Document Detail


Prophylactic antiarrhythmic therapy of high-risk survivors of myocardial infarction: lower mortality at 1 month but not at 1 year.
MedLine Citation:
PMID:  3549043     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine whether prophylactic antiarrhythmic therapy influences mortality in high-risk patients after acute myocardial infarction, 143 such patients were randomized in a double-blind individually dose-adjusted, placebo-controlled trial an average of 14 +/- 7 days after myocardial infarction and followed for 1 year. Patients were judged to be at high risk on the basis of (1) ejection fraction less than 40% (n = 60), (2) arrhythmias of Lown class 3 or higher (n = 26), or (3) both (n = 57). Aprindine was chosen because of its long half-life, few side effects, and antiarrhythmic efficacy. Baseline characteristics in the treatment arms did not differ. Holter-detected arrhythmias were reduced in aprindine-treated patients at 3 months (p less than .001) and at 1 year (p less than .001). One patient was lost to follow-up; in the remaining patients 1 year mortality was 20% (28/142; 12 aprindine and 16 placebo). There was no significant difference between the two study arms in overall mortality and sudden death. However, among those who died, median duration of survival was longer in aprindine-treated patients (86 vs 21.5 days) (p = .04). Although antiarrhythmic treatment with aprindine of high-risk patients after myocardial infarction does not affect 1 year survival, mortality appears to be delayed; thus there may be a role for short-term treatment before more definitive therapy such as surgery.
Authors:
S H Gottlieb; S C Achuff; E D Mellits; G Gerstenblith; K L Baughman; L Becker; N C Chandra; S Henley; J O Humphries; C Heck
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  75     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1987 Apr 
Date Detail:
Created Date:  1987-04-30     Completed Date:  1987-04-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  792-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aprindine / administration & dosage*
Arrhythmias, Cardiac / etiology,  mortality,  prevention & control*
Capsules
Clinical Trials as Topic
Death, Sudden / epidemiology
Double-Blind Method
Electrocardiography
Humans
Indenes / administration & dosage*
Maryland
Monitoring, Physiologic
Myocardial Infarction / complications,  mortality*
Random Allocation
Risk
Time Factors
Grant Support
ID/Acronym/Agency:
NHLBI17655-10/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Capsules; 0/Indenes; 37640-71-4/Aprindine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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