Amiodarone In Severe Congestive Heart Failure

A randomized study of low-dose amiodarone has found that the compound, when added to standard therapy for heart failure, reduces mortality and hospital admission in congestive heart failure patients. These effects appeared to be independent of any antiarrhythmic effects of the compound.

The Argentinian GESICA study involved 516 patients who received a standard regimen consisting of diuretics, digitalis and ACE inhibitors and who were randomized to receive either 300mg/day amiodarone or no treatment. The amiodarone group had a 28% reduction in death, and these reductions were apparent both for sudden death (-27%) and death due to progressive heart failure (-23%). Fewer patients in the amiodarone group were admitted to hospital due to worsening heart failure (-31%), and the drug was well-tolerated, with 12 patients withdrawn from therapy.

The authors of the study note that despite major advances in the care of heart failure patients, particularly with the increasing use of ACE inhibitors to improve survival, there is still a clear need for other treatments to reduce mortality further. The results of GESICA are encouraging, they note, but should not be extrapolated to patients with less severe heart failure until further studies have been carried out.