October 6, 1993JAMA
Effects of Prophylactic Antiarrhythmic Drug Therapy in Acute Myocardial Infarction
Key result
Prophylactic use of class I antiarrhythmics after myocardial infarction increased mortality (OR 1.14; 95% CI 1.01-1.28), whereas beta-blockers reduced mortality (OR 0.81; 95% CI 0.75-0.87).
Why the study?
Does prophylactic antiarrhythmic drug therapy reduce mortality in patients with acute myocardial infarction?
Population
98,000 patients with myocardial infarction pooled from 138 randomized, parallel controlled trials
Comparison
Prophylactic therapy with antiarrhythmic agents vs Control group
Design
Meta-analysis, randomized
Authors
Discussion
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Member takes
Implication
Avoid prophylactic class I antiarrhythmics after MI; confirms harm and reinforces beta-blocker benefit.
Study Design
Type
Meta-Analysis (n=98,000)
Structured PICO
Does prophylactic antiarrhythmic drug therapy reduce mortality in patients with acute myocardial infarction?
P
Population
98,000 patients with myocardial infarction pooled from 138 randomized, parallel controlled trials
I
Intervention
Prophylactic therapy with antiarrhythmic agents (Class I, Class II/beta-blockers, Class III/amiodarone, or Class IV/calcium channel blockers)
C
Comparator
Control group (from randomized parallel controlled trials)
O
Outcome
Mortalityhard clinical
Main Result
Effect estimate: OR 1.14 (95% CI 1.01 to 1.28)
Absolute Event Rate: 5.6% vs 5%
p-value: p=.03
In patients with myocardial infarction, prophylactic use of class I antiarrhythmics increases mortality, whereas beta-blockers and amiodarone reduce mortality.
Cite This Study
Koon Teo (1993) conducted a meta-analysis in Myocardial infarction (n=98,000). Antiarrhythmic agents (Class I, II, III, IV) vs. Control was evaluated on Mortality (OR 1.14, 95% CI 1.01 to 1.28, p=.03). Prophylactic use of class I antiarrhythmics after myocardial infarction increased mortality (OR 1.14; 95% CI 1.01-1.28), whereas beta-blockers reduced mortality (OR 0.81; 95% CI 0.75-0.87).