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Impact of different pharmacotherapies on long-term outcomes in patients with electrical storm

Objective: The study sought to assess the long-term prognostic impact of different pharmacotherapies, including angiotensin-converting enzyme inhibitor-inhibitor/angiotensin receptor blocker (ACEi/ARB), statins, and amiodarone in patients with electrical storm (ES). Background: Data regarding the ou...

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Main Authors: Schupp, Tobias (Author) , Behnes, Michael (Author) , Ellguth, Dominik (Author) , Müller, Julian (Author) , Reiser, Linda (Author) , Kern-Bollow, Armin (Author) , Taton, Gabriel (Author) , Reichelt, Thomas (Author) , Engelke, Niko (Author) , Kim, Seung‑Hyun (Author) , Borggrefe, Martin (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: February 2019
In: Pharmacology
Year: 2019, Volume: 103, Issue: 3-4, Pages: 179-188
ISSN:1423-0313
DOI:10.1159/000496228
Online Access:Verlag, Volltext: https://doi.org/10.1159/000496228
Verlag, Volltext: https://www.karger.com/Article/FullText/496228
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Author Notes:Tobias Schupp, Michael Behnes, Dominik Ellguth, Julian Müller, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Niko Engelke, Seung-hyun Kim, Christoph Nienaber, Muharrem Akin, Kambis Mashayekhi, Thomas Bertsch, Martin Borggrefe, Ibrahim Akin
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Summary:Objective: The study sought to assess the long-term prognostic impact of different pharmacotherapies, including angiotensin-converting enzyme inhibitor-inhibitor/angiotensin receptor blocker (ACEi/ARB), statins, and amiodarone in patients with electrical storm (ES). Background: Data regarding the outcome of patients with ES is limited. Methods: Consecutive patients with ES from 2002 to 2016 were included. Patients on ACEi/ARB were compared to patients without ACEi/ARB, respectively, for statin and amiodarone therapy. The primary prognostic endpoint was all-cause mortality at 4 years. Secondary endpoints comprised ES recurrences, rehospitalization, and major adverse cardiac events (MACE) at 4 years. Kaplan-Meier survival curves and multivariable Cox regression analyses were applied. Results: A total of 84 consecutive patients surviving episodes of ES was included. Beta-blocker was given in 95%, ACEi/ARB in 80%, statin in 60%, and amiodarone in 54%. ACEi/ARB patients were associated with improved all-cause mortality at 4 years (mortality rate 34 vs. 65%, log rank p = 0.018; HR 0.428; 95% CI 0.208-0.881; p = 0.021), as well as improved freedom from MACE. In contrast, statin and amiodarone therapy had no impact on long-term outcomes in ES patients. Conclusion: ACEi/ARB therapy is associated with improved survival and MACE in patients with ES, whereas statins and amiodarone therapy had no impact on long-term prognostic endpoints.
Item Description:Gesehen am 27.05.2019
Physical Description:Online Resource
ISSN:1423-0313
DOI:10.1159/000496228

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