Utjecaj amiodarona na kliničke ishode transplantacije srca

master's thesis

• Title (english): The effect of amiodarone on clinical outcomes of heart transplantation
• Author: Ana Čerkez
• Mentor: Hrvoje Gašparović (mentor)
• Committee member: Bojan Biočina (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Hrvoje Gašparović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Pharmacology and Toxicology

Abstract

UVOD: Amiodaron je lijek koji se često koristi kod pacijenata sa srčanim zatajenjem koji čekaju transplantaciju. S obzirom na njegovu složenu farmakokinetiku postavlja se pitanje o sigurnosti primjene amiodarona prije transplantacije. ----- CILJ: Cilj je ovog rada istražiti mogući utjecaj predtransplantacijske primjene amiodarona na ishode transplantacije. Primarni ishod od interesa je mortalitet unutar 30 dana. ----- METODE: Ovo je retrospektivno istraživanje provedeno na 177 pacijenata koji su podvrgnuti transplantaciji srca. Pacijenti su bili podijeljeni u dvije grupe s obzirom na terapiju amiodaronom prije transplantacije i uspoređeni na temelju preoperativnih karakteristika i postoperativnih ishoda. ----- REZULTATI: U preoperativnim karakteristikama uočena je statistički značajna razlika u broju pacijenata s LVAD-om (11/55 u odnosu na 7/121; p=0.004), broju pacijenata s fibrilacijom atrija (34/55 u odnosu na 27/119; p<0.001) i potrebi za inotropnom potporom (31/55 u odnosu na 36/120; p<0.001). U postoperativnim rezultatima razlika u vrijednostima srčanog indeksa prvi postoperativni dan bila je statistički značajna (3.61 [3.2-4.0] u odnosu na 3.9 [3.3-4.6]; p=0.034). Statistički značajna razlika nije uočena u mortalitetu unutar 30 dana (7/55 u odnosu na 12/122; p=0.565). ----- ZAKLJUČAK: Predtransplantacijska primjena amiodarona nema utjecaj na mortalitet.

Abstract (english)

INTRODUCTION: Amiodarone is a drug frequently used in patients with heart failure awaiting heart transplantation. Due to its very complex pharmacokinetics some concerns about the safety of pre-transplant amiodarone use have been raised. ----- AIM: The aim of this research was to investigate the effect of amiodarone use prior to the transplantation on outcomes of transplantation, with the primary outcome of interest being 30-day mortality. ----- METHODS: This research was a retrospective review of 177 patients that underwent heart transplantation. The patients were divided into 2 groups based on the pre-transplant use of amiodarone and compared based on their perioperative characteristics and postoperative outcomes. ----- RESULTS: Statistically significant difference between the 2 groups in their preoperative characteristics was observed in the number of patients with LVAD (11/55 vs.7/121; p=0.004) and atrial fibrillation (34/55 vs. 27/119; p<0.001) and in the need for inotropic support (31/55 vs. 36/120; p<0.001). In the postoperative results statistically significant difference was observed in cardiac index (3.61 [3.2-4.0] vs. 3.9 [3.3-4.6]; p=0.034) measured in the first postoperative day. No statistically significant difference was determined regarding 30-day mortality (7/55 vs.12/122; p=0.565). ----- CONCLUSION: Pre-transplant amiodarone use is not associated with mortality.

• Keywords: amiodaron; transplantacija srca; mortalitet
• Keywords (english): amiodarone; heart transplant; mortality
• Language: croatian
• URN:NBN: urn:nbn:hr:105:332510
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-12-05 09:24:50