用阿米奥达龙预防心房动的连续或偶发性预防治疗:一项随机试验
Sheba Ahmed1, Michiel Rienstra, Harry J G M Crijns
1Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
JAMA
|October 16, 2008
概括
对心房的插曲性阿米奥达龙治疗在主要不良事件上没有区别,但增加了复发和死亡率. 持续治疗维持了鼻节律,复发较少,死亡率较低.
科学领域:
- 心脏病学 心脏病学
- 临床试验 临床试验
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿米奥达龙对心房是有效的,但与不良事件相关.
- 评估替代阿米奥达龙治疗策略对于患者的安全至关重要.
- 反复出现症状的持续性心房动会给健康带来重大风险.
研究的目的:
- 为了比较心房动的偶发性和持续性阿米奥达龙治疗之间的重大不良事件.
- 评估插曲性与连续性阿米奥达龙在维持鼻节律方面的疗效.
- 评估阿米奥达龙治疗策略对死亡率和住院病人的影响.
主要方法:
- 一项随机试验涉及209名患有复发性症状持久性心房的患者.
- 患者在心脏转变后接受了偶发性或持续的阿米奥达龙治疗.
- 主要终点:阿米奥达龙和心脏病相关重大事件的组合;次要终点:死亡率和住院病例.
主要成果:
- 在偶发性和连续性amiodarone组之间,初级复合终点没有显著差异.
- 插曲性治疗导致心房的复发率显著增加 (80%与54%相比).
- 插曲性治疗与较高的全因死亡率和心血管住院病例相关 (53%对34%).
结论:
- 与连续治疗相比,插曲性阿米奥达并没有减少主要不良事件.
- 插曲性阿米奥达龙显著增加了心房的复发.
- 持续的阿米奥达龙治疗与死亡率和住院治疗的更好结果有关.
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