Lenient vs. strict rate control in patients with atrial fibrillation and heart failure: a post-hoc analysis of the RACE II study
| Autor: | Bart A. Mulder, M. Alings, Michiel Rienstra, Maarten P. van den Berg, Hessel F. Groenveld, Harry J.G.M. Crijns, Isabelle C. Van Gelder, Jan G.P. Tijssen, Race Investigators, Dirk J. van Veldhuisen, Hans L. Hillege |
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| Přispěvatelé: | Cardiologie, MUMC+: MA Cardiologie (9), RS: CARIM School for Cardiovascular Diseases, Ethical, Legal, Social Issues in Genetics (ELSI), Life Course Epidemiology (LCE), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Cardiology |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Rate control Placebo-controlled study Heart failure Amiodarone PLACEBO-CONTROLLED TRIAL Patient Care Planning Quality of life Heart Rate QUALITY-OF-LIFE Internal medicine RHYTHM CONTROL Post-hoc analysis medicine MANAGEMENT Humans Cumulative incidence Aged RISK Ejection fraction business.industry Atrial fibrillation Stroke Volume RATE CONTROL EFFICACY ASSOCIATION Middle Aged medicine.disease DYSFUNCTION Hospitalization AMIODARONE Treatment Outcome ELECTRICAL CARDIOVERSION RACE Depression Chemical Cardiology Quality of Life Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | European journal of heart failure, 15(11), 1311-1318. Wiley European Journal of Heart Failure, 15(11), 1311-1318. Wiley European journal of heart failure, 15(11), 1311-1318. Wiley-Blackwell |
| ISSN: | 1388-9842 |
| Popis: | AIMS: It is unknown whether lenient rate control is an acceptable strategy in patients with AF and heart failure. We evaluated differences in outcome in patients with AF and heart failure treated with lenient or strict rate control.METHODS AND RESULTS: This post-hoc analysis of the RACE II trial included patients with an LVEF ≤ 40% at baseline or a previous hospitalization for heart failure or signs and symptoms of heart failure. Primary outcome was a composite of cardiovascular morbidity and mortality. Secondary endpoints were AF-related symptoms and quality of life. Two hundred and eighty-seven (46.7%) of the 614 patients had heart failure. Patients with heart failure had significantly higher NT-proBNP plasma levels, a lower LVEF, and more often used ACE inhibitors, ARBs, and diuretics. At 3 years follow-up, the primary outcome occurred more frequently in patients with heart failure (16.7% vs. 11.5%, P = 0.04). In heart failure patients, the estimated cumulative incidence of the primary outcome was 15.0% (n = 20) in the lenient and 18.2% (n = 26) in the strict group (P = 0.53). No differences were found in any of the primary outcome components, in either heart failure hospitalizations [8 (6.1%) vs. 9 (6.8%) patients in the lenient vs. strict group, respectively], symptoms, or quality of life.CONCLUSION: In patients with AF and heart failure with a predominantly preserved EF, the stringency of rate control seems to have no effect on cardiovascular morbidity and mortality, symptoms, and quality of life. |
| Databáze: | OpenAIRE |
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