Dofetilide在充血性心力衰竭患者左心室功能障碍。丹麦调查Dofetilide心律失常和死亡率的研究小组。

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Torp-Pedersen C,穆勒M, Bloch-Thomsen PE,科比L, Sandoe E, Egstrup K, agn E, Carlsen J, Videbaek J,马尔尚B, Camm AJ

Dofetilide在充血性心力衰竭患者左心室功能障碍。丹麦调查Dofetilide心律失常和死亡率的研究小组。

郑传经地中海J。1999年9月16日,341 (12):857 - 65。

PubMed ID

10486417 (在PubMed

]

文摘

背景:心房颤动发生频繁充血性心力衰竭患者,通常导致临床恶化和住院治疗。或许可以维持窦性节律与抗心律失常的药物,但是这些药物增加死亡的风险。方法:我们研究了1518例充血性心力衰竭和严重的左心室功能障碍症状在34丹麦医院。我们随机选取了762名患者接受dofetilide,小说第三类抗心律失常的代理,和756年接受安慰剂的双盲研究。在医院治疗了,包括三天的心脏监测和剂量调整。主要终点是死于任何原因。结果:在平均随访18个月,dofetilide组的311名患者(41%)和317例安慰剂组(42%)死亡(风险比,0.95;95%置信区间,0.81至1.11)。dofetilide治疗显著降低因充血性心力衰竭恶化而住院治疗的风险(风险比,0.75;95%置信区间,0.63至0.89)。 Dofetilide was effective in converting atrial fibrillation to sinus rhythm. After one month, 22 of 190 patients with atrial fibrillation at base line (12 percent) had sinus rhythm restored with dofetilide, as compared with only 3 of 201 patients (1 percent) given placebo. Once sinus rhythm was restored, dofetilide was significantly more effective than placebo in maintaining sinus rhythm (hazard ratio for the recurrence of atrial fibrillation, 0.35; 95 percent confidence interval, 0.22 to 0.57; P<0.001). There were 25 cases of torsade de pointes in the dofetilide group (3.3 percent) as compared with none in the placebo group. CONCLUSIONS: In patients with congestive heart failure and reduced left ventricular function, dofetilide was effective in converting atrial fibrillation, preventing its recurrence, and reducing the risk of hospitalization for worsening heart failure. Dofetilide had no effect on mortality.

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药物

Dofetilide