Amiodarone combined with metoprolol improves cardiac function in patients with coronary heart disease complicated by arrhythmia.

Abstract

Objective: To evaluate the efficacy and safety of amiodarone combined with metoprolol for improving cardiac function in patients with coronary heart disease (CHD) complicated by arrhythmia.

Methods: A retrospective analysis was conducted on 102 patients with CHD and arrhythmia treated at Zhuzhou Central Hospital from January 2018 to March 2021. Patients were divided into two groups: an amiodarone group (n = 48) and a combination group (amiodarone plus metoprolol, n = 54). Primary endpoints included therapeutic efficacy, time to clinical stability and cardioversion, QT dispersion (QTd), heart rate, hemodynamic indices (plasma fibrinogen, hematocrit, plasma viscosity), cardiac function indices (LVEDD, LVEF, LVESD), heart rate variability (HRV) indices (premature contractions, SDNN, SDNNI), myocardial biomarkers, and adverse events. Cardiovascular event rates were also compared using a 3-year follow-up.

Results: The combination group showed a significantly higher efficacy rate (P<0.05), with faster clinical stabilization and cardioversion (P<0.05). Both groups improved post-treatment, but the combination group showed greater improvements in QTd, heart rate, hemodynamics, cardiac function, HRV indices, and myocardial markers (all P<0.05). Adverse events were significantly lower in the combination group (P<0.001), as was the incidence of cardiovascular events during follow-up (P<0.05).

Conclusion: Amiodarone combined with metoprolol is a safe and effective strategy for managing CHD complicated by arrhythmia, providing superior improvements in cardiac function and HRV, with a lower rate of adverse events.