| Autor: |
McMurray, John, Køber, Lars, Robertson, Michele, Dargie, Henry, Colucci, Wilson, Lopez-Sendon, Jose, Remme, Willem, Sharpe, D. Norman, Ford, Ian |
| Jazyk: |
angličtina |
| Předmět: |
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| Zdroj: |
Journal of the American College of Cardiology. (4):525-530 |
| ISSN: |
0735-1097 |
| DOI: |
10.1016/j.jacc.2004.09.076 |
| Popis: |
ObjectivesWhether beta-blockers reduce atrial arrhythmias and, when added to an angiotensin-converting enzyme (ACE) inhibitor, ventricular arrhythmia is unknown.BackgroundVentricular and atrial arrhythmias are common after acute myocardial infarction (AMI) and are associated with a poor prognosis. Angiotensin-converting enzyme inhibitors reduce the incidence of both types of arrhythmia.MethodsThe antiarrhythmic effect of carvedilol was examined in a placebo-controlled multicenter trial, the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) study, which enrolled 1,959 patients with reduced left ventricular systolic function after AMI, 98% of whom were treated with an ACE inhibitor.ResultsThe incidence of atrial fibrillation/flutter was 53 to 984 (5.4%) in the placebo group and 22 to 975 (2.3%) in the carvedilol group, giving a carvedilol/placebo hazard ratio (HR) of 0.41 (95% confidence interval [CI] 0.25 to 0.68; p = 0.0003). The corresponding rates of ventricular tachycardia/flutter/fibrillation were 38 to 984 (3.9%) and 9 to 975 (0.9%) (HR 0.24, 95% CI 0.11 to 0.49; p < 0.0001).ConclusionsCarvedilol has a powerful antiarrhythmic effect after AMI, even in patients already treated with an ACE inhibitor. Carvedilol suppresses atrial as well as ventricular arrhythmias in these patients. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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