials where amiodarone could be tested in patients with a recent myocardial infarction, having a reduced left ventricular ejection fraction, a high initial heart rate, and taking beta-blockers.
Key Words: Amiodarone • acute myocardial infarction • arrhythmias • left ventricular function • heart rate • beta-blockers
f1 Correspondence: Marek Malik, Department of Cardiological Sciences, St. George's Hospital Medical School, London SW17 0RE, U.K.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): 1064 - 1108. [Full Text] [PDF]
|
|
|
|
|
|
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Zipes, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Eur. Heart J., September 1, 2006; 27(17): 2099 - 2140. [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF]
|
|
|
|
|
|
S.G. Priori, E. Aliot, C. Blomstrom-Lundqvist, L. Bossaert, G. Breithardt, P. Brugada, A.J. Camm, R. Cappato, S.M. Cobbe, C. Di Mario, et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology Eur. Heart J., August 2, 2001; 22(16): 1374 - 1450. [PDF]
|
|
|
|
 |
|
 R. Bargout, A. Jankov, E. Dincer, R. Wang, T. Komodromos, O. Ibarra-Sunga, G. Filippatos, and B. D. Uhal Amiodarone induces apoptosis of human and rat alveolar epithelial cells in vitro Am J Physiol Lung Cell Mol Physiol, May 1, 2000; 278(5): L1039 - L1044. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.M Pratt, A.J Camm, J.T Bigger Jr, G Breithardt, R.W.F Campbell, A.E Epstein, L.J Kappenberger, K.-H Kuck, S Pocock, S Saksena, et al. Evaluation of antiarrhythmic drug efficacy in patients with an ICD. Unlimited potential or replete with complexity and problems? Eur. Heart J., November 1, 1999; 20(21): 1538 - 1552. [Abstract] [PDF]
|
|
|
|
|
|
D. V. Exner, J. A. Reiffel, A. E. Epstein, R. Ledingham, M. J. Reiter, Q. Yao, H. J. Duff, D. Follmann, E. Schron, H. L. Greene, et al. Beta-blocker use and survival in patients with ventricular fibrillation or symptomatic ventricular tachycardia: the antiarrhythmics versus implantable defibrillators (AVID) trial J. Am. Coll. Cardiol., August 1, 1999; 34(2): 325 - 333. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Boutitie, J.-P. Boissel, S. J. Connolly, A. J. Camm, J. A. Cairns, D. G. Julian, M. Gent, M. J. Janse, P. Dorian, and G. Frangin Amiodarone Interaction With ß-Blockers : Analysis of the Merged EMIAT (European Myocardial Infarct Amiodarone Trial) and CAMIAT (Canadian Amiodarone Myocardial Infarction Trial) Databases Circulation, May 4, 1999; 99(17): 2268 - 2275. [Abstract] [Full Text] [PDF]
|
|