Impact of pre-implant amiodarone exposure on outcomes in cardiac transplant recipients

Verfasser / Beitragende:
[Douglas Jennings, Brandon Martinez, Sheila Montalvo, David Lanfear]
Ort, Verlag, Jahr:
2015
Enthalten in:
Heart Failure Reviews, 20/5(2015-09-01), 573-578
Format:
Artikel (online)
ID: 605479062
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245 0 0 |a Impact of pre-implant amiodarone exposure on outcomes in cardiac transplant recipients  |h [Elektronische Daten]  |c [Douglas Jennings, Brandon Martinez, Sheila Montalvo, David Lanfear] 
520 3 |a Amiodarone remains one of the preferred antiarrhythmic medications for patients with advanced heart failure awaiting cardiac transplant. However, the long half-life and rapid redistribution of this agent into donor myocardium expose heart transplant recipients to potential adverse outcomes. In reviewing the current body of literature, we found that pre-operative amiodarone exposure can increase the risk of bradycardia post-transplant; however, this is unlikely to require permanent pacemaker implant. Further, amiodarone has several serious drug-drug interactions with calcineurin inhibitors. Clinicians should therefore consider empiric reduction in initial dosing for tacrolimus or cyclosporine, and carefully monitor blood levels for at least 3months post-transplant. Although the evidence is conflicting, amiodarone exposure pre-operatively may increase the risk of early graft failure and mortality. Amiodarone use should be minimized whenever possible; if amiodarone cannot practically be discontinued in the pre-transplant phase, judicious monitoring for QTc prolongation and ventricular arrhythmia should be implemented after transplant. As most of the studies included in this review suffered from small sample sizes and limited follow-up, additional research in this area is warranted. 
540 |a Springer Science+Business Media New York, 2015 
690 7 |a Amiodarone  |2 nationallicence 
690 7 |a Heart transplant  |2 nationallicence 
690 7 |a Graft survival  |2 nationallicence 
690 7 |a Drug interaction  |2 nationallicence 
690 7 |a Bradycardia  |2 nationallicence 
700 1 |a Jennings  |D Douglas  |u Department of Pharmacy, New York-Presbyterian Hospital, Columbia University Medical Center, 622 West 168th Street VC-B, 10032, New York, NY, USA  |4 aut 
700 1 |a Martinez  |D Brandon  |u College of Pharmacy, Nova Southeastern University, 3200 S. University Drive, 33328, Ft. Lauderdale, FL, USA  |4 aut 
700 1 |a Montalvo  |D Sheila  |u College of Pharmacy, Nova Southeastern University, 3200 S. University Drive, 33328, Ft. Lauderdale, FL, USA  |4 aut 
700 1 |a Lanfear  |D David  |u Department of Cardiovascular Medicine, Henry Ford Hospital, 2799W. Grand Blvd., 48202, Detroit, MI, USA  |4 aut 
773 0 |t Heart Failure Reviews  |d Springer US; http://www.springer-ny.com  |g 20/5(2015-09-01), 573-578  |x 1382-4147  |q 20:5<573  |1 2015  |2 20  |o 10741 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Jennings  |D Douglas  |u Department of Pharmacy, New York-Presbyterian Hospital, Columbia University Medical Center, 622 West 168th Street VC-B, 10032, New York, NY, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Martinez  |D Brandon  |u College of Pharmacy, Nova Southeastern University, 3200 S. University Drive, 33328, Ft. Lauderdale, FL, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Montalvo  |D Sheila  |u College of Pharmacy, Nova Southeastern University, 3200 S. University Drive, 33328, Ft. Lauderdale, FL, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lanfear  |D David  |u Department of Cardiovascular Medicine, Henry Ford Hospital, 2799W. Grand Blvd., 48202, Detroit, MI, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Heart Failure Reviews  |d Springer US; http://www.springer-ny.com  |g 20/5(2015-09-01), 573-578  |x 1382-4147  |q 20:5<573  |1 2015  |2 20  |o 10741