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Effect of dofetilide in patients with recent myocardial infarction and left-ventricular dysfunction: a randomised trial.

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Title:	Effect of dofetilide in patients with recent myocardial infarction and left-ventricular dysfunction: a randomised trial.
Authors:	Køber, L (AUTHOR), Bloch Thomsen, P E (AUTHOR), Møller, M (AUTHOR), Torp-Pedersen, C (AUTHOR), Carlsen, J (AUTHOR), Sandøe, E (AUTHOR), Egstrup, K (AUTHOR), Agner, E (AUTHOR), Videbaek, J (AUTHOR), Marchant, B (AUTHOR), Camm, A J (AUTHOR), Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) Study Group (CORPORATE AUTHOR)
Source:	Lancet. 12/16/2000, Vol. 356 Issue 9247, p2052-2058. 7p.
Subjects:	Myocardial infarction complications, Myocardial infarction-related mortality, Sulfonamide drugs, Myocardial depressants, Phenethylamines, Heart ventricle diseases, Atrial fibrillation, Clinical trials, Comparative studies, Left heart ventricle, Research methodology, Medical cooperation, Myocardial infarction, Research, Atrial flutter, Evaluation research, Randomized controlled trials, Blind experiment, Disease complications, Therapeutics
Abstract:	Background: Arrhythmias cause much morbidity and mortality after myocardial infarction, but in previous trials, antiarrhythmic drug therapy has not been convincingly effective. Dofetilide, a new class III agent, was investigated for effects on all-cause mortality and morbidity in patients with left-ventricular dysfunction after myocardial infarction.Methods: In 37 Danish coronary-care units, 1510 patients with severe left-ventricular dysfunction (wall motion index < or = 1.2, corresponding to ejection fraction < or = 0.35) were enrolled in a randomised, double-blind study comparing dofetilide (n=749) with placebo (n=761). The primary endpoint was all-cause mortality. Secondary endpoints included cardiac and arrhythmic mortality and total arrhythmic deaths. Analyses were by intention to treat.Findings: No significant differences were found between the dofetilide and placebo groups in all-cause mortality (230 [31%] vs 243 [32%]), cardiac mortality (191 [26%] vs 212 [28%]), or total arrhythmic deaths (129 [17%] vs 140 [18%]). Atrial fibrillation or flutter was present in 8% of the patients at study entry. In these patients, dofetilide was significantly better than placebo at restoring sinus rhythm (25 of 59 vs seven of 56; p=0.002). There were seven cases of torsade de pointes ventricular tachycardia, all in the dofetilide group.Interpretation: In patients with severe left-ventricular dysfunction and recent myocardial infarction, treatment with dofetilide did not affect all-cause mortality, cardiac mortality, or total arrhythmic deaths. Dofetilide was effective in treating atrial fibrillation or flutter in this population. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection
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