Risicofactoren voor sterfte onder gebruikers van ibopamine

Objective. To assess risk factors for mortality in users of ibopamine in the Netherlands. Design. Retrospective cohort study. Methods. All 2147 community pharmacies and drug dispensing general practitioners were asked to list all patients to whom they had dispensed ibopamine in the preceding years. Responders received a questionnaire on cardiovascular risk factors and mortality for the general practitioner of a random sample of 3146 of these patients and were requested to send an anonymised printout of the complete medication record. Mortality rates were compared across categories of ibopamine use, adjusted for disease severity. To assess medication use, drug exposure was compared in a three-month period before date of death in the deceased, and before a random date in patients still alive at the end of the study period. Results. In patients with class III/IV heart failure according to the New York Heart Association (NYHA), multivariate analysis indicated that current use of ibopamine was significantly associated with mortality (RR: 1.37; 95% confidence interval (95% CI): 1.15-1.64). In patients with NYHA class I/II heart failure, however, multivariate analysis showed a 2.03 (95% CI: 1.10-3.72) risk of mortality in current users of ibopamine. Apart from current use of ibopamine, male sex and increased serum creatinine were also independent risk factors for mortality in all NYHA classes. Conclusion. Not only patients with NYHA class III/IV heart failure, but also patients with NYHA class I/II heart failure may be at increased risk of mortality when using ibopamine. The indications for prescribing ibopamine need adjustment.