Prognostic impact of beta-blocker compared to combined amiodarone therapy secondary to ventricular tachyarrhythmias

• Verfasst von: Schupp, Tobias [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Reiser, Linda [VerfasserIn]
• Verfasst von: Kern-Bollow, Armin [VerfasserIn]
• Verfasst von: Taton, Gabriel [VerfasserIn]
• Verfasst von: Reichelt, Thomas [VerfasserIn]
• Verfasst von: Ellguth, Dominik [VerfasserIn]
• Verfasst von: Engelke, Niko [VerfasserIn]
• Verfasst von: Ansari, Uzair [VerfasserIn]
• Verfasst von: El-Battrawy, Ibrahim [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Lang, Siegfried [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Prognostic impact of beta-blocker compared to combined amiodarone therapy secondary to ventricular tachyarrhythmias
• Verf.angabe: Tobias Schupp, Michael Behnes, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Uzair Ansari, Ibrahim El-Battrawy, Thomas Bertsch, Christel Weiß, Christoph Nienaber, Siegfried Lang, Muharrem Akin, Kambis Mashayekhi, Martin Borggrefe, Ibrahim Akin
• Jahr: 2019
• Umfang: 7 S.
• Fussnoten: Available online 15 November 2018 ; Gesehen am 18.02.2019
• Titel Quelle: Enthalten in: International journal of cardiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1981
• Jahr Quelle: 2019
• Band/Heft Quelle: 277(2019), Seite 118-124
• ISSN Quelle: 1874-1754
• DOI: doi:10.1016/j.ijcard.2018.11.030
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Amiodarone
• Sach-SW: Beta-blocker
• Sach-SW: ICD
• Sach-SW: Mortality
• Sach-SW: Ventricular fibrillation
• Sach-SW: Ventricular tachycardia
• K10plus-PPN: 158777030X

Abstract

Objective The study sought to assess the prognostic impact of treatment with beta-blocker (BB) compared to combined BB plus amiodarone (BB-AMIO) on long-term survival in patients surviving ventricular tachyarrhythmias on admission. Background Data regarding the prognostic outcome of patients presenting with ventricular tachyarrhythmias treated with BB and BB-AMIO is limited. Methods A large retrospective registry was used including consecutive patients surviving index episodes of ventricular tachyarrhythmias from 2002 to 2016. Patients treated with BB were compared to patients with BB-AMIO. The primary prognostic endpoint was long-term all-cause death at 3years. Kaplan-Meier, multivariable Cox regression and propensity score matching analyses were applied. Results A total of 1354 patients was included, 85% treated with BB, 15% with BB-AMIO. Within the unmatched real-life cohort, uni- and multivariable Cox regression models revealed BB associated with improved long-term survival compared to BB-AMIO (univariable: HR=0.550; p=0.001, multivariable: HR=0.712; statistical trend, p=0.052). After propensity-score matching (n=186 matched pairs), BB therapy was still associated with improved survival compared to BB-AMIO (mortality rate 18% versus 26%; log rank p=0.042; HR=0.634; 95% CI=0.407-0.988; p=0.044). Prognostic superiority of BB was mainly observed in patients with LVEF≥35% (HR=0.463; 95% CI=0.215-0.997; p=0.049) and in those without atrial fibrillation (non-AF) (HR=0.415; 95% CI=0.202-0.852; p=0.017). Conclusion BB therapy is associated with improved secondary long-term prognosis compared to BB-AMIO in patients surviving index episodes of ventricular tachyarrhythmias.