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Amiodarone Compared with Lidocaine for Out-Of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation on Hospital Arrival: a Nationwide Database Study.
Cardiovasc Drugs Ther 2016; 30(5):485-491CD

Abstract

PURPOSE

The latest resuscitation guidelines recommend the use of amiodarone in adult patients with out-of-hospital cardiac arrest (OHCA) and refractory ventricular fibrillation (VF) to improve the rates of return of spontaneous circulation. However, there is limited evidence to suggest that amiodarone is superior to lidocaine with respect to survival at discharge. The purpose of the present study was to evaluate the hypothesis that amiodarone is superior to lidocaine with regard to the rate of survival to hospital discharge for OHCA patients with VF/pulseless VT (pVT) on hospital arrival.

METHODS

Using the Japanese Diagnosis Procedure Combination inpatient database, we identified 3951 patients from 795 hospitals who experienced cardiogenic OHCA and had refractory ventricular fibrillation on hospital arrival between July 2007 and March 2013. The patients were categorized into amiodarone (n = 1743) and lidocaine (n = 2208) groups, from which 801 propensity score-matched pairs were generated.

RESULTS

There was no significant difference in the rate of survival to hospital discharge between the amiodarone and lidocaine groups (15.2 % vs. 17.1 %; difference, -1.9 %; 95 % CI, -5.5 to 1.7) in propensity score-matched analyses. Cox regression analyses did not indicate significant in-hospital mortality differences between the amiodarone and lidocaine groups for the propensity score-matched groups (hazard ratio, 1.05; 95 % CI, 0.94 to 1.17).

CONCLUSIONS

The present nationwide study suggested that there was no significant difference in the rate of survival to hospital discharge between cardiogenic OHCA patients with persistent ventricular fibrillation on hospital arrival treated with amiodarone or lidocaine.

Authors+Show Affiliations

Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138555, Japan. t-tagami@nms.ac.jp. Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan. t-tagami@nms.ac.jp.Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138555, Japan.Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan.Department of Health Informatics and Policy, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138555, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27618826

Citation

Tagami, Takashi, et al. "Amiodarone Compared With Lidocaine for Out-Of-Hospital Cardiac Arrest With Refractory Ventricular Fibrillation On Hospital Arrival: a Nationwide Database Study." Cardiovascular Drugs and Therapy, vol. 30, no. 5, 2016, pp. 485-491.
Tagami T, Matsui H, Tanaka C, et al. Amiodarone Compared with Lidocaine for Out-Of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation on Hospital Arrival: a Nationwide Database Study. Cardiovasc Drugs Ther. 2016;30(5):485-491.
Tagami, T., Matsui, H., Tanaka, C., Kaneko, J., Kuno, M., Ishinokami, S., ... Yasunaga, H. (2016). Amiodarone Compared with Lidocaine for Out-Of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation on Hospital Arrival: a Nationwide Database Study. Cardiovascular Drugs and Therapy, 30(5), pp. 485-491.
Tagami T, et al. Amiodarone Compared With Lidocaine for Out-Of-Hospital Cardiac Arrest With Refractory Ventricular Fibrillation On Hospital Arrival: a Nationwide Database Study. Cardiovasc Drugs Ther. 2016;30(5):485-491. PubMed PMID: 27618826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Amiodarone Compared with Lidocaine for Out-Of-Hospital Cardiac Arrest with Refractory Ventricular Fibrillation on Hospital Arrival: a Nationwide Database Study. AU - Tagami,Takashi, AU - Matsui,Hiroki, AU - Tanaka,Chie, AU - Kaneko,Junya, AU - Kuno,Masamune, AU - Ishinokami,Saori, AU - Unemoto,Kyoko, AU - Fushimi,Kiyohide, AU - Yasunaga,Hideo, PY - 2016/9/14/pubmed PY - 2017/2/24/medline PY - 2016/9/14/entrez KW - Amiodarone KW - Antiarrhythmic KW - CPR KW - Cardiac arrhythmias SP - 485 EP - 491 JF - Cardiovascular drugs and therapy JO - Cardiovasc Drugs Ther VL - 30 IS - 5 N2 - PURPOSE: The latest resuscitation guidelines recommend the use of amiodarone in adult patients with out-of-hospital cardiac arrest (OHCA) and refractory ventricular fibrillation (VF) to improve the rates of return of spontaneous circulation. However, there is limited evidence to suggest that amiodarone is superior to lidocaine with respect to survival at discharge. The purpose of the present study was to evaluate the hypothesis that amiodarone is superior to lidocaine with regard to the rate of survival to hospital discharge for OHCA patients with VF/pulseless VT (pVT) on hospital arrival. METHODS: Using the Japanese Diagnosis Procedure Combination inpatient database, we identified 3951 patients from 795 hospitals who experienced cardiogenic OHCA and had refractory ventricular fibrillation on hospital arrival between July 2007 and March 2013. The patients were categorized into amiodarone (n = 1743) and lidocaine (n = 2208) groups, from which 801 propensity score-matched pairs were generated. RESULTS: There was no significant difference in the rate of survival to hospital discharge between the amiodarone and lidocaine groups (15.2 % vs. 17.1 %; difference, -1.9 %; 95 % CI, -5.5 to 1.7) in propensity score-matched analyses. Cox regression analyses did not indicate significant in-hospital mortality differences between the amiodarone and lidocaine groups for the propensity score-matched groups (hazard ratio, 1.05; 95 % CI, 0.94 to 1.17). CONCLUSIONS: The present nationwide study suggested that there was no significant difference in the rate of survival to hospital discharge between cardiogenic OHCA patients with persistent ventricular fibrillation on hospital arrival treated with amiodarone or lidocaine. SN - 1573-7241 UR - https://www.unboundmedicine.com/medline/citation/27618826/Amiodarone_Compared_with_Lidocaine_for_Out_Of_Hospital_Cardiac_Arrest_with_Refractory_Ventricular_Fibrillation_on_Hospital_Arrival:_a_Nationwide_Database_Study_ L2 - https://doi.org/10.1007/s10557-016-6689-7 DB - PRIME DP - Unbound Medicine ER -