RT Journal
A1 Hine LK, Laird N, Hewitt P, Chalmers TC
T1 MEta-analytic evidence against prophylactic use of lidocaine in acute myocardial infarction
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1989
FD December 1
VO 149
IS 12
SP 2694
OP 2698
DO 10.1001/archinte.1989.00390120056011
UL http://dx.doi.org/10.1001/archinte.1989.00390120056011
AB • Although lidocaine prophylaxis reduces the incidence of ventricular fibrillation during acute myocardial infarction (AMI), randomized control trials (RCTs) have not demonstrated any significant mortality effect of this therapy. We conducted a meta-analysis of 14 RCTs of lidocaine prophylaxis during AMI to detect any mortality effect. Six prehospital- and eight hospital-phase RCTs that randomized totals of 7656 and 1407 patients, respectively, were selected and reviewed in a blinded fashion. Mortality data were evaluated according to therapy type, reporting interval, and patient category. The prehospital-phase RCTs showed no meaningful mortality effect (risk difference, 0.0184; 95% confidence interval, −0.048 to +0.012). The hospital-phase RCTs showed a statistically significant increase in mortality during the treatment period for lidocaine recipients (risk difference, 0.029; 95% confidence interval, +0.004 to +0.055). These results confirm that lidocaine administered to monitored patients during the prehospital phase of AMI will not reduce mortality by a clinically important amount and suggest that lidocaine administered in the hospital phase of monitored, uncomplicated AMI may increase mortality among recipients with proved AMI.(Arch Intern Med. 1989;149:2694-2698)