I.V. Therapy Can Reduce Heart Surgery Risks
Tarlach, Gemma M, Drug Topics
The antiarrhythmic drug amiodarone (Cordarone I.V., WyethAyerst) significantly reduces the risk of atrial fibrillation following open heart surgery. It also shaves time off the average hospital stay for open heart patients when it is administered intravenously as a prophylactic, according to a new study.
Researchers at the Heart Institute of St. Joseph Medical Center in Towson, Md., found a 25% relative reduction in the development of atrial fibrillation for patients who received amiodarone intravenously, compared with those who received a placebo. The amiodarone recipients also had a shorter average hospital stay-7.6 days, compared with 8.2 for the placebo group. While the research team admitted the difference in stay was not statistically significant, they believe it showed a positive effect for amiodarone on patients.
The Amiodarone Reduces CABG Hospitalization (ARCH) study involved 300 patients undergoing urgent coronary artery bypass graft (CABG) or vascular surgery in a randomized, double-blind, placebo-controlled trial. A similar study on amiodarone's protective factor against atrial fibrillation in patients undergoing complex surgery, published recently in the New England Journal of Medicine, also indicated a positive effect for patients who received the antiarrhythmic as prophylaxis. That study, however, involved a seven-day loading period with the oral form of the drug.
The ARCH study, done with the intravenous form of amiodarone and without a loading period, created special challenges for its designers. Bill Grimm, R.Ph., supervisor of central pharmacy at St. Joseph, was responsible for deciding what concentration of the drug to use for study participants. Current package inserts from Wyeth-Ayerst, which supplied the drug for use in ARCH, call for a concentration of 1. …