Management and outcome of @entity1 with XXXX during @entity583 : the GUSTO-III experience. Global use of strategies to open occluded coronary arteries.

@entity1 @entity2643 @entity2778 @entity955 @entity583 @entity204
OBJECTIVE: To investigate the use of antiarrhythmic agents and electrical cardioversion in the management of @entity1 with @entity955 complicating @entity583 , and their relation to 30 day and one year mortality. DESIGN: Prospective study of 1138 @entity1 with @entity955 from the GUSTO-III trial. INTERVENTIONS: Of the 1138 study @entity1 , 317 (28%) received antiarrhythmic treatment, including class I antiarrhythmic agents (12%), @entity2778 (5%), and @entity2643 (15%); electrical cardioversion was attempted in 116 (10%). RESULTS: Sinus rhythm was restored in 72% of @entity1 receiving class I antiarrhythmic agents, 67% of those receiving @entity2778 , 79% of those receiving @entity2643 , and 64% of those having electrical cardioversion. After adjusting for baseline characteristics and complications occurring before the onset of @entity955 , there was no difference among the treatment groups in the incidence of sinus rhythm at the time of discharge or before deterioration to @entity204 . However, the use of class I antiarrhythmic drugs or @entity2778 was associated with a lower unadjusted 30 day and one year mortality. After adjustment for baseline factors and pre- @entity955 , the odds ratios for 30 day and one year mortality were 0.42 (95% confidence interval (CI) 0.19 to 0.89) and 0.58 (95% CI 0.33 to 1.04) with class I agents, and 0.31 (95% CI 0.07 to 1.32) and 0.31 (95% CI 0.09 to 1.02) with @entity2778 . In contrast, there was no association between the use of @entity2643 or electrical cardioversion and 30 day or one year mortality. CONCLUSIONS: There was a strong trend towards lower mortality associated with the use of class I antiarrhythmic agents or @entity2778 in managing @entity1 with @entity955 after @entity583 . Randomised trials are indicated.
