The Association Between the Use of Antiarrhythmic Drugs in Non-Valvular Atrial Fibrillation and Patient Prognosis Using Data from the China Atrial Fibrillation (China-AF) Registry
| Autor: | Jian-Zeng Dong, Yan-Ming Li, Xin Du, Xin-Xu Li, Danni Zheng, Liu He, Xiao-Xia Hou |
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| Rok vydání: | 2019 |
| Předmět: |
Male
China medicine.medical_specialty Non valvular atrial fibrillation Subgroup analysis 030204 cardiovascular system & hematology Lower risk 03 medical and health sciences 0302 clinical medicine Clinical Research Risk Factors Internal medicine Atrial Fibrillation Humans Medicine Registries Aged business.industry Incidence Incidence (epidemiology) Hazard ratio Confounding Atrial fibrillation General Medicine Middle Aged Prognosis medicine.disease Confidence interval Hospitalization Stroke Treatment Outcome 030220 oncology & carcinogenesis Cardiology Female business Anti-Arrhythmia Agents |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| Popis: | BACKGROUND Results of the landmark Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) trial comparing rhythm control and rate control strategies has led to dramatic changes in the pharmacological management of non-valvular atrial fibrillation (NVAF) patients. We sought to investigate the effect of antiarrhythmic drugs (AADs) on the clinical outcomes of NVAF patients using "real-world" data from China. MATERIAL AND METHODS We evaluated the association between AAD usage and clinical outcomes using clinical data of 8161 NVAF patients who were AAD-naive before enrollment in the China Atrial Fibrillation Registry, recruited between August 2011 and February 2017. The primary outcome was all-cause mortality. RESULTS Compared with 6167 patients who never used any AADs, 1994 patients in the AAD group had lower incidence (per 100 person-years) of all-cause mortality (1.44 versus 3.91), cardiovascular death (0.45 versus 2.31), ischemic stroke (1.36 versus 2.03), and cardiovascular hospitalization (9.83 versus 10.22) over a mean follow-up duration of 316.7±90.4 days. After adjusting for potential confounders, AAD usage was associated with a lower risk of all-cause mortality [hazard ratio (HR): 0.50, 95% confidence interval (CI): 0.31-0.81] and decreased risk of cardiovascular death (HR: 0.30, 95% CI: 0.13-0.68). Subgroup analysis revealed AAD was associated with higher risk of cardiovascular hospitalization among female patients. CONCLUSIONS AAD usage was associated with lower risk of 1-year all-cause mortality and cardiovascular death in "real-world" patients with NVAF. |
| Databáze: | OpenAIRE |
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