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

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Abstract

Objective

The study sought to assess the impact of treatment with beta-blocker (BB) or ACE inhibitor/angiotensin receptor blocker (ACEi/ARB) on secondary survival in patients presenting with ventricular tachyarrhythmia.

Background

Data regarding outcome of patients presenting with ventricular tachyarrhythmia treated with BB and ACEi/ARB is limited.

Methods

A large retrospective registry was used including consecutive patients presenting with ventricular tachycardia and fibrillation from 2002 to 2016 on admission. Applying propensity-score matching for harmonization, the impact of “BB” and “ACEi/ARB” was comparatively evaluated. The primary prognostic outcome was long-term all-cause death at 3 years.

Results

A total of 972 matched patients were included. Both patients with BB (long-term mortality rate 18 versus 27%; log rank p = 0.041; HR = 0.661; 95% CI = 0.443–0.986; p = 0.043) and with ACEi/ARB (long-term mortality rate 13 versus 23%; log rank p = 0.004; HR = 0.544; 95% CI = 0.359–0.824; p = 0.004) revealed better secondary survival compared to patients without after presenting with ventricular tachyarrhythmia on admission. The prognostic benefit of BB was comparable to ACEi/ARB (long-term mortality rate 21 versus 26%; log rank p = 0.539).

Conclusion

BB and ACEi/ARB were associated with improved secondary survival in patients surviving ventricular tachyarrhythmia on admission.

Trial Registration

ClinicalTrials.gov identifier: NCT02982473

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Funding

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Author information

Author notes

  1. T.S. and M.Be. contributed equally.

Authors and Affiliations

  1. First Department of Medicine, University Medical Center Mannheim (UMM) Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany

    Tobias Schupp, Michael Behnes, Siegfried Lang, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Uzair Ansari, Ibrahim El-Battrawy, Martin Borggrefe & Ibrahim Akin

  2. European Center for AngioScience (ECAS) and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany., Mannheim, Germany

    Tobias Schupp, Michael Behnes, Siegfried Lang, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Uzair Ansari, Ibrahim El-Battrawy, Martin Borggrefe & Ibrahim Akin

  3. Institute of Biomathematics and Medical Statistics, Faculty of Medicine Mannheim, University Medical Center Mannheim (UMM), Heidelberg University, Mannheim, Germany

    Christel Weiß

  4. Royal Brompton and Harefield Hospitals, NHS, London, UK

    Christoph Nienaber

  5. Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany

    Thomas Bertsch

  6. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany

    Muharrem Akin

  7. Division of Cardiology and Angiology II, University Heart Centre Freiburg Bad Krozingen, University of Freiburg, Bad Krozingen, Germany

    Kambis Mashayekhi

Authors
  1. Tobias Schupp
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  2. Michael Behnes
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  18. Ibrahim Akin
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Corresponding author

Correspondence to Michael Behnes.

Ethics declarations

There is no potential conflict of interests to disclose for any author. This study is based on a retrospective data analysis/registry and has been approved by the local ethics commission II of the faculty of Medicine Mannheim, University of Heidelberg, where no informed consent was deemed necessary for this study (ethical approval number 2016-612NMA) (ClinicalTrials.gov identifier: NCT02982473).

Conflict of Interest

The authors declare that they have no conflict of interest.

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Schupp, T., Behnes, M., Weiß, C. et al. Beta-Blockers and ACE Inhibitors Are Associated with Improved Survival Secondary to Ventricular Tachyarrhythmia. Cardiovasc Drugs Ther 32, 353–363 (2018). https://doi.org/10.1007/s10557-018-6812-z

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