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document
Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction : EMIAT . European Myocardial Infarct Amiodarone Trial Investigators . BACKGROUND Ventricular arrhythmias are a major cause of death after myocardial infarction , especially in patients with poor left-ventricular function . Previous attempts to identify and suppress arrhythmias with various antiarrhythmic drugs failed to reduce or actually increase mortality . Amiodarone is a powerful antiarrhythmic drug with several potentially beneficial actions , and has shown benefit in several small-scale studies . We postulated that this drug might reduce mortality in patients at high risk of death after myocardial infarction because of impaired ventricular function , irrespective of whether they had ventricular arrhythmias . METHODS The European Myocardial Infarct Amiodarone Trial ( EMIAT ) was a randomised double-blind placebo-controlled trial to assess whether amiodarone reduced all-cause mortality ( primary endpoint ) and cardiac mortality and arrhythmic death ( secondary endpoints ) in survivors of myocardial infarction with a left-ventricular ejection fraction ( LVEF ) of 40 % or less . Intention-to-treat and on-treatment analyses were done . FINDINGS EMIAT enrolled 1486 patients ( 743 in the amiodarone group , 743 in the placebo group ) . Median follow-up was 21 months . All-cause mortality ( 103 deaths in the amiodarone group , 102 in the placebo group ) and cardiac mortality did not differ between the two groups . However , in the amiodarone group , there was a 35 % risk reduction ( 95 % CI 0-58 , p = 0.05 ) in arrhythmic deaths . INTERPRETATION Our findings do not support the systematic prophylactic use of amiodarone in all patients with depressed left-ventricular function after myocardial infarction . However , the lack of proarrhythmia and the reduction in arrhythmic death support the use of amiodarone in patients for whom antiarrhythmic therapy is indicated .
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Intervention_Pharmacological
amiodarone
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Intervention_Pharmacological
Amiodarone
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
amiodarone
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Intervention_Pharmacological
amiodarone
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Intervention_Control
placebo
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Intervention_Pharmacological
amiodarone
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Intervention_Pharmacological
amiodarone
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Intervention_Pharmacological
amiodarone
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Outcome_Mortality
mortality
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Outcome_Mortality
all-cause mortality
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Outcome_Mortality
cardiac mortality and arrhythmic death
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Outcome_Mortality
All-cause mortality
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Outcome_Mortality
cardiac mortality
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Outcome_Other
risk reduction
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Outcome_Mortality
arrhythmic deaths
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Outcome_Mortality
arrhythmic death
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Participant_Condition
patients with left-ventricular dysfunction after recent myocardial infarction : EMIAT .