SPC365

Previous use of amiodarone and its effect on arrhythmic events and outcomes in patients with acute myocardial infarction

Session: Posters (Sessão 1 - Écran 6) - Cuidados Intensivos em Síndromes Coronárias Agudas
Speaker: Vanda Neto

Congress: CPC 2023
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 13. Acute Coronary Syndromes
Subtheme: 13.4 Acute Coronary Syndromes – Treatment
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Vanda Devesa Neto; João Fiuza; Joana Correia; Gonçalo Ferreira; Nuno Craveiro; Luis Ferreira Santos

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Introduction </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Episodes of cardiac arrhythmias routinely manifest during or following an acute myocardial infarction (AMI) and are associated with worse outcomes. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">This study aims to assess if patients previously treated with oral amiodarone had fewer episodes of detectable atrial fibrillation (AF) and sustained ventricular tachycardia (VT) and its impact on in-hospital mortality (IHM) and 12-month mortality (12MM) after an AMI episode. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Methods: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">A retrospective analysis of 1251 patients admitted to a Cardiology department diagnosed with AMI was performed. Usual medication before hospital admission was confirmed in every patient. The Chi-square test (&chi;2) was used to evaluate the association between previous use of oral amiodarone and episodes of VT and AF during the hospital stay, as well as the association with IHM. In addition, 12MM was evaluated with a Kaplan-Meier survival analysis. Logistic regression model was used to assess the predictive value of the significant variables for the presence of VT and AF.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Results: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Mean patient age was 69 (&plusmn;13); 69% were men. 69% had ST-elevation myocardial infarction. 8% had a previous diagnosis of AF. Patients previously treated with oral amiodarone and beta-blockers were 3% and 28%, respectively. 64% of patients previously treated with oral amiodarone continued the prescription during their hospital stay. 1.3% had an episode of sustained VT during hospital stay, and 5% had an episode of paroxysmal AF. Cardiogenic shock occurred in 5% of patients. IHM and 12MM were, respectively, 7% and 13%. Previous treatment with oral amiodarone was significantly associated with fewer episodes of sustained VT during hospital stay (&chi;2=15.674; p&lt;0.01; OR 8.9) and with fewer IHM (&chi;2=3.313; p=0.042; OR 2.4). No significant association was found between the previous use of amiodarone and detectable episodes of AF (p=0.49). Patients who experienced episodes of sustained VT had significantly higher IHM (&chi;2=60.865; p&lt;0.001; OR 19) and 12MM (&chi;2=4.176; p=0.03; OR 4.2). In logistic regression analysis, amiodarone&#39;s effects were independent of beta-blocker use (p&lt;0,01). </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Conclusion: </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Previous use of amiodarone in patients admitted with acute myocardial infarction was associated with fewer episodes of sustained VT and IHM. Although prophylactic treatment with antiarrhythmic drugs is not indicated in acute myocardial infarction, in patients previously treated with amiodarone, its maintenance can be useful to prevent arrhythmic events.</span></span></span></span></p>