151. Electrophysiologic and clinical effects of angiotensin-converting enzyme inhibitors in patients with prior myocardial infarction, nonsustained ventricular tachycardia, and depressed left ventricular function. MUSTT Investigators. Multicenter UnSustained Tachycardia Trial.
- Author
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Singh SN, Karasik P, Hafley GE, Pieper KS, Lee KL, Wyse DG, and Buxton AE
- Subjects
- Aged, Death, Sudden, Cardiac, Defibrillators, Implantable, Female, Humans, Male, Middle Aged, Myocardial Infarction complications, Myocardial Infarction mortality, Myocardial Infarction physiopathology, Randomized Controlled Trials as Topic, Retrospective Studies, Risk Factors, Stroke Volume, Survival Analysis, Survival Rate, Tachycardia, Ventricular complications, Treatment Outcome, Ventricular Dysfunction, Left complications, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Electrophysiologic Techniques, Cardiac, Myocardial Infarction drug therapy, Tachycardia, Ventricular physiopathology, Ventricular Dysfunction, Left physiopathology
- Abstract
Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce sudden cardiac death and all-cause mortality. They also may have direct antiarrhythmic properties. We retrospectively analyzed the data from the Multicenter UnSustained Tachycardia Trial (MUSTT), to determine the effects of ACE inhibitors on inducibility of sustained ventricular tachycardia and on sudden cardiac death and overall mortality in 2,087 patients with prior myocardial infarction, nonsustained ventricular tachycardia, and depressed left ventricular function. Results of electrophysiologic testing were compared by use of ACE inhibitors at baseline, and outcomes were compared between the 564 patients prescribed ACE inhibitors at discharge and the 1,523 patients who did not receive treatment. The inducibility of sustained ventricular tachycardia during electrophysiologic testing did not differ by baseline ACE inhibitor use (unadjusted p = 0.75). Patients discharged from hospital on ACE inhibitors had a lower ejection fraction, more extensive coronary artery disease, and fewer previous revascularizations at baseline. After adjustments for differences in baseline factors and initial hospitalization variables, there were no significant differences in total mortality (p = 0.47) or arrhythmic death or cardiac arrest (p = 0.51) with ACE inhibitor use at discharge over a median 43 months of follow-up.
- Published
- 2001
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