Mortality of newly diagnosed heart failure treated with amiodarone A propensity-matched study.
BACKGROUND
Studies on the safety of amiodarone therapy in heart failure (HF) presented conflicting results. We evaluated the relationship of commencing treatment with amiodarone (CTA) with the mortality and the morbidity of patients newly diagnosed with HF.


METHODS
Prospective cohort study over 7 years on 3734 patients with HF. Main outcomes were all-cause and cardiovascular mortality, hospitalizations and visits. 739 patients who commenced treatment with amiodarone were propensity-matched with another 739 patients. Non-commencing treatment with amiodarone. We analyze the independent relationship of commencing treatment with amiodarone, with the mortality and the morbidity, stratifying patients for cardiovascular co-morbidity, after propensity score-matching.


RESULTS
During a median follow-up of 46.1 months, 644 (43.6%) died, and 1086 (73.5%) were hospitalized. Commencing treatment with amiodarone was associated with a higher all-cause mortality (HR 1.70 [CI 95%, 1.50 to 1.91]), particularly among women (HR: 1.77 [1.55 to 2.00]), and among patients with non-systolic HF (HR: 1.87 [1.66 to 2.09], P<0.001 in all the cases), even after adjustment for the propensity to take amiodarone, or other medications, and other potential confounders. Commencing treatment with amiodarone was not associated with cardiovascular mortality, hospitalizations, or visits.


CONCLUSIONS
The commencement of treatment with amiodarone is associated with an increased mortality of patients with heart failure, mainly in women and in patients with non-systolic heart failure.
Andrey
Jose L
JL
Department of Medicine, Hospital Universitario Puerto Real, University of Cadiz, School of Medicine, Spain.
Gomez-Soto
Francisco M
FM
Romero
Sotero P
SP
Escobar
Miguel A
MA
García-Egido
A Antonio
AA
Garcia-Arjona
Rocio
R
Gomez
Francisco
F
D000367:Age Factors; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage / Q000627:therapeutic use*; D002423:Cause of Death / Q000639:trends; D003935:Diagnostic Techniques, Cardiovascular; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D011379:Prognosis; D057216:Propensity Score; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014665:Vasodilator Agents; D000638:Amiodarone