PMID- 17602979
OWN - NLM
STAT- MEDLINE
DCOM- 20070719
LR  - 20231024
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 13
IP  - 5
DP  - 2007 Jun
TI  - The safety of amiodarone in patients with heart failure.
PG  - 340-5
AB  - BACKGROUND: Uncertainty persists about the safety and efficacy of amiodarone for 
      the management of heart failure. METHODS AND RESULTS: We randomized 3029 patients 
      with chronic heart failure to receive carvedilol or metoprolol and followed 
      patients for a median of 58 months. One hundred fifty-five of 1466 patients in 
      New York Heart Association (NYHA) Class II and 209 of 1563 in Class III or IV 
      received amiodarone at baseline. Persistence with amiodarone treatment was high 
      and 66% received amiodarone after 4 years. During follow-up, 38.7% and 58.9% of 
      patients receiving amiodarone in NYHA Classes II and III + IV died versus 26.2% 
      and 43.3% not receiving amiodarone (P < .001). This difference was maintained in 
      multivariable analysis (hazard ratio [HR] 1.5, 95% confidence interval [CI] 
      1.2-1.7, P < .001). The difference was explained by an increased risk of death 
      due to circulatory failure (HR 2.4, CI 1.9-3.1, P < .001) in patients receiving 
      amiodarone. Sudden death was not different (HR 1.07, CI 0.8-1.4, P = .7). The 
      increased risk was similar across NYHA classes with HR of 1.60 (CI 1.2-2.1, P < 
      .001) in NYHA Class II versus 1.58 (CI 1.3-1.9, P < .001) in Classes III + IV. 
      CONCLUSIONS: Treatment with amiodarone was associated with an increased risk of 
      death from circulatory failure independent of functional class.
FAU - Torp-Pedersen, Christian
AU  - Torp-Pedersen C
AD  - Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
FAU - Metra, Marco
AU  - Metra M
FAU - Spark, Philip
AU  - Spark P
FAU - Lukas, Mary Ann
AU  - Lukas MA
FAU - Moullet, Christine
AU  - Moullet C
FAU - Scherhag, Armin
AU  - Scherhag A
FAU - Komajda, Michel
AU  - Komajda M
FAU - Cleland, John G F
AU  - Cleland JG
FAU - Remme, Willem
AU  - Remme W
FAU - Di Lenarda, Andrea
AU  - Di Lenarda A
FAU - Swedberg, Karl
AU  - Swedberg K
FAU - Poole-Wilson, Philip A
AU  - Poole-Wilson PA
CN  - COMET Investigators
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Adrenergic alpha-Antagonists)
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Carbazoles)
RN  - 0 (Propanolamines)
RN  - 0K47UL67F2 (Carvedilol)
RN  - GEB06NHM23 (Metoprolol)
RN  - N3RQ532IUT (Amiodarone)
SB  - IM
MH  - Adrenergic alpha-Antagonists/therapeutic use
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Aged
MH  - Amiodarone/*adverse effects/therapeutic use
MH  - Anti-Arrhythmia Agents/*adverse effects/therapeutic use
MH  - Atrial Fibrillation/prevention & control
MH  - Carbazoles/therapeutic use
MH  - Carvedilol
MH  - Death, Sudden, Cardiac/prevention & control
MH  - Female
MH  - Heart Failure/*drug therapy/*mortality
MH  - Humans
MH  - Male
MH  - Metoprolol/therapeutic use
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Propanolamines/therapeutic use
EDAT- 2007/07/03 09:00
MHDA- 2007/07/20 09:00
CRDT- 2007/07/03 09:00
PHST- 2006/10/26 00:00 [received]
PHST- 2007/02/23 00:00 [revised]
PHST- 2007/02/28 00:00 [accepted]
PHST- 2007/07/03 09:00 [pubmed]
PHST- 2007/07/20 09:00 [medline]
PHST- 2007/07/03 09:00 [entrez]
AID - S1071-9164(07)00069-3 [pii]
AID - 10.1016/j.cardfail.2007.02.009 [doi]
PST - ppublish
SO  - J Card Fail. 2007 Jun;13(5):340-5. doi: 10.1016/j.cardfail.2007.02.009.