Schupp Tobias, Behnes Michael, Ellguth Dominik, Müller Julian, Reiser Linda, Bollow Armin, Taton Gabriel, Reichelt Thomas, Engelke Niko, Kim Seung-Hyun, Nienaber Christoph, Akin Muharrem, Mashayekhi Kambis, Bertsch Thomas, Borggrefe Martin, Akin Ibrahim
First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany.
First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany,
Pharmacology. 2019;103(3-4):179-188. doi: 10.1159/000496228. Epub 2019 Jan 29.
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).
Data regarding the outcome of patients with ES is limited.
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.
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.
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.
本研究旨在评估不同药物治疗（包括血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂[ACEi/ARB]、他汀类药物和胺碘酮）对电风暴（ES）患者的长期预后影响。
关于ES患者预后的数据有限。
纳入2002年至2016年连续的ES患者。分别将接受ACEi/ARB治疗的患者与未接受ACEi/ARB治疗的患者进行他汀类药物和胺碘酮治疗的比较。主要预后终点为4年全因死亡率。次要终点包括4年时ES复发、再次住院和主要不良心脏事件（MACE）。应用Kaplan-Meier生存曲线和多变量Cox回归分析。
共纳入84例连续存活ES发作的患者。95%的患者给予β受体阻滞剂，80%给予ACEi/ARB，60%给予他汀类药物，54%给予胺碘酮。接受ACEi/ARB治疗的患者4年全因死亡率有所改善（死亡率分别为34%和65%，对数秩检验p = 0.018；HR 0.428；95%CI 0.208 - 0.881；p = 0.021），MACE发生率也有所降低。相比之下，他汀类药物和胺碘酮治疗对ES患者的长期预后无影响。
ACEi/ARB治疗与ES患者生存率提高和MACE发生率降低相关，而他汀类药物和胺碘酮治疗对长期预后终点无影响。
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