Skip Navigation


European Heart Journal Advance Access originally published online on March 31, 2009
European Heart Journal 2009 30(10):1245-1253; doi:10.1093/eurheartj/ehp100
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
30/10/1245    most recent
ehp100v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Piccini, J. P.
Right arrow Articles by O’Connor, C. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Piccini, J. P.
Right arrow Articles by O’Connor, C. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Amiodarone for the prevention of sudden cardiac death: a meta-analysis of randomized controlled trials

Jonathan P. Piccini*, Jeffrey S. Berger and Christopher M. O’Connor

Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center #31115, Durham, NC 27710, USA

Received 10 October 2008; revised 14 January 2009; accepted 26 February 2009; online publish-ahead-of-print 31 March 2009.

* Corresponding author. Tel: +1 919 308 9861, Fax: +1 919 668 7058, Email: jonathan.piccini{at}duke.edu

Aims: Not all patients at risk for sudden cardiac death (SCD) are eligible for, or have access to implantable cardioverter defibrillator (ICD) implantation. There are conflicting data regarding the efficacy and safety of amiodarone for the prevention of SCD.

Methods and results: We conducted a meta-analysis of all randomized controlled trials examining the use of amiodarone vs. placebo/control for the prevention of SCD. We identified 15 trials, which randomized 8522 patients to amiodarone or placebo/control. Amiodarone decreased the incidence of SCD [7.1 vs. 9.7%; OR 0.71 (0.61–0.84), P < 0.001] and cardiovascular death (CVD) [14.0 vs. 16.3%; OR 0.82 (0.71–0.94), P = 0.004]. There was a 1.5% absolute risk reduction in all-cause mortality which did not meet statistical significance (P = 0.093). Amiodarone therapy increased the risk of pulmonary [2.9 vs. 1.5%; OR 1.97, (1.27–3.04), P = 0.002], and thyroid [3.6 vs. 0.4%; OR 5.68, (2.94–10.98), P < 0.001] toxicity.

Conclusion: Amiodarone reduces the risk of SCD by 29% and CVD by 18%, and therefore, represents a viable alternative in patients who are not eligible for or who do not have access to ICD therapy for the prevention of SCD. However, amiodarone therapy is neutral with respect to all-cause mortality and is associated with a two- and five-fold increased risk of pulmonary and thyroid toxicity.

Key Words: Amiodarone • Sudden cardiac death • Cardiomyopathy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.