Prophylactic antiarrhythmic therapy of high-risk survivors of myocardial infarction: Lower mortality at 1 month but not at 1 year

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

Research output: Contribution to journalArticlepeer-review

Abstract

To determine whether prophylactic andiarrhythmic 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 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 < .001) and at 1 year (p < .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-treatment before more definitive therapy such as surgery.

Original languageEnglish (US)
Pages (from-to)792-799
Number of pages8
JournalCirculation
Volume75
Issue number4
DOIs
StatePublished - 1987

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Prophylactic antiarrhythmic therapy of high-risk survivors of myocardial infarction: Lower mortality at 1 month but not at 1 year'. Together they form a unique fingerprint.

Cite this