Beta-Blockers and ACE Inhibitors Are Associated with Improved Survival Secondary to Ventricular Tachyarrhythmia

Schupp, Tobias; Behnes, Michael; Weiß, Christel; Nienaber, Christoph; Lang, Siegfried; Reiser, Linda; Bollow, Armin; Taton, Gabriel; Reichelt, Thomas; Ellguth, Dominik; Engelke, Niko; Ansari, Uzair; El‐Battrawy, Ibrahim; Bertsch, Thomas; Akin, Muharrem; Mashayekhi, Kambis; Borggrefe, Martin; Akın, İbrahim

doi:10.1007/s10557-018-6812-z

Cited by 20 publications

(18 citation statements)

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“…In patients with systolic heart failure, ACEi/ARB therapy was already consistently shown to decrease both all-cause and cardiovascular mortality [18][19][20][21]. In line, we recently demonstrated that ACEi/ARB therapy is associated with improved long-term all-cause mortality in 528 propensity-matched patients presenting with an index episode of ventricular tachyarrhythmias on admission [14]. In contrast, statin therapy was not associated with allcause mortality in ES patients.…”

Section: Discussionmentioning

confidence: 71%

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Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm

et al. 2019

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Objective: The study sought to assess the long-term prognostic impact of different pharmacotherapies, including angiotensin-converting enzyme inhibitor-inhibitor/angiotensin receptor blocker (ACEi/ARB), statins, and amiodarone in patients with electrical storm (ES). Background: Data regarding the outcome of patients with ES is limited. Methods: Consecutive patients with ES from 2002 to 2016 were included. Patients on ACEi/ARB were compared to patients without ACEi/ARB, respectively, for statin and amiodarone therapy. The primary prognostic endpoint was all-cause mortality at 4 years. Secondary endpoints comprised ES recurrences, rehospitalization, and major adverse cardiac events (MACE) at 4 years. Kaplan-Meier survival curves and multivariable Cox regression analyses were applied. Results: A total of 84 consecutive patients surviving episodes of ES was included. Beta-blocker was given in 95%, ACEi/ARB in 80%, statin in 60%, and amiodarone in 54%. ACEi/ARB patients were associated with improved all-cause mortality at 4 years (mortality rate 34 vs. 65%, log rank p = 0.018; HR 0.428; 95% CI 0.208–0.881; p = 0.021), as well as improved freedom from MACE. In contrast, statin and amiodarone therapy had no impact on long-term outcomes in ES patients. Conclusion: ACEi/ARB therapy is associated with improved survival and MACE in patients with ES, whereas statins and amiodarone therapy had no impact on long-term prognostic endpoints.

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Section: Discussionmentioning

confidence: 71%

“…Risk stratification was performed according to the following pharmacotherapies at discharge, as recently been described [14]: (1) ACEi/ARB was compared to non-ACEi/ARB patients. All types of ACEi or ARB were allowed.…”

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confidence: 99%

Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm

et al. 2019

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“…We identified 49 CA registries and 15 SCD registries, including the newly formed Australian UCDP Registry8–17 (table 1). Nine registries were categorised as ‘other’.…”

Section: Resultsmentioning

confidence: 99%

Cardiac arrest and sudden cardiac death registries: a systematic review of global coverage

et al. 2020

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BackgroundSudden cardiac death (SCD) is a major global health problem, accounting for up to 20% of deaths in Western societies. Clinical quality registries have been shown in a range of disease conditions to improve clinical management, reduce variation in care and improve outcomes.AimTo identify existing cardiac arrest (CA) and SCD registries, characterising global coverage and methods of data capture and validation.MethodsBiomedical and public search engines were searched with the terms ‘registry cardio*’; ‘sudden cardiac death registry’ and ‘cardiac arrest registry’. Registries were categorised as either CA, SCD registries or ‘other’ according to prespecified criteria. SCD registry coordinators were contacted for contemporaneous data regarding registry details.ResultsOur search strategy identified 49 CA registries, 15 SCD registries and 9 other registries (ie, epistries). Population coverage of contemporary CA and SCD registries is highly variable with registries densely concentrated in North America and Western Europe. Existing SCD registries (n=15) cover a variety of age ranges and subpopulations, with some enrolling surviving patients (n=8) and family members (n=5). Genetic data are collected by nine registries, with the majority of these (n=7) offering indefinite storage in a biorepository.ConclusionsMany CA registries exist globally, although with inequitable population coverage. Comprehensive multisource surveillance SCD registries are fewer in number and more challenging to design and maintain. Challenges identified include maximising case identification and case verification.Trial registration numberCRD42019118910.

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“…Cardiac autonomic nerves can induce or promote arrhythmias directly or indirectly by altering electrophysiological features [13,14]. A large retrospective study demonstrated that beta blockers and ACE inhibitors are associated with improved secondary survival in patients surviving ventricular arrhythmias on admission [15]. KCNH2 mediates the rapid activation of delayed rectifier potassium current (IKr), which is important for normal ventricular repolarization [16].…”

Section: Discussionmentioning

confidence: 99%

Identification of Target Genes of Antiarrhythmic Traditional Chinese Medicine Wenxin Keli

Yao

Liu

Zeng

et al. 2020

Cardiovascular Therapeutics

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Wenxin Keli (WXKL) is a traditional Chinese medicine drug approved for the treatment of cardiovascular diseases. This study aimed to identify WXKL-targeting genes involved in antiarrhythmic efficacy of WXKL. The Traditional Chinese Medicine Systems Pharmacology (TCMSP) technology platform was used to screen active compounds of WXKL and WXKL-targeting arrhythmia-related genes. A pig model of myocardial ischemia (MI) was established by balloon-expanding the endothelium of the left coronary artery. Pigs were divided into the model group and WXKL group (n = 6). MI, QT interval, heart rate, and arrhythmia were recorded, and the mRNA expression of target genes in myocardial tissues was detected by PCR. Eleven active ingredients of WXKL and eight WXKL-targeting arrhythmia-related genes were screened. Five pathways were enriched, and an “ingredient-gene-path” network was constructed. WXKL markedly decreased the incidence of arrhythmia in the MI pig model (P<0.05). The QT interval was significantly shortened, and the heart rate was slowed down in the WXKL group compared with the model group (P<0.05). In addition, the expression of sodium channel protein type 5 subunit alpha (SCN5A) and beta-2 adrenergic receptor (ADRB2) was downregulated, while muscarinic acetylcholine receptor M2 (CHRM2) was upregulated in the WXKL group (P<0.05). In conclusion, WXKL may shorten the QT interval and slow down the heart rate by downregulating SCN5A and ADRB2 and upregulating CHRM2 during MI. These findings provide novel insight into molecular mechanisms of WXKL in reducing the incidence of ventricular arrhythmia.

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Beta-Blockers and ACE Inhibitors Are Associated with Improved Survival Secondary to Ventricular Tachyarrhythmia

Abstract: ClinicalTrials.gov identifier: NCT02982473.

Cited by 20 publications

References 39 publications

Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm

Impact of Different Pharmacotherapies on Long-Term Outcomes in Patients with Electrical Storm

Cardiac arrest and sudden cardiac death registries: a systematic review of global coverage

Identification of Target Genes of Antiarrhythmic Traditional Chinese Medicine Wenxin Keli

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