Document Detail


Spironolactone therapy is associated with reduced ventricular tachycardia rate in patients with cardiomyopathy.
MedLine Citation:
PMID:  20946289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Multiple pharmacological therapies currently in prevalent clinical use for cardiac diseases have antifibrotic properties. Spironolactone, a potent antifibrotic agent, is currently used for advanced heart failure. Therapies such as HMG-CoA reductase inhibitors (statins) and angiotensin-converting enzyme inhibitors (ACEi) also have antifibrotic properties. However, the effect of these medications on the ventricular arrhythmia phenotype is currently unknown. Therefore, we set out to define the ventricular arrhythmia rates in patients actively treated with such therapies.
METHODS AND RESULTS: We retrospectively evaluated the ventricular tachycardia (VT) rates in patients with structural heart disease actively treated with therapies with antifibrotic properties. VT rates were significantly diminished in patients treated with spironolactone (158 ± 26 beats per minute [bpm], n = 21) compared to patients on no medications (205 ± 22 bpm, n = 13) or those who were on similar heart-failure therapies but not on spironolactone (186 ± 32 bpm, n = 82). In addition, we observed that VT rates showed a significant trend toward lower rates in patients receiving either statins or ACEi, compared to patients on no medical therapy. In multivariate analysis, spironolactone therapy was identified as the single most significant variable for reduced VT rate.
CONCLUSION: Use of spironolactone in patients with heart failure is associated with reduced VT rate. Similar but less-significant reductions in VT rates were observed with use of other pharmacological agents with antifibrotic properties, such as statins and ACEi. Our findings, at least in part, could account for reduction in sudden cardiac death rates documented with use of these therapies.
Authors:
Vassilis Dimas; Colby Ayers; James Daniels; Jose A Joglar; Joseph A Hill; R Haris Naseem
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-14
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  34     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-08     Completed Date:  2011-08-09     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  309-14     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Affiliation:
Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, Texas 75390-8573, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathies / drug therapy*,  epidemiology*
Comorbidity
Diuretics / therapeutic use
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Prevalence
Risk Assessment
Risk Factors
Spironolactone / therapeutic use*
Tachycardia, Ventricular / drug therapy*,  epidemiology*
Texas / epidemiology
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL-075173/HL/NHLBI NIH HHS; HL-080144/HL/NHLBI NIH HHS; HL-090842/HL/NHLBI NIH HHS; P30 HL101254/HL/NHLBI NIH HHS; R01 HL075173/HL/NHLBI NIH HHS; R01 HL080144/HL/NHLBI NIH HHS; R01 HL090842/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Diuretics; 52-01-7/Spironolactone
Comments/Corrections

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