Congestive heart failure after acute myocardial infarction in patients receiving antiarrhythmic agents for ventricular premature complexes (Cardiac Arrhythmia Pilot Study)

• Published in: The American journal of cardiology Vol. 63; no. 7; pp. 393 - 398
• Main Authors: Greene, H.Leon, Richardson, David W., Hallstrom, Alfred P., McBride, Ruth, Capone, Robert J., Barker, Allan H., Roden, Dan M., Echt, Debra S., The CAPS Investigators
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-02-1989; Elsevier
• Subjects: Anilides - adverse effects; Anti-Arrhythmia Agents - adverse effects; Antiarythmic agents; Biological and medical sciences; Cardiac Complexes, Premature - drug therapy; Cardiac Complexes, Premature - etiology; Cardiovascular system; Double-Blind Method; Encainide; Female; Flecainide - adverse effects; Heart Failure - chemically induced; Heart Failure - etiology; Heart Failure - mortality; Humans; Imipramine - adverse effects; Male; Medical sciences; Middle Aged; Moricizine; Myocardial Infarction - complications; Pharmacology. Drug treatments; Phenothiazines - adverse effects; Random Allocation; Stroke Volume - drug effects; Human; Heart failure; Intensive cardiocirculatory care; Infarct; Arrhythmia; Acute; Cardiovascular disease; Controlled therapeutic trial; Coronary heart disease; Survival; Chemotherapy; Treatment; Myocardium; Complication; Antiarrhythmia agent
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(89)90306-8

The Cardiac Arrhythmia Pilot Study (CAPS) was a randomized, double-blind trial of antiarrhythmic drugs (encainide, flecainide, moricizine, imipramine and placebo) in 502 patients with an ejection fraction >0.20 and at least 10 ventricular premature complexes/hour, 6 to 60 days after acute myocardial infarction. Patients were followed for 1 year and the incidence of new or worsened congestive heart failure (CHF) was evaluated. Heart failure in the 1-year follow-up was gauged by the development (in order of increasing severity) of new symptoms (grade 1), the need for a change in therapy, including addition of digitalis, addition or increase of dose of diuretics or afterload reduction agents or discontinuation of β-blocking agents (grade 2), or by hospitalization (grade 3). Sixty-one of 502 patients (12%) required hospitalization for CHF in the 1-year follow-up. One hundred five of 403 patients (26%) in the active treatment group and 18 of 99 patients (18%) in the placebo group (difference not significant) developed CHF requiring hospitalization or a change in therapy or both. Although patients with severely impaired ejection fraction were excluded, new or worsened CHF was common in follow-up during CAPS.