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Amiodarone Use Prior to Cardiac Transplant Impacts Early Post-Transplant Survival

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Abstract

Purpose

It remains unclear if use of amiodarone pre-cardiac transplantation impacts early post-transplant survival.

Methods

We selected all patients undergoing heart transplant from 2004 to 2006 with available information using the United Network for Organ Sharing database (n = 4057). Multivariable Cox models compared the risk of death within 30 days post-transplant in patients who were taking amiodarone at the time of transplant listing (n = 1227) to those who were not (n = 2830).

Results

Mean age was 52 (± 12) years, and 23% were women. Patients who died within 30 days (n = 168) were older; had higher panel reactive antibody levels, higher bilirubin levels, and higher prevalence of prior cardiac surgery; were often at status 1B; and had higher use of amiodarone at listing compared to those who survived (5.3% versus 3.6%; p = 0.02). Cause of death was unknown in 49% and was reported as graft failure in 43% of cases. In multivariable Cox models, patients on amiodarone at the time of listing had 1.56-fold higher risk of post-transplant death within 30 days (95% confidence intervals 1.08–2.27) compared to patients who were not on amiodarone at listing (C-statistic 0.70).

Conclusion

In conclusion, patients who reported taking amiodarone at the time of listing for transplant had a higher risk of death within 30 days post-transplant.

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Acknowledgments

This work was supported in part by the Health Resources and Services Administration contract 234-2005-370011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

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Authors and Affiliations

Authors

Contributions

Salman S. Allana, MD: Participated in research design and drafting of the paper.

Furqan A. Rajput, MD, MS: Participated in drafting and critical revision of the paper.

Jason W. Smith, MD: Participated in critical revision with intellectual content.

Lucian Lozonschi, MD: Participated in research design and critical revision of the paper.

Jinn-ing Liou, MS: Participated in data analysis and interpretation.

Maryl Johnson, MD: Participated in critical revision of the paper.

Takushi Kohmoto, MD, PhD: Participated in critical revision of the paper.

Ravi Dhingra, MD, MPH: Participated in research design, data analysis, data interpretation, and drafting of the paper.

Corresponding author

Correspondence to Ravi Dhingra.

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The authors declare that they have no conflict of interest.

Ethical Approval and Informed Consent

Due to the retrospective nature of our study using de-identified data from the UNOS registry, the protocol was exempt from the University of Wisconsin-Madison Institutional Review Board. Informed consent was also deemed not necessary for this study.

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Allana, S.S., Rajput, F.A., Smith, J.W. et al. Amiodarone Use Prior to Cardiac Transplant Impacts Early Post-Transplant Survival. Cardiovasc Drugs Ther 35, 33–40 (2021). https://doi.org/10.1007/s10557-020-07092-9

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